Digital health literacy among primary and secondary school teachers-a quantitative study.

Introduction: Digital health literacy (DHL) is a key competency for individuals' daily decisions toward their health behavior and wellbeing. While there is much focus on health literacy (HL) among the general population, teachers have been rarely addressed. Given the shortages in the teaching workforce in Europe and the impact of demanding working conditions on their health, it is important to address DHL in teachers. This paper examines the DHL of primary and secondary teachers and its associations with sociodemographic and school-related factors. Methods: An online cross-sectional study was conducted with 1,600 German primary and secondary school teachers between October and December 2022. To assess DHL, the Digital Health Literacy Instrument (DHLI) including seven subscales was used. Statistical analyses were conducted on item and subscale level and an overall DHL score was calculated. Next to descriptive analyses, bivariate and regression analyses were conducted to explore potential associations with sociodemographic and school-related factors. Results: The frequency of difficulty in using digital health information varied across DHL dimensions and was greatest for protecting privacy (70.9%) and evaluating reliability (40.0%). In multivariate analysis, females more often reported a sufficient ability of adding content (OR = 1.61, CI = 1.05-2.48), while males more often reported a sufficient ability to protect their privacy (OR = 0.45, CI = 0.27-0.75). Teachers with leadership positions more often reported a sufficient ability in adding content (OR = 1.78, CI = 1.07-2.98). Regarding the ability to determine the relevance of online health-related information, no associations with a predictor variable were found. Discussion: The results suggest that it is important to examine the individual dimensions of DHL and their distinct associations with sociodemographic and school-level factors, rather than just to rely on the overall level of DHL. The differential patterns identified in this study suggest a greater intervention need for teachers from higher age groups, primary and secondary general schools, and those without leadership roles. However, based on the limited predictive power of the variables included, further individual and school-level factors and their potential association with DHL should be investigated in the future. The promotion of DHL should be integrated into both teacher education and in-service training.

How do adolescents experience the decision-making process on travel mode choice?

Active travel can contribute to multiple health benefits in youth. Previous research has identified several factors influencing travel behavior. This study investigates how adolescents process these factors during their decision-making process on travel mode choice. Semi-structured interviews were conducted with 13 adolescents (11-14 years) and analysed using deductive-inductive thematic analysis. Four themes were generated from which the decision-making process on mode choice was conceptualized according to adolescents. The step-by-step process in which travel mode options were gradually reduced, was dependent on the context (Theme 1), the perceived availability of travel mode choice options, which was influenced by factors beyond the individual's perceived control (Theme 2), and on adolescents' pros/cons assessment to identify the most convenient option. Adolescents' habitually used travel mode influenced the decision at several stages throughout the process (Theme 4). To promote healthy travel behaviors, interventions should consider contextual circumstances, balance between enabling autonomous choices and promoting advantages of active travel modes, address individual travel modes and include practices that foster conscious processing of decision-making.

Parental perspectives on the decision-making process on transport mode choice in adolescents: a qualitative study with mothers and fathers.

Objective: The present study aims to understand the familial decision-making process on transport mode choice in adolescents with a focus on the parental perspective within this process. Background: Active travel contributes to adolescents' overall physical activity and its positive health effects. Based on the social-learning theory, especially parents are assigned a central role for adolescents' travel behavior. The aim of the present study was to examine how parents are involved in the decision-making process on transport mode choice in adolescents. Method: The study is part of the cross-sectional mixed-methods ARRIVE study which includes semi-structured interviews with mothers (n = 12) and fathers (n = 7) of 11- to 14-year-old German adolescents. The interviews focused on travel behavior in adolescents and the decision-making process on transport mode choice from the parental perspective. All interviews were analyzed inductively using Thematic Analysis. Results: Our study revealed that parents do not primarily decide for or against active travel in adolescents, but are mostly involved in the decision-making process, especially in case of a deviation from the main transport mode. Different forms of parental involvement in the decision-making process were identified. Some parents acted as main decision makers which is the highest form of involvement while others gave their children complete freedom of choose a transport mode for themselves. These parents accepted their child's choice fully which shows a low involvement in the decision-making process. Conclusion: The results provide a deeper understanding of the familial decision-making process on travel behavior in adolescents. The results indicate an occasionally parental involvement in the decision-making process on the mainly used transport mode by adolescents, and that mothers and fathers are always involved when deviating from the main mode. Implications: Further research should investigate changes in travel behavior from childhood to young adulthood to understand long-term travel decisions in families. Due to the findings that parents are often involved in the decision-making process on transport mode choice and that they mainly reported safety concerns as barriers to their children's active travel, further research should focus especially on the social and physical environment of adolescents.

Associations of parents' and adolescents' active travel behavior across various destinations - a sex/gender analysis.

