Digital tools to promote or measure health literacy in children aged 3–5 years: scoping review

Health literacy is a determinant of health that should be promoted and measured in early childhood. In the era of digitalization, this could involve digital platforms. However, little knowledge exists on the extent, range, and nature of literature on digital tools for promoting or measuring young children's health literacy. Addressing this gap, a scoping review was undertaken to explore what digital health literacy tools for children aged 3-5 years could be identified in the literature, what their key features were, how they were designed, whether children were codesigners, and whether the tools had been evaluated. Eligibility criteria included the literature being peer-reviewed, published between 2013 and 2024, and in English. Nine health and education databases were searched, and 19 articles met the inclusion criteria. Few of the reported tools covered the core dimensions of health literacy, underlying the need for digital tools that promote and/or measure young children's health-related knowledge and information-related skills. There was sparse description of design approaches, and little evidence children were engaged as active design partners, which is critical to address. Encouragingly, some evidence was usually provided to rationalize choices around specific digital technologies and/or design features, which could be further bolstered with evidence from the field of educational technology for children. There is strength in the literature's reporting of evaluation studies using well-respected design approaches; however, sample sizes were sometimes small, long-term follow-up did not often occur, and the influence of contextual factors on children's use of the tools was not explored.