Beyond One-Size-Fits-All

The increasing reliance on digital health interventions has underscored the need to enhance digital health literacy to improve individual health outcomes and quality of life. This study explores the effectiveness of digital health literacy interventions, including mobile applications, online education platforms, and telehealth services, in improving health knowledge and self-care behaviors. A systematic literature review was conducted using databases such as PubMed, Scopus, and Google Scholar, with selected studies focusing on adult populations and chronic disease management. Findings indicate that digital interventions significantly enhance health literacy and health-related behaviors; however, challenges such as disparities in digital access, socioeconomic factors, and variations in digital literacy levels limit widespread adoption. Comparative analysis reveals that while digital interventions offer advantages in accessibility and engagement, they must be adapted to different demographic and socioeconomic contexts to ensure equity. Policy implications highlight the necessity of investing in digital infrastructure, integrating digital literacy into healthcare education, and implementing data security regulations to foster trust and usability. The study concludes that digital health literacy is a crucial component of modern healthcare strategies. Addressing barriers and optimizing digital intervention designs are essential for maximizing the potential of digital health tools in promoting preventive care and improving public health outcomes. Future research should focus on long-term intervention effectiveness, AI-driven personalization, and culturally inclusive health literacy programs.

Aim/Purpose: To conduct a needs assessment and subsequently create micro-storytelling media aimed at enhancing the Digital Intelligence Quotient (DQ) skills of young individuals. Background: In today's digital society, DQ has emerged as a vital skill that elevates individuals in all aspects of life, from daily living to education. To empower Thai youth, this study seeks to innovate DQ content by adapting it into a digital format known as micro-storytelling. This unique approach combines the art of storytelling with digital elements, creating engaging and effective micro-learning media Methodology: The methodology comprises three phases: 1) assessing the need for digital micro-storytelling development; 2) developing digital micro-storytelling; and 3) evaluating the DQ skills among young individuals. The sample group consisted of 55 higher education learners for needs assessment and 30 learners in the experiment group. Data analysis involves PNI modified, mean, and standard deviation. Contribution: This research contributes by addressing the urgent need for DQ skills in the digital era and by providing a practical solution in the form of digital micro-storytelling, tailored to the preferences and needs of Thai youth. It serves as a valuable resource for educators and policymakers seeking to empower young learners with essential digital competencies. Findings: The findings demonstrate three significant outcomes: 1) The learners wanted to organize their own learning experience with self-paced learning in a digital landscape, and they preferred digital media in the form of video. They were most interested in developing DQ to enhance their understanding of digital safety, digital security, and digital literacy; 2) according to a consensus of experts, digital micro-storytelling has the greatest degree of quality in terms of its development, content, and utilization, with an overall average of 4.86; and 3) the overall findings of the assessment of DQ skills indicate a favorable level of proficiency. Recommendations for Practitioners: Align materials with micro-learning principles, keeping content concise for effective knowledge retention. Empower students to personalize their digital learning and promote self-paced exploration based on their interests. Recommendation for Researchers: Researchers should continuously assess and update digital learning materials to align with the evolving digital landscape and the changing needs of students and investigate the long-term effects of DQ improvement, especially in terms of online safety and digital literacy in students' future lives and careers. Impact on Society: This study's impact on society is centered around fostering a DQ, promoting innovative educational approaches, and elevating Thai youth with essential digital skills. It contributes to a safer, more informed, and digitally literate generation prepared for the challenges of the digital era. Future Research: Undertake comparative studies to analyze the effectiveness of different digital learning formats and methodologies. Comparing micro-storytelling with other approaches can help identify the most efficient and engaging methods for enhancing DQ.

Few studies have explored the specific internal mechanisms and links by which digital literacy impacts learning outcomes. This study investigates the complex relationship between digital literacy and learning outcomes among college students, using social cognitive theory (SCT) and structural equation modeling (SEM) as theoretical frameworks. Data were collected from 589 college students in China’s northwest region. The results reveal that digital literacy affected learning outcomes indirectly through the digital atmosphere, self-efficacy for digital technology, and digital learning. Specifically, digital atmosphere and digital learning mediate the relationship between digital literacy and learning outcomes. Self-efficacy for digital technology and digital learning jointly mediate the relationship between digital literacy and learning outcomes. Digital literacy has a positive and significant impact on the digital atmosphere and influences students’ self-efficacy for digital technology, thereby motivating them to participate in digital learning and ultimately having a positive impact on learning outcomes. Overall, the findings highlight the importance of developing digital literacy, optimizing digital learning atmospheres, and enhancing self-efficacy to fully leverage undergraduates’ learning potential in the digital age.

