The Effects of a Short Video Intervention on Digital Health Literacy Skills: An Online Randomised Controlled Trial.

Abstract

Social media has an influence on public health communication. There are growing concerns about digital health literacy, and how younger adults find good-quality health information online, and their ability to use and appraise it. To test a digital health literacy intervention addressing critical appraisal of online health information for younger adults focused on three core elements: Who said it? When did they say it? Why did they say it? Participants were randomised to receive the intervention via one of three formats: (1) a short-animated video, (2) a TikTok-style short video, (3) literacy-sensitive written text, or (4) a control group. The primary outcomes were critical digital health literacy (critical DHL) and engagement. The secondary outcomes were digital health literacy (DHL) measured by eHEALS, acceptability, personal relevance, intentions to share and novelty. Participants aged 18-39 were recruited via an online social research panel. The sample (n = 2124) included 54% women; 50% had no university qualifications and 30% reported inadequate health literacy. The critical DHL mean score was significantly higher across intervention arms compared to control: control 8.5 out of 19 (SD4.7); text 11.0 (SD4.5); animation 10.9 (SD4.6); TikTok 10.4 (SD4.7) (p < 0.001). Engagement showed no significant differences across arms. All intervention arms increased eHEALS scores compared to control (p < 0.001). Acceptability and intention to share were high across all interventions (scored > 16/21 and > 3/5, respectively). Text scored highest on personal relevance (p = 0.003) and animation scored highest in novelty (p = 0.054) compared to TikTok. There was an interaction effect with gender with TikTok and text intervention arms showing a greater impact on men than women compared to control (p = 0.010). Brief, scalable social media-style interventions can support critical health literacy skills in younger people. Further research is needed to understand how different formats perform in real-world social media environments. Prospectively registered with Australian New Zealand Clinical Trials Registry: trial number ACTRN12623001229662, trial registration date: 29/11/2023.