Abstract
Background: The increasing digitalisation of information and public services has become a significant challenge to society. The World Health Organisation (WHO) has developed the WHO European Region 2023-2030 to support National authorities to increase their capacities to better govern digital transformation in the health sector. The Improving Digital Empowerment for Active Healthy Living (IDEAHL) project had, among others, the objective of developing the European Digital Health Literacy Strategy (EDHLS).It was developed by the IDEAHL consortium (10 European countries) on the basic of inputs collected through a co-creation approach involving specific population groups taking into consideration gender and social inclusion perspectives.
Why we made the EDHLS? Because we wanted to combine the evidence from the scientific literature with needs and barriers expressed by a large group of citizens from different socioeconomic and cultural backgrounds.
Approach: Digital health literacy (dHL) is considered a superdeterminant of health and vital to reduce health inequalities.
To build the EDHLS we started by conducting a scoping review. Multidimensional scales are usually used to measure dHL which provide quantitative information. The literature shows that a richer understanding of the needs of society requires the combination of quantitative and qualitative information.
Secondly, a co-creation methodology was designed. Strategic stakeholders who work close to vulnerable population participated in the design of the research questions to ensure the cultural and target-specific sensitivity.
The information gathered was incorporated into a multi-component matrix that fed the strategy, which is a double approximation of digital literacy (training and skills development, content and curriculum, evaluation and monitoring, policy and strategy) and health literacy (access, understanding, critical appraisal, application of the information). And also includes three levels and four health dimensions.
Finally, 12 dHL interventions encompassing social support for person-centred care models, were selected based on the Hanlon method for piloting the dHL strategy.
Results: The EDHLS was co-created, piloted, evaluated and is already being used by health authorities working on the development of new dHL public policies. In figures:
- 1,434 citizens from 10 different countries participated in the co-creation activities carried out.
- 19 different populations groups were involved in 140 co-creation sessions: migrants, low-income citizens, prisoners, school children, adolescents, healthcare professionals and social workers, young women, pregnant women, autonomous older people (and fragile), formal and informal caregivers, digital literacy and digital health experts, lecturers, professionals, families, members of the Women´s Health Task Force and policy makers.
- 804 citizens participated in 17 pilot interventions.
- EDHLS contain 4 toolkits related to digital, health literacy, cross-cutting components and evaluation.
- EDHLS addresses transversal components: accessibility, collaboration, equity, ethics and privacy, gender, inclusion, participation, social environment and sustainability.
Implications: What is the learning for the audience? Next steps? Citizens involvement in the development of health policies helps to align with the real needs of citizens, increases trust in public institutions, and facilitates greater acceptance of policies when they are made public.
The EDHLS will be translated into different languages and sent to all the people who participated in the co-creation and pilot actions