Digital delivery of pre-operative total knee replacement (TKR) education and prehabilitation could improve patient outcomes pre- and post-operatively. Rigorously developing digital interventions is vital to help ensure they achieve their intended outcomes whilst mitigating their potential drawbacks. To develop a pre-operative TKR education and prehabilitation digital intervention, the 'Virtual Knee School' (VKS). The VKS was developed using an evidence-, theory- and person-based approach. This involved a mixed methods design with four phases. The first three focused on planning the VKS. The final phase involved creating a VKS prototype and iteratively refining it through concurrent think-aloud interviews with nine patients who were awaiting/had undergone TKR. Meta-inferences were generated by integrating findings from all the phases. ISRCTN registration of the overall project was obtained on 24 April 2020 (ISRCTN11759773). Most participants found the VKS prototype acceptable overall and considered it a valuable resource. Conversely, a minority of participants felt the prototype's digital format or content did not meet their individual needs. Participants'feedback was used to refine the prototype's information architecture, designand content. Two meta-inferences were generated and recommend: 1. Comprehensive pre-operative TKReducation and prehabilitation support should be rapidly accessible in digital and non-digital formats. 2. Pre-operative TKR digital interventions should employ computer- and self-tailoring to account for patients'individual needs and preferences. Integrating evidence, theoryand stakeholders'perspectives enabled the development of a promising VKS digital intervention for patients awaiting TKR. The findings suggest future research evaluating the VKS is warranted and provide recommendations for optimising pre-operative TKRcare. Patient and Public Involvement (PPI) was central throughout the project. For example, PPI representatives contributed to the project planning, were valued members of the Project Advisory Group, had key roles in developing the VKS prototypeand helped disseminate the project findings.

