BACKGROUND: The online environment provides adolescents with vast amounts of health-related information; however, navigating this effectively requires high levels of eHealth literacy to avoid misinformation and harmful content. Parental guidance is often considered a crucial factor in shaping adolescents' online health behaviors; however, there is limited longitudinal research examining how parental eHealth literacy mediation influences adolescents' development of eHealth literacy over time. OBJECTIVE: This study aims to examine the reciprocal relationship between parental eHealth literacy mediation and adolescents' eHealth literacy. It also investigates whether parental education moderates this relationship, specifically exploring whether higher levels of parental education enhance the effectiveness of eHealth literacy mediation in improving adolescents' eHealth literacy. METHODS: A 3-wave longitudinal study was conducted, collecting data from 2500 adolescent-parent pairs. A random intercept cross-lagged panel model was applied to assess the reciprocal effects between parental eHealth literacy mediation and adolescents' eHealth literacy across the 3 waves. Parental education was included in the model as a potential moderating variable to examine whether it influences the strength of the relationship between parental eHealth literacy mediation and adolescents' eHealth literacy. RESULTS: The findings revealed no significant within-person effects, indicating that changes in parental eHealth literacy mediation over time did not lead to corresponding changes in adolescents' eHealth literacy (T1→T2 β=-.03, P=.65; T2→T3 β=.01, P=.84), and vice versa (T1→T2 β=.02, P=.71; T2→T3 β=-.07, P=.19). Furthermore, the data did not support a moderating effect of parental education, suggesting that higher educational attainment does not enhance the impact of parental eHealth literacy mediation. However, a significant between-person association was observed: adolescents with higher levels of eHealth literacy tend to have parents who engage more frequently in eHealth literacy mediation (r=0.30, P<.001). CONCLUSIONS: This study contributes to the understanding of parental involvement in shaping adolescents' eHealth literacy. Contrary to expectations, parental eHealth literacy mediation does not appear to have a significant longitudinal impact on the development of adolescents' eHealth literacy, nor does higher parental education strengthen this relationship. These findings suggest that additional factors beyond parental mediation and education may play a critical role in supporting adolescents' ability to navigate online health information effectively.

Interdisciplinary Research Team on Internet and Society Faculty of Social Studies Masaryk University Brno Czech Republic

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Paul Bryant, Bryant J Alison. Adolescents and the internet. Adolesc Med Clin. 2005 Jun;16(2):413–26, x. doi: 10.1016/j.admecli.2005.03.001.S1547-3368(05)00013-6 PubMed DOI

Park E, Kwon M. Health-related internet use by children and adolescents: systematic review. J Med Internet Res. 2018 Apr 03;20(4):e120. doi: 10.2196/jmir.7731. v20i4e120 PubMed DOI PMC

Colditz J, Woods M, Primack B. Adolescents seeking online health information: topics, approaches, challenges. In: Moreno M, Radovic A, editors. Technology and Adolescent Mental Health. Cham, Switzerland: Springer; 2018. pp. 21–35.

Teoh JY, Cacciamani GE, Gomez Rivas J. Social media and misinformation in urology: what can be done? BJU International. 2021 Sep 27;128(4):397–397. doi: 10.1111/bju.15517. PubMed DOI

Engel E, Gell S, Heiss R, Karsay K. Social media influencers and adolescents’ health: a scoping review of the research field. Social Science & Medicine. 2024 Jan;340:116387. doi: 10.1016/j.socscimed.2023.116387. PubMed DOI

Abel T, McQueen D. Critical health literacy and the COVID-19 crisis. Health Promot Int. 2020 Dec 01;35(6):1612–1613. doi: 10.1093/heapro/daaa040. 5815087 PubMed DOI PMC

Can R, Kurtuluş S. Examination of adolescents? E-health literacy levels in terms of internet usage and some variables related to Covid-19. Dicle Medical Journal [Dicle Tip Dergisi] 2023 Dec 01;50(4):519–528. doi: 10.5798/dicletip.1411922. DOI

Pimentel SM, Avila MAGD, Prata RA, Nunes HRDC, Silva JBD. Associação entre letramento em saúde, ameaça pela COVID-19 e intenção vacinal de adolescentes brasileiros. Rev Latino-Am Enfermagem. 2022;30(spe):1–13. doi: 10.1590/1518-8345.6154.3760. DOI

Taba M, Allen TB, Caldwell PH, Skinner SR, Kang M, McCaffery K, Scott KM. Adolescents' self-efficacy and digital health literacy: a cross-sectional mixed methods study. BMC Public Health. 2022 Jun 20;22(1):1223. doi: 10.1186/s12889-022-13599-7. 10.1186/s12889-022-13599-7 PubMed DOI PMC

World Health Organization (WHO) WHO. Geneva, Switzerland: WHO; 2021. [2025-05-30]. Health literacy in the context of health, well-being and learning outcomes: the case of children and adolescents in schools. https://iris.who.int/bitstream/handle/10665/344901/WHO-EURO-2021-2846-42604-59268-eng.pdf?sequence=1 .

Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Prom Int. 2000;15(3):259–267. doi: 10.1093/heapro/15.3.259. DOI

Sørensen Kristine, Van den Broucke Stephan, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H, (HLS-EU) Consortium Health Literacy Project European Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012 Jan 25;12:80. doi: 10.1186/1471-2458-12-80. 1471-2458-12-80 PubMed DOI PMC

PARK H, MOON M, BAEG JH. Association of eHealth literacy with cancer information seeking and prior experience with cancer screening. CIN: Computers, Informatics, Nursing. 2014;32(9):458–463. doi: 10.1097/CIN.0000000000000077. PubMed DOI

Hsu W, Chiang C, Yang S. The effect of individual factors on health behaviors among college students: the mediating effects of eHealth literacy. J Med Internet Res. 2014 Dec;16(12):e287. doi: 10.2196/jmir.3542. v16i12e287 PubMed DOI PMC

Mitsutake S, Shibata A, Ishii K, Oka K. Association of eHealth literacy with colorectal cancer knowledge and screening practice among internet users in Japan. J Med Internet Res. 2012 Nov 13;14(6):e153. doi: 10.2196/jmir.1927. v14i6e153 PubMed DOI PMC

Rowlands G, Shaw A, Jaswal S, Smith S, Harpham T. Health literacy and the social determinants of health: a qualitative model from adult learners. Health Promot Int. 2017 Mar 01;32(1):130–138. doi: 10.1093/heapro/dav093.2950953 PubMed DOI

Clark L. Parental mediation theory for the digital age. Communication Theory. 2011;21(4):323–343. doi: 10.1111/j.1468-2885.2011.01391.x. DOI

Donaldson AA, Lindberg LD, Ellen JM, Marcell AV. Receipt of sexual health information from parents, teachers, and healthcare providers by sexually experienced U.S. adolescents. J Adolesc Health. 2013 Aug;53(2):235–40. doi: 10.1016/j.jadohealth.2013.03.017. S1054-139X(13)00192-4 PubMed DOI PMC

Gulec H, Smahel D. Individual and parental factors of adolescents' mHealth app use: nationally representative cross-sectional study. JMIR Mhealth Uhealth. 2022 Dec 16;10(12):e40340. doi: 10.2196/40340. v10i12e40340 PubMed DOI PMC

Porter SC, Guo C, Molino J, Toomey SL, Chan E. The influence of task environment and health literacy on the quality of parent-reported ADHD data. Appl Clin Inform. 2017 Dec 16;03(01):24–37. doi: 10.4338/aci-2011-10-ra-0062. PubMed DOI PMC

Livingstone S, Mascheroni G, Dreier M, Chaudron S, Lagae K. How Parents of Young Children Manage Digital Devices at Home: The Role of Income, Education and Parental Style. London, UK: EU Kids Online; 2015.

Sanders LM, Shaw JS, Guez G, Baur C, Rudd R. Health literacy and child health promotion: implications for research, clinical care, and public policy. Pediatrics. 2009 Nov;124 Suppl 3:S306–14. doi: 10.1542/peds.2009-1162G.124/Supplement_3/S306 PubMed DOI

Nathanson AI. Mediation of children’s television viewing: working toward conceptual clarity and common understanding. Annals of the International Communication Association. 2016 May 18;25(1):115–151. doi: 10.1080/23808985.2001.11679002. DOI

Joussemet M, Landry R, Koestner R. A self-determination theory perspective on parenting. Canadian Psychology [Psychologie canadienne] 2008 Aug;49(3):194–200. doi: 10.1037/a0012754. DOI

Mikuška Jakub, Smahel D, Dedkova L, Staksrud E, Mascheroni G, Milosevic T. Social relational factors of excessive internet use in four European countries. Int J Public Health. 2020 Nov 13;65(8):1289–1297. doi: 10.1007/s00038-020-01484-2.10.1007/s00038-020-01484-2 PubMed DOI

Gray NJ, Klein JD, Noyce PR, Sesselberg TS, Cantrill JA. Health information-seeking behaviour in adolescence: the place of the internet. Soc Sci Med. 2005 Apr;60(7):1467–78. doi: 10.1016/j.socscimed.2004.08.010.S0277-9536(04)00393-4 PubMed DOI

Gray N, Klein J. Adolescents and the internet: health and sexuality information. Curr Opin Obstet Gynecol. 2006 Oct;18(5):519–24. doi: 10.1097/01.gco.0000242954.32867.76.00001703-200610000-00008 PubMed DOI

