Thomas Link

Introduction: Digital health information sources are playing an increasingly prominent role in health promotion, public health and in healthcare systems. Consequently, digital health literacy skills are likewise becoming increasingly important. Methods: -DIGI, applied in the European Health Literacy Survey (2019-2021) of the WHO M-POHL network, analyzing data from 28,057 respondents from 13 countries. The instrument is a modified and extended version of the Digital Health Literacy Instrument (DHLI). Results: The scale displayed high internal consistency. Confirmatory factor analysis (CFA) strengthened the hypothesized one-factor structure. In most countries, the data displayed acceptable fit to the unidimensional Rasch partial credit model (PCM). Pearson correlation with a measure of general health literacy showed sufficient discriminant validity, and a social gradient was found. Testing for predictive validity showed that the scale score predicts health-related outcomes. Discussion: The study shows that considerable proportions of the general adult populations across countries in Europe have limited DHL skills. The level of DHL has direct potential consequences for some forms of health service utilization, in some countries. Implications of the study include recommendations for improving digital health literacy, promoting organizational health literacy and quality assurance for digital health information and resources.

In the published article, the title was "HLS19-DIGI: A new instrument for measuring digital health literacy -development, validation and associations with determinants and health outcomes in 13 countries"The correct title is: "Measuring digital health literacy and its associations with determinants and health outcomes in 13 countries"The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.In the original published article the corresponding author 's e-mail was diamos@zahav.net.ilThe corrected e-mail is: dlevin-za@univ.haifa.ac.il Following the title change, the correction on: full citation of the original version of the article.Levin-Zamir D, Van den Broucke S, Bíró É, Bøggild H, Bruton L, De Gani SM, Søberg Finbråten H, Gibney S, Griebler R, Griese L, Guttersrud Ø, Klocháňová Z, Kucera Z, Le C, Link T, Mancini J, Miksova D, Schaeffer D, Ribeiro da Silva C, Sørensen K, Straßmayr C, Telo de Arriaga M, Vrdelja M and Pelikan J, on behalf of the HLS19 Consortium of the WHO Action Network M-POHL (2025) HLS19-DIGI -a new instrument for measuring digital health literacy: development, validation and associations with determinants and health outcomes in 13 countries. Front. Public Health 13:1472706. doi: 10.3389/fpubh.2025.1472706 The new citation should be:Levin-Zamir D, Van den Broucke S, Bíró É, Bøggild H, Bruton L, De Gani SM, Søberg Finbråten H, Gibney S, Griebler R, Griese L, Guttersrud Ø, Klocháňová Z, Kucera Z, Le C, Link T, Mancini J, Miksova D, Schaeffer D, Ribeiro da Silva C, Sørensen K, Straßmayr C, Telo de Arriaga M, Vrdelja M and Pelikan J, on behalf of the HLS19 Consortium of the WHO Action Network M-POHL (2025) Measuring digital health literacy and its associations with determinants and health outcomes in 13 countries Front. Public Health 13:1472706. doi: 10.3389/fpubh.2025.1472706 The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.1. In the published article, there was an error in the Abstract.The term "HLS19-DIGI" has been added and the sentence below has been added: "The instrument is a modified and extended version of the Digital Health Literacy Instrument (DHLI)."So that the section now reads:"Methods: Using a concept validation approach, the aim of the study was to validate the digital health literacy measure HLS19-DIGI, applied in the European Health Literacy Survey (2019-2021) of the WHO M-POHL network, analyzing data from 28,057 respondents from 13 European countries."The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.2. In section 1.1, the last paragraph, where in the original paragraph "(DHLI)" is mentioned and replace it with "(Digital Health Literacy Instrument-DHLI)". 3. In the 1.2 caption, please replace the original caption "Rational for developing a new digital health literacy measure" with the following new caption: "Rational for a further developed digital health literacy measure". 4. In the 1.2 section, paragraph 2, line 4 please add the word "further" to the original text in two places in the line, so the corrected text would read: "…opportunity to further develop and validate a further developed measure for DHL." 5. In the 1.2 section, paragraph 3, line 1, please delete the word "new" from the sentence, or that the corrected sentence reads: "this article is part of a series of papers, introducing health literacy tools that have been developed, applied and tested through the HLS19 study (27-30)". 6. In the 1.2 section, paragraph 3, line 5, please add the words "or further" so that the sentence reads: "the aim of this series is to use the data collected in the HLS19 to examine the psychometric properties of the newly or further developed health literacy tools and different aspects of their validity". 7. In the 2.1 caption, please delete the words "development of" so that the caption reads "2.1 the HLS19-DIGI instrument". 8. In the 2.1 section, paragraph 1, in line 1, please add the word "further" so that the sentence reads: "The DHL instrument further developed for the HLS19 survey, named HLS19-DIGI, is based on the DHLI measure ( 16) but aligned more strongly with the concept and model of general health literacy proposed by the HLS-EU study ( 27), and promoted by M-POHL. 9. In the 2.1 section, paragraph 1 in line 7, please add the citation ( 16), so that the sentence reads: "Compared to the DHLI ( 16), the HLS19-DIGI adds the dimension of understanding digitally accessed health information and eliminates the redundancy on the topic of applying health information." 10. In the 2.1 section, paragraph 3, in line 14, please add the citation ( 16), so that the sentence reads: We have adapted, shortened and extended the content of the DHLI tool ( 16), translated it into several languages and tested it, and this paper reports on the psychometric testing. 11. In section 4 Discussion, paragraph 2, line 2, please replace the word "new" with the words "further developed" so that the sentence now reads: "This article described the conceptual background, development, and validation of a further developed instrument to measure DHL at the population level and investigated its determinants and associations with health outcomes." 12. In section 4.1 Limitation, in the third sentence, beginning in line 3, please delete the word "this" which was a typo, and add the word "which" so that the sentence now reads: "For some countries, the non-response rates for several items were markedly higher than for other HLS19 measures, which may be partly due to the fact that people cannot evaluate something they do not do in everyday life, namely if they do not use the Internet to search for health information." 13. In section 5 Conclusions, in the first sentence, please delete the word "new" so that the sentence now reads; "A compact, conceptually sound instrument to measure DHL was validated for 13 languages in 13 countries, showing acceptable psychometric properties."End of template. If you would like to request a correction for a reason not seen here, please contact the journal's editorial office.