Digital health technology provides opportunities to leverage artificial intelligence and other digital applications to promote cardiovascular health. Digital health technologies include artificial intelligence (such as machine learning [ML], neural networks),1 analytic systems, mobile apps, wearables, email, text messaging, and telemedicine.2 In this article, we review the role of digital technology in cardiovascular health and a selection of recent studies to evaluate the evidence of its effectiveness. Artificial intelligence is broadly defined as the capability of computer systems to perform tasks similar to humans.3 Examples include vision, speech, pattern recognition, and decision making. Machine learning is the ability of the computer program to learn from experience. This typically occurs from analysis of large sets of data processed through human-derived algorithms to enhance, predict, and explain outcomes.4 An example of the use of ML in clinical care is cardiovascular disease (CVD) prediction and electrocardiographic interpretation. Neural networks, named after the human nervous system, are nonlinear statistic models that control where signals are sent. Neural networks can be used for decision making such as cardiovascular diagnosis confirmation. Digital Technology Use in Cardiovascular Risk Assessment Several studies have demonstrated improved CVD risk factor identification using ML compared with traditional risk assessment tools. Researchers developed an ML risk calculator and compared it with the American College of Cardiology/American Heart Association CVD risk calculator in 6459 participants from the Multi-Ethnic Study of Atherosclerosis.5 Study participants were free of CVD at baseline and followed for 13 years. Results revealed that the American College of Cardiology/American Heart Association risk calculator was less precise: statin therapy was recommended to 46% of the sample, with 23.8% of CVD events occurring in those not recommended a statin. In comparison, the ML risk calculator recommended a statin to 11% of the sample, with 14.4% of CVD events occurring in those not recommended a statin.5 Similarly in 3 cohorts from Australia, 4 ML models were developed and compared with the 2008 Framingham model. The ML models provided 2.7% to 5.2% better predictions across all 3 cohorts.6 Taken together, the authors of these studies suggest ML provides promise in providing more precise estimates of CVD risk. Digital Health Interventions for Cardiovascular Disease Prevention Digital health interventions have the potential to provide a personalized approach to promote cardiovascular health. Behavior change theory is a key component of digital interventions and includes theoretical frameworks such as supportive accountability,7 self-efficacy theory,8 social cognitive theory, and the health belief model.9 Precision healthcare has been promoted for decades. Many of the challenges in operationalizing precision healthcare are healthcare accessibility, scheduling, care continuity, and inadequate knowledge exchange between provides and patients.10 Thus, promotion of healthy lifestyles and lifestyle risk factor reduction remain inadequately addressed in patients with CVD.11 To achieve sustainable change, individual-level personalized strategies may be leveraged through digital health interventions. Evidence of the effectiveness of digital health interventions has varied but is promising overall. Text messaging has been successfully used to provide information regarding healthy diet and physical activity recommendations, monitoring, and individual feedback. Text messaging has resulted in improvements in diet and activity in many (TextMe,12 Mobile MyPlate,13 MyQuest,14 Text-To-Move15), but not all studies.16 Smartphone/mobile apps have been designed to improve dietary and physical activity behavior. Examples include apps that track dietary patterns and activity through user input of text or visual images.17,18 Users can set their own goals and receive feedback on progress toward goals. Reviews of smartphone apps have had variable results with many demonstrating short-term improvement. Villinger et al19 conducted a systematic review and meta-analysis of the effectiveness of mobile app interventions on nutrition behaviors (41 studies, 27 randomized controlled trials [RCTs]). Findings revealed significantly improved nutrition behaviors and nutrition-related outcomes (P = .004 and P = .043, respectively). A second systematic review of 27, primarily RCTs, found significant between-group improvements in 19 of the 27 studies.20 A meta-analysis of 6 RCTs in adults using a smartphone app as the primary component of the intervention revealed a trend for more steps per day in the intervention compared with the control groups, with programs lasting less than 3 months more effective than longer programs.21 Taken together, text messaging and smartphone/mobile apps have the potential to improve lifestyle behaviors associated with cardiovascular health. The addition of strategies to increase sustainability of the effects needs to be assessed. Digital Health Interventions: Primary and Secondary Prevention Widmer et al2 conducted a meta-analysis of 51 RCTs and cohort studies using digital health interventions for the prevention of CVD events and risk factor modification. Subgroup analyses of primary prevention studies (2 studies) did not provide evidence of a statistically significant reduction in CVD outcomes. However, evaluation of individual risk factors in primary prevention studies found a significant reduction in weight (11 studies; −3.35 lb), systolic blood pressure (23 studies; mean difference, −2.12 mm Hg), total cholesterol (13 studies; mean difference, −5.19 mg/dL), low-density lipoprotein cholesterol (8 studies; mean difference, −4.96 mg/dL), and glucose (6 studies; mean difference, −1.38 mg/dL).2 A subgroup analysis of secondary prevention studies demonstrated a significant impact of digital interventions on CVD outcomes (relative risk, 0.60; a 40% relative risk reduction), improvement in body mass index (6 studies; mean difference, −0.31 kg/m2) but no improvement in weight, systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and glucose. Taken together, this meta-analysis suggested that digital interventions were beneficial not only in lowering CVD events in higher-risk patients but also in lowering risk factors in primary prevention approaches.2 In a second meta-analysis conducted by Akinosun et al,11 researchers analyzed 25 RCTs in patients with traditional CVD risk factors who received a digital intervention versus usual care.11 Findings revealed benefits in total cholesterol (mean difference, −0.29), high-density lipoprotein cholesterol (mean difference, −0.09), low-density lipoprotein (mean difference, 0.18), physical activity (mean difference 0.23), physical inactivity (relative risk, 0.54), and diet (relative risk, 0.79). There was no significant improvement in body mass index, systolic and diastolic blood pressure, hemoglobin A1C, alcohol intake, smoking, and medication adherence. Authors concluded that digital interventions were more effective at improving healthy behaviors than reducing unhealthy behaviors. In patients who experienced a myocardial infarction, a digital health intervention providing medication reminders, vital sign and activity tracking, education, and outpatient care coordination resulted in a 52% lower 30-day readmission rate compared with usual care.22 Sociodemographic characteristics (age, sex, and race) did not influence use of the digital intervention, highlighting a potential role for digital interventions in the promotion of equity in social determinants of health.23 Digital Health Interventions in Cardiac Rehabilitation Cardiac rehabilitation is an essential component of secondary prevention of CVD.24 Some patients face barriers in participation in cardiac rehabilitation due to physical accessibility, time, and travel.25 Digital health interventions have the potential to bridge these barriers and increase participation. Digital delivery of cardiac rehabilitation therapy with real-time personalized support has several advantages.26 In a systematic review of 31 studies in which authors examined digital health interventions for cardiac rehabilitation, the results revealed that cardiac rehabilitation program adherence was greater in patients using digital interventions than traditional methods alone. Secondary benefits were found in self-efficacy, weight management, diet, and quality of life. Taken together, digital cardiac rehabilitation was feasible and effective whether used alone or in combination with traditional cardiac rehabilitation.26 Conclusion Digital health technology is an evolving field with tremendous potential to improve cardiovascular health. Cardiovascular disease remains the major cause of death in the United States. The age-adjusted mortality rate has increased in the last decade. More people died from CVD causes in 2020 (nearly 900 000 deaths) than any year since 2003.27 Opportunities to reduce CVD and CVD risk have not been fully leveraged, and digital technology interventions have the potential to meet this need. Digital health technology also has the potential to provide equitable and personalized care. Device data, electronic medical record data, and social determinants of health data provide an opportunity to combine and identify longitudinal trends and risk factors before CVD begins. In the future, large data sets can be created that can be analyzed using ML to identify patterns and structures within and among the data to provide a more robust risk assessment to promote CVD prevention.

