Co-creating an inclusive and comprehensive European digital Health Literacy Strategy

Digital technologies are a driving force in empowering citizens and health professionals to address preventable risk factors for disease. The Improving Digital Empowerment for Active Healthy Living (IDEAHL) project aims to develop and test new models and approaches for the development and application of digital health literacy (dHL) interventions through the co-creation of a comprehensive and inclusive EU dHL Strategy. The main objective of the EU dHL Strategy is to empower people to use digital health tools safely and effectively, thereby promoting informed decision-making and self-care. It will be useful for citizens, professionals, managers and policy-makers. The Strategy was planned and co-created to involve health and non-health sectors, and citizens, including vulnerable groups. It was developed by IDEAHL consortium (14 partners in 10 EU countries) using inputs gathered through a co-creation approach involving specific populations, and considering gender and social inclusion perspectives: migrants, low-income citizens, prisoners, pregnant women, children, older people in fragile conditions, autonomous older people, families with chronic diseases, caregivers, health and care students and professionals, policy-makers… IDEAHL consortium launched an extensive co-creation process to co-design and plan its dHL Strategy. A series of inclusive face-to-face and online co-creation activities were set up: workshops, role-plays, focus groups using innovative facilitation techniques such as narratives, graphic facilitation, world café, storytelling, photo-voice, brainstorming… with involvement of a wide range of stakeholders in all project countries. A social media campaign informed the general public and invited feedback. During the co-creation phase, 1434 participants from 19 target population groups collaborated in 140 sessions. Their contributions were incorporated into the strategy recommendations, based on a dual core framework of digital components (training and skills development, content and curriculum, evaluation and monitoring, policy and strategy) and health information components (access, understanding, critical appraisal and application of the health information) for micro, meso and macro levels of intervention in each of the self-care, promotion, prevention and treatment health dimensions. Its transversal value elements covers accessibility, collaboration, equity, ethics and privacy, gender, inclusion, participation, social environment and sustainability. The Strategy was publicly endorsed through a social media campaign, increasing the engagement of citizens and policy-makers. Co-creation helped to raise awareness of dHL among people and organisations. Reliable health information sources and tailored digital health training were identified as key needs. Recommendations were developed based on the co-creation results. Monitoring and evaluation of the progress of pilot actions according to the guidelines of the EU dHL strategy have been considered to assess their impact and help fine-tune the design of the strategy. Policy-makers will find concrete solutions, agreed with dHL experts and end-users, to implement any dHL action that has an impact not only on health and care systems, but also on citizens at a societal and personal level. The EU dHL Strategy implementation will empower EU citizens to use digital tools to take a more active role in managing their own health and well-being, and support social innovation for person-centred care models.