Zusammenfassung Die Messung von Gesundheitskompetenz (GK) begann in den 1990er-Jahren mit Instrumenten, die sich auf ein funktionales Verständnis von GK konzentrierten. Seither hat sich das Verständnis von GK und damit auch die Messung von GK weiterentwickelt. Für die Messung einer umfassenden allgemeinen GK werden in diesem Beitrag 2 besonders gut validierte Instrumente vorgestellt, der Health Literacy Questionnaire (HLQ) und der HLS 19 -Q12-Fragebogen. Der HLQ umfasst 9 Skalen mit insgesamt 44 Items, die verschiedene GK-Aspekte in der Krankheitsbewältigung abdecken. Der HLQ wurde in zahlreichen Studien validiert und bisher in 47 Sprachen übersetzt. Er weist eine hohe Inhalts- und Kriteriumsvalidität auf und wird zum Beispiel im Rahmen des WHO European Action Network on Health Literacy for Prevention and Control of Noncommunicable Diseases und in der European Joint Action on Cardiovascular Diseases and Diabetes (JACARDI) eingesetzt. Auf Basis der 9 Skalen können GK-Profile zu Stärken und Herausforderungen erstellt werden. Der HLS 19 -Q12 ist ein Kurzfragebogen zur Messung der allgemeinen GK und basiert auf dem HLS 19 -Q47. Er besteht aus 12 Items, wurde in mehr als 20 Ländern validiert und ist in mehr als 30 Sprachen übersetzt. Der HLS 19 -Q12 weist ebenfalls eine hohe Inhalts- und Kriteriumsvalidität auf und wird in den Health Literacy Surveys des WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL) und der European Joint Action Prevent Non-Communicable Diseases eingesetzt. Aus den 12 Items wird ein Gesamtwert berechnet, der in 4 GK-Stufen kategorisiert werden kann. Um langfristig eine vergleichbare Datenbasis zu schaffen, wird empfohlen, diese beiden Instrumente in Studien, Evaluationen und für das Monitoring von GK zu verwenden.