Background Smoking is a major contributor to preventable disease and premature death globally. Despite various smoking cessation (SC) strategies, relapse rates remain high. Digital technologies present new opportunities to support SC. This study aimed to map the characteristics of digital SC interventions using a scoping review of reviews. Methods This review adheres to the PRISMA-ScR guideline and a preregistered protocol (doi:10.17605/OSF.IO/N7MS6). We searched MEDLINE, Scopus, PsycInfo, and CINAHL for systematic reviews on digital SC interventions. Reviews with any human populations, digital interventions, and SC as the primary outcome were included. Two reviewers independently screened and selected studies in Rayyan and extracted data. Data were synthesized using descriptive statistics. Results Out of 669 hits, 36 reviews (33 systematic, two umbrella, and one scoping) with 437 studies (mostly RCTs) met the inclusion criteria. While some reviews focused on specific groups (e.g., pregnant women), most addressed any smokers. Intervention delivery modality was mainly via text messaging (alone or with phone/video calls) or apps with mobile phones as delivery devices. Few reviews reported on utilization, satisfaction, or unintended effects of interventions. Sociodemographic moderators, especially digital health literacy, were rarely addressed. Outcome measures and follow-up durations varied widely, limiting comparability. Conclusions Digital interventions offer scalable, customizable approaches for SC. However, diversity in approaches, populations, and evaluation methods hinders evidence synthesis. Research gaps include the insufficient data on digital health literacy and long-term outcomes of interventions. Public health efforts should promote standardized evaluation of digital SC interventions, inclusive design, and digital (health) literacy considerations. Future reviews should focus on specific modalities and populations to inform effective, targeted SC strategies. Key messages • Digital interventions for SC show strong potential, but inconsistent methods and limited long-term data hinder comparability, scalability, and implementation in public health practice. • Improving digital health literacy and filling key evidence gaps will ensure inclusive, equitable access to SC tools, supporting sustainable health and reducing health disparities.

ObjectivesInterventions addressing the individual and environmental protective factors of adolescents are suggested to have potential for reducing adolescent substance use. While universally delivered school-based substance use prevention interventions are common,...