Gulec H, Kvardova N, Smahel D. Adolescents' disease- and fitness-related online health information seeking behaviors: the roles of perceived trust in online health information, eHealth literacy, and parental factors. Computers in Human Behavior. 2022 Sep;134:107318. doi: 10.1016/j.chb.2022.107318. DOI

Patterson SP, Hilton S, Flowers P, McDaid LM. What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Sex Transm Infect. 2019 Sep;95(6):462–467. doi: 10.1136/sextrans-2018-053710. sextrans-2018-053710 PubMed DOI PMC

Rideout V, Fox S, Peebles A, Robb MB. Coping With COVID-19: How Young People Use Digital Media to Manage Their Mental Health. San Francisco, CA: Common Sense and Hopelab; 2021.

Gaskin G, Longhurst C, Anoshiravani A. Internet access and attitudes toward online personal health information among detained youth. Pediatrics. 2012 Nov;130(5):914–7. doi: 10.1542/peds.2012-1653.peds.2012-1653 PubMed DOI

Daraz L, Morrow AS, Ponce OJ, Beuschel B, Farah MH, Katabi A, Alsawas M, Majzoub AM, Benkhadra R, Seisa MO, Ding J(, Prokop L, Murad MH. Can patients trust online health information? A meta-narrative systematic review addressing the quality of health information on the internet. J Gen Intern Med. 2019 Sep 21;34(9):1884–1891. doi: 10.1007/s11606-019-05109-0. 10.1007/s11606-019-05109-0 PubMed DOI PMC

Smahel D, Mascheroni G, Livingstone S, Helsper EJ, van Deursen A, Tercova N, Stoilova M, Georgiou M, Machackova H, Alho K. Theoretical Integration of ySKILLS: Towards a New Model of Digital Literacy. Leuven, Belgium: ySKILLS; 2023.

Norman CD, Skinner HA. eHEALS: The eHealth Literacy Scale. J Med Internet Res. 2006 Nov 14;8(4):e27. doi: 10.2196/jmir.8.4.e27. v8i4e27 PubMed DOI PMC

World Health Organization (WHO) WHO. Geneva, Switzerland: WHO; 2020. [2025-05-30]. Digital health: transforming and extending the delivery of health services. https://www.who.int/europe/news/item/09-09-2020-digital-health-transforming-and-extending-the-delivery-of-health-services .

Landry KE. Using eHealth to improve health literacy among the patient population. Creat Nurs. 2015 Feb 01;21(1):53–7. doi: 10.1891/1078-4535.21.1.53. PubMed DOI

Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011 Jul 19;155(2):97–107. doi: 10.7326/0003-4819-155-2-201107190-00005.155/2/97 PubMed DOI

Miller TA. Health literacy and adherence to medical treatment in chronic and acute illness: a meta-analysis. Patient Educ Couns. 2016 Jul;99(7):1079–1086. doi: 10.1016/j.pec.2016.01.020. S0738-3991(16)30041-6 PubMed DOI PMC

Zheng M, Jin H, Shi N, Duan C, Wang D, Yu X, Li X. The relationship between health literacy and quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes. 2018 Oct 16;16(1):201. doi: 10.1186/s12955-018-1031-7. 10.1186/s12955-018-1031-7 PubMed DOI PMC

Kim K, Shin S, Kim S, Lee E. The relation between eHealth literacy and health-related behaviors: systematic review and meta-analysis. J Med Internet Res. 2023 Jan 30;25:e40778. doi: 10.2196/40778. v25i1e40778 PubMed DOI PMC

Fleary SA, Joseph P, Pappagianopoulos JE. Adolescent health literacy and health behaviors: a systematic review. J Adolesc. 2018 Jan;62:116–127. doi: 10.1016/j.adolescence.2017.11.010.S0140-1971(17)30185-9 PubMed DOI

Sansom-Daly UM, Lin M, Robertson EG, Wakefield CE, McGill BC, Girgis A, Cohn RJ. Health literacy in adolescents and young adults: an updated review. J Adolesc Young Adult Oncol. 2016 Jun;5(2):106–18. doi: 10.1089/jayao.2015.0059. PubMed DOI

Tümer Adile, Sümen Adem. E-health literacy levels of high school students in Turkey: results of a cross-sectional study. Health Promot Int. 2022 Apr 29;37(2):daab174. doi: 10.1093/heapro/daab174.6413678 PubMed DOI

Cheng C, Huang Y, Sun C, An C, Chang Yu-Tien, Chu Chi-Ming, Chang Chi-Wen. Gender-specific determinants of eHealth literacy: results from an adolescent internet behavior survey in Taiwan. Int J Environ Res Public Health. 2022 Jan 07;19(2):664. doi: 10.3390/ijerph19020