BACKGROUND: Active travel behavior such as walking and cycling is associated with several health benefits. Especially the family environment seems to be important for active travel in children and adolescents. Currently, little is known regarding travel behavior in leisure time and associations of travel behavior within parent-adolescent dyads. METHODS: The present analysis is based on the German ARRIVE study (Active tRavel behavioR in the famIly enVironmEnt), which incorporated a large scale, representative cross-sectional online survey including 517 parent-child dyads consisting of adolescents (N = 517; boys = 263, girls = 254) aged 11-15 years and one of their parents (N = 517; fathers = 259, mothers = 258). Based on that survey which took place in June 2021 (during the COVID-19 pandemic), we calculated the prevalence of active travel to four commonly visited destinations (school/work, friends/relatives, shopping stores and recreational activities) using an adapted version of the travel to school questionnaire by Segura-Diaz JM, Rojas-Jimenez A, Barranco-Ruiz Y, Murillo-Pardo B, Saucedo-Araujo RG, Aranda-Balboa MJ, et al. (Int J Environ Res Public Health 17(14), 2020). In addition, we investigated the associations between parents' and adolescents' travel behavior using scores for school/work, leisure time (friends/relatives, shopping stores and recreational activities) and overall (school/work and leisure time). RESULTS: Across all destinations, prevalence of active travel in adolescents (63.08%) was higher than in parents (29.21%). Active travel to school (47.33%) as well as to work (20.43%) indicated the lowest prevalence. Linear regression models revealed significant associations in overall active travel between mothers and adolescents (girls: ß = 0.308, p < 0.001; boys: ß = 0.302, p = 0.001) and in leisure time active travel behavior between mothers and daughters (ß = 0.316, p < 0.001). Related to school/work active travel there were no associations between parents and adolescents. CONCLUSION: The associations between adolescents' and parents' travel behavior differ depending on gender: they are solely seen in mother-adolescents dyads. Furthermore, our findings conclude that travel is a routine and independent of the destination.

Motivation and Basic Psychological Needs Satisfaction in Active Travel to Different Destinations: A Cluster Analysis with Adolescents Living in Germany.

Active travel in adolescence contributes to improved health outcomes. Self-Determination Theory suggests that motivation and basic psychological needs influence travel behavior. Person-centered approaches can examine interrelationships of these constructs underlying travel behavior. The aim of this study was to investigate (i) which clusters can be identified in adolescents, (ii) whether clusters explain overall active travel behavior, (iii) whether clusters were associated with travel mode to various destinations or distance, and (iv) whether differences across clusters appear regarding sex/gender, age, and weight status. The sample included 517 (263 male, 254 female) adolescents from Germany, aged 11-15. Self-organizing maps analysis identified six clusters from nine input variables: intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, amotivation, autonomy satisfaction, competence satisfaction, and relatedness satisfaction. The most beneficial cluster regarding active travel demonstrated highest basic psychological needs satisfaction and autonomous motivation with low controlled motivation and amotivation. The most vulnerable cluster was characterized by generally low levels of motivation except for external regulation and amotivation. Clusters were not associated with distance to school, friends/relatives, shopping facilities, or leisure facilities. The findings support the importance of high quality and high quantity of motivation for active travel in adolescents.

Active travel behaviour in the family environment: protocol for the mixed-methods cross-sectional ARRIVE study.

INTRODUCTION: Active travel is an important source of physical activity and a primary contributor to overall health among adolescents. To understand and promote active travel behaviour in adolescents, developing a more robust understanding of the predictors of active travel and its associated decision-making processes is needed. Situated within a theoretical socioecological framework for adolescent travel behaviour, the mixed-methods Active tRavel behavioR in the famIly enVironmEnt study aims to quantitatively assess the influence of several predictors of adolescent travel behaviour, and to qualitatively understand the associated decision-making processes of both adolescents and parents. METHODS AND ANALYSIS: Our mixed-methods approach will feature online surveys and semistructured interviews. The online questionnaire, developed in accordance with a theoretical framework of adolescent active travel, will examine adolescent travel behaviour with respect to four different destinations while controlling for multiple relevant individual, social and physical environment factors. To enable the comparison of adolescent and parental perspectives, the questionnaire will be answered by a representative sample of German adolescents (11-15 years old) and their parents.Our semistructured interviews, likewise framed based on the central tenets of the theoretical framework of adolescent active travel, will seek to explore the decision-making process of families regarding travel mode choice via conducting interviews with each member (ie, father, mother, adolescent). To investigate travel decision-making processes, adolescents and their parents will be invited to talk about trips they undertook using both active and passive transport modes during the last week. Thematic analyses will be conducted to highlight the central concerns, priorities and values of participants' decision-making processes. ETHICS AND DISSEMINATION: This study has received ethical approval from the ethics commission of the Friedrich-Alexander-University Erlangen-Nuremberg. Study results will be disseminated at scientific conferences and published in peer-reviewed journals. Additionally, study findings will be made publicly available to relevant health, policy, and research stakeholders and groups.