Digital health interventions have gained prominence in the management of chronic diseases like Type 1 Diabetes Mellitus (T1DM), helping patients adhere to their treatment plans. However, the effectiveness of these interventions in improving adherence to T1DM management varies globally. To systematically review existing digital interventions designed to improve adherence to T1DM management. To identify key features of digital tools that enhance adherence and glycaemic control in T1DM patients. Primary outcomes were improvements in patient adherence, measured by frequency of insulin administration, self-monitoring of blood glucose, and HbA1c levels. Secondary outcomes included patient satisfaction and engagement with digital interventions. A systematic review of randomized controlled trials (RCTs) was conducted using the PICO framework. The review encompassed studies from various global regions. Studies included T1DM patients across different age groups. Databases such as PubMed, Cochrane, and Ovid were searched for relevant studies. A total of 12 randomized controlled trials (RCTs) were included in this review, focusing on improving adherence in T1DM patients. The digital interventions evaluated included mobile health applications, continuous glucose monitoring, telemedicine platforms, and educational video games. Most studies demonstrated significant improvements in patient adherence behaviours, such as insulin administration and self-monitoring of blood glucose, reductions in HbA1c levels were also noted. The improvements in HbA1c as seen in this review for individuals with T1DM are in line with findings from prior studies. The evidence showed that digital health technologies could enhance glycaemic control. These findings are in line with other studies where real-time data monitoring equipment of the emergent CGM systems and mobile apps facilitated accurate and timely modification of diabetes self-management. The reviewed studies also highlighted the effectiveness of digital technology-targeted interventions in enhancing the aspect of self-management and health behaviour among T1DM patients. These results are also aligned with the behavioural change theories which highlight the significance of education, perceived self-ability and continuous feedback in adopting good health behaviour. Digital interventions have a positive impact on adherence to T1DM management and glycaemic control. Their application, particularly in low-resource settings, holds great potential for improving health outcomes. Not applicable. The aim of this review was to look at how mobile applications among other digital tools can assist people living with Type 1 Diabetes (T1DM) through continuous glucose monitoring to manage their health condition in a better way. For this purpose, we reviewed 12 different studies and found that interventions delivered through digital tools enhanced patients' adherence to their treatment by helping them lower the blood sugar levels as measured by HbA1c levels. Main findings reflected how digital tools improved health behaviours and self-management of T1DM. This was facilitated by real-time data monitoring and feedback for the diabetes care. In conclusion, Digital health interventions have the potential to positively impact the T1DM treatment leading to improved health outcomes especially in low resource settings.

In recent decades, technology has emerged as a beacon of hope to aid humanity in addressing two pressing issues of our time: human health and climate change. However, despite advances in medicine and climate technology, rates of infectious diseases (Jones et al., 2008) and carbon dioxide emissions (Olivier & Peters, 2020) continue to rise. Alongside technological and systemic regulations, it is also the behavior of each individual that contributes to curtailing infectious diseases and carbon dioxide emissions. Yet, individuals often struggle to align their good intentions with their actual behavior. This gap underscores the complexity of breaking ingrained habits and adopting new behaviors, demanding more than mere intention. The question of how to achieve behavior change in the context of health and climate change is not easily answered; it requires extensive interdisciplinary research. Information Systems research can support and advance the study of behavior change through digital interventions. Digital interventions, due to their availability and scalability, stand as promising tools for facilitating behavior change and research. The inclusion of measurement instruments within technological devices furthermore allows for the collection of real-world behavioral data. Consequently, Information Systems research can not only contribute but also enhance the empirical validation and expansion of behavioral theories. Despite the potential that Information Systems hold in the realm of behavioral research, it remains a domain far from being fully explored. The main objectives of this dissertation are to provide insights into the effectiveness of digital interventions in fostering healthy and environmentally sustainable behavior within the real-world context, alongside the empirical validation of behavioral and motivation theories. To accomplish this, the dissertation adopts an interdisciplinary approach encompassing two experimental field studies and one survey field study. The field studies are centered on behavior change in the realms of health and sustainability behavior among children and employees. The first two chapters revolve around the outcomes of two large-scale field experiments, investigating hand washing behavior of children in day care centers. Within Chapter 1, a digital intervention is designed and the applicability and effectiveness of the intervention are affirmed across day care centers in Finland and Germany. The data indicate that soaping time of children, a proxy for hand washing quality, can be improved by 62% while the digital behavior intervention is in place. In Chapter 2, the intervention subsequently serves as a tool to empirically validate and expand behavioral theory, specifically the Motivation Crowding Theory. The results provide empirical evidence for the efficacy of digital rewards in children. This underscores the value of digital rewards while disproving potential negative effects as suggested by the Motivation Crowding Theory. The findings of Chapters 1 and 2 underscore the effectiveness of digital behavior change interventions leveraging digital rewards both in research and in practice. The research undertaken in this context can serve as a blueprint for Information Systems researchers venturing into behavioral research, particularly with children. Moreover, it offers practitioners guidance for the design of effective and scalable systems tailored to children. Chapter 3 presents the results of a field study that examines the motivations of train drivers to use Green Information Systems in the workplace and thus to contribute to energy savings in the transportation sector. The results of the interviews and surveys conducted for this purpose confirm the applicability of the Protection Motivation Theory in the context of Information Systems. The collected data show that employees’ moti- vation to engage in climate-protective behavior depends on their perception of their own response efficacy and the severity of climate change. The identified motivations provide important starting points for the development of digital behavior interventions aimed at promoting environmentally friendly behavior among employees. Overall, this thesis illustrates that Information Systems can support human behavior change, and serve as a tool to measure and examine behavior change and underlying behavioral theories. The conducted field studies underscore the effectiveness of digital interventions in real-world settings. With the chosen interdisciplinary approach and a combination of different methods, existing behavioral theories are utilized in the field of Information Systems, empirically validated, and expanded. The research emphasizes that Information Systems have the potential to assist individuals in changing their health and sustainability behavior, addressing two pressing issues of our time.

