Table 3.

Main dimensions and competence areas of the media literacy framework in North-Rhine Westphalia, Germany (41), and pertinent exemplary health literacy exercises.

Main dimension	Competence area	Exemplary exercises and learning goals regarding health literacy in class
1. Operating and applying	1.1 Media equipment (hardware)	Using a mobile phone and a tablet to search for health information.
	1.2 Digital tools	Using different tools or web-based applications (e.g., PowerPoint) to filter, summarize and creatively represent health information.
	1.3 Data organization	Securely storing, retrieving and accessing health information and data from multiple locations.
	1.4 Data protection and information security	Ensuring data protection, privacy and information security of online health information and storing data on a hardware.
2. Informing and researching	2.1 Information seeking	Defining a search topic, search strategies, and terms related to health needed to search for information.
	2.2 Analyzing information	Understanding, filtering, structuring, and preparing health information and being able to grasp and describe their meaning.
	2.3 Evaluating information	Critically evaluating the quality of health information and identifying strategies and intentions behind health information, sources, and information providers, and fact checking their reliability against other sources.
	2.4 Critical information review and use	Recognizing inappropriate health media content and estimate its legal base and the underlying social norms; knowing youth and consumer protection and using health-related support and assistance structures.
3. Communicating and cooperating	3.1 Communication and cooperation processes	Communicating and collaborating in groups of students through digital tools to share search health information results with the class.
	3.2 Communication and cooperation rules	Knowing and understanding the rules of (digital) health-related communication and using those when interacting with others.
	3.3 Communication and cooperation in the society	Creating health-related (digital) communication processes in the sense of participating in society and understanding ethical principles with regard to social norms and applying them on the internet.
	3.4 Cyber violence and cyber crime	Knowing the risks and effects of cyber violence and knowing how to deal with them when using the internet for health issues.
4. Producing and presenting	4.1 Media production and presentation	Planning, designing and presenting search results regarding health information, preparing them to share in class.
	4.2 Design tools	Knowing different design elements of media products, e.g., audio and video, radio plays, explanatory films or animation, and applying them in a reflective manner for presenting health information to others.
	4.3 Documentation of sources	Providing all sources of the health information and data used at the end of a PowerPoint presentation, which allows other to check the sources.
	4.4 Legal basis	Understanding and applying copyrights and rights of use when using images or illustrations during the creation and presentation of health-related content.
5. Analyzing and reflecting	5.1 Media analysis	Comparing a scientific article in a journal with a newspaper article in a daily magazine with respect to their health information.
	5.2 Opinion forming	Analyzing the spread of fitness and nutrition trends and commercial intentions on social networks (such as Instagram, YouTube, Twitter, TikTok) and understanding the power of and how influencers can form opinions as part of their job.
	5.3 Identity creation	Understanding how social networks disseminate health topics that can influence perceptions of reality and using this insight for their own identity building, e.g., through reflecting the difference between virtual and real world.
	5.4 Self-regulated media use	Being able to critically evaluate the effects of the media and to use them for health-related topics in a responsible manner.
6. Problem solving and modeling	6.1 Principles of the digital world	Comparing different search machines on the internet (e.g., DuckDuck, Google, Ecosia) and different hardware (e.g., mobile phone and tablet) and analyzing the results of the gathered health information.
	6.2 Recognizing algorithms	Recognizing how health information results and medicine advertising on the internet change when certain health keywords are searched for on commercial sites.
	6.3 Modeling and programming	Programming a bot with a construction-app so that they may be able to bypass algorithms on social media.
	6.4 Importance of algorithms	Analyzing the influence of algorithms on the digitized society and the effects of automation, e.g., when dealing with a research for health information.