Reading is a fundamental skill to acquire during children's school career. The present meta‐analysis examined research on the effectiveness of digital technologies to foster early reading skills during Tier‐1 interventions (ie, high‐quality core reading instruction which is intended to promote learning for all children). Unlike previous meta‐analyses, this meta‐analysis investigated the effectiveness in a broad way, taking into account cognitive versus non‐cognitive learning outcomes, near versus far transfer outcomes and immediate versus delayed outcomes. Furthermore, different study characteristics were taken into account including participant characteristics, the targeted reading subskills, duration of intervention, type of technology and the level of integration. A total of 568 effect sizes from 72 studies encompassing 60,890 participants were analysed using a meta‐analytic three‐level model. A Hedges' g effect size of 0.37 was obtained, suggesting that using digital technologies generally have a positive, albeit small, effect compared to traditional teaching methods. Moderator analyses indicated that this effect was robust to cognitive and non‐cognitive outcomes, near and far transfer outcomes, and immediate and delayed outcomes, but differed by participants' age and study quality. Recommendations are formulated to push forward research on how digital interventions can be effectively implemented in the classroom. Practitioner notes What is already known about this topic Digital technologies can foster (early) reading skills. Meta‐analyses to date focus only on the effect of digital reading interventions in terms of cognitive outcomes. Unclear how different factors moderate the effectiveness of digital reading interventions (eg, type of technology, trained content, level of integration). What this paper adds Results corroborate previous findings indicating a positive but small effect compared to traditional teaching methods. This study provides some evidence that this effect was robust to cognitive and non‐cognitive outcomes, near and far transfer outcomes, and immediate and delayed outcomes. The effect differed by participants' age and study quality. Game elements, adaptivity and whether the intervention was well integrated made little difference to the effectiveness of the intervention. Implications for practice and/or policy The results confirm that digital reading interventions are effective in fostering cognitive, non‐cognitive and efficiency outcomes. Call for more intervention studies investigating how game characteristics and the level of integration of a digital tool moderate the effectiveness. There is a need for reports of pilot studies investigating the effectiveness of recent digital technologies such as AR and VR.

Health and healthcare are increasingly dependent on internet and digital solutions. Medically underserved communities that experience health disparities are often those who are burdened by digital disparities. While digital equity and digital health equity are national priorities, there is limited evidence about how community-based organizations (CBOs) consider and develop interventions. We conducted key informant interviews in 2022 purposively recruiting from health and welfare organizations engaged in digital equity work. Nineteen individuals from 13 organizations serving rural and/or urban communities from the local to national level participated in semi-structured interviews via Zoom regarding their perspectives on digital health equity interventions. Directed content analysis of verbatim interview transcripts was conducted to identify themes. Themes emerged at individual, organizational, and societal levels. Individual level themes included potential benefits from digital health equity, internet access challenges, and the need for access to devices and digital literacy. Organizational level themes included leveraging community assets, promising organizational practices and challenges. For the societal level, the shifting complexity of the digital equity ecosystem, policy issues, and data for needs assessment and evaluation were described. Several example case studies describing these themes were provided. Digital health equity interventions are complex, multi-level endeavors. Clear elucidation of the individual, organizational, and societal level factors that may impact digital health equity interventions are necessary to understanding if and how CBOs participate in such initiatives. This study presents unique perspectives directly from CBOs driving programs in this new arena of digital health equity.

Digital literacy in the era of technology-based educational transformation has become an essential competency. As educational leaders, school principals play a strategic role in ensuring the integration of digital technology in managing and developing learning at schools. However, previous research highlights a gap between the need for digital literacy in the field and the ability of school principals to utilize it effectively. Studies indicate that despite the availability of technology, digital learning has not been optimally implemented. This is attributed to the low competence of school principals in effectively using digital platforms. This research aims to develop and test the effectiveness of a strategic collaborative mentoring model as an approach to enhancing the digital literacy learning competence of school principals, particularly in using platforms like Google Meet and Canva. The study employed the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) design and development method, involving 40 school principals in Bojong District, Tegal Regency. The participants were divided into two groups: 20 principals in the control group and 20 principals in the experimental group. The learning tools trial was conducted using a t-test, while the effectiveness of the model was measured using the n-Gain Score test. The results indicate that the strategic collaborative mentoring model significantly improved the digital literacy learning competence of school principals. The average n-Gain Score shows a high category of improvement in the experimental group compared to the control group. The strategic collaborative mentoring model is effective in enhancing the digital literacy learning competence of school principals in supporting learning activities. This research contributes both theoretically and practically to the development of more strategic and collaborative mentoring-based training for school principals.

BackgroundParental health literacy is associated with child health outcomes. Parents are increasingly turning to the internet to obtain health information. In response, health care providers are using digital interventions to communicate information to assist parents in managing their child’s health conditions. Despite the emergence of interventions to improve parental health literacy, to date, no systematic evaluation of the effectiveness of the interventions has been undertaken.ObjectiveThe aim of this review is to examine the effect of digital health interventions on health literacy among parents of children aged 0-12 years with a health condition. This includes evaluating parents’ engagement (use and satisfaction) with digital health interventions, the effect of these interventions on parental health knowledge and health behavior, and the subsequent impact on child health outcomes.MethodsThis systematic review was registered a priori on PROSPERO (International Prospective Register of Systematic Reviews) and developed according to the Joanna Briggs Institute methodology for systematic reviews. The databases CINAHL, MEDLINE, and PsycINFO were searched for relevant literature published between January 2010 and April 2021. Studies were included if they were written in English. A total of 2 authors independently assessed the search results and performed a critical appraisal of the studies.ResultsFollowing the review of 1351 abstracts, 31 (2.29%) studies were selected for full-text review. Of the 31 studies, 6 (19%) studies met the inclusion criteria. Of the 6 studies, 1 (17%) was excluded following the critical appraisal, and the 5 (83%) remaining studies were quantitative in design and included digital health interventions using web-based portals to improve parents’ health knowledge and health behavior. Owing to heterogeneity in the reported outcomes, meta-analysis was not possible, and the findings were presented in narrative form. Of the 5 studies, satisfaction was measured in 3 (60%) studies, and all the studies reported high satisfaction with the digital intervention. All the studies reported improvement in parental health literacy at postintervention as either increase in disease-specific knowledge or changes in health behavior. Of the 5 studies, only 1 (20%) study included child health outcomes, and this study reported significant improvements related to increased parental health knowledge.ConclusionsIn response to a pandemic such as COVID-19, there is an increased need for evidence-based digital health interventions for families of children living with health conditions. This review has shown the potential of digital health interventions to improve health knowledge and behavior among parents of young children with a health condition. However, few digital health interventions have been developed and evaluated for this population. Future studies with robust research designs are needed and should include the potential benefits of increased parent health literacy for the child.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42020192386; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192386

The effect of digital interventions on related health literacy and skills for individuals living with chronic diseases: A systematic review and meta-analysis

The development in teaching dental education toward ever greater digitization has gained enormous momentum in the last 2 years due to the pandemic. However, acceleration is not synonymous with improvement, especially from the learners' point of view. Therefore, the aim of this survey among students of dentistry was to determine which digital learning strategies and which media are preferred. Undergraduate students of clinical semesters (6th to 9th) in dental medicine during at the University of Freiburg participated in an online-survey. Questions were asked about personal learning strategies for and experience with using digital media for private and educational reasons. Furthermore, students were asked which digital learning formats they preferred for different learning phases. Students (N=148) are experienced in using digital media for learning. They prefer classical media (such as textbooks and lectures) for acquiring basic theoretical knowledge and mention digital teaching formats more in relation to practical training and complex treatment procedures. 67% prefer learning alone and 90% rate visualizations as helpful for learning. 78% report, that they feel well supported in the learning process by digital media and 83% agree that e-learning offerings are a quality factor for university teaching. 82% state e.g. that the growing range of online content allows a more flexible approach to face to face-teaching, enriches classroom teaching (78%) and helps organize one's own study (79%). Students have a positive attitude towards the use of digital media, especially when it comes to having more time available for practical exercises. They also see an advantage in the fact that through the use of digital media, lectures can be organized more flexibly and also the organization of their studies can be optimized. New digital teaching media should be created based on these results. It is important to consider which digital formats seem suitable for which content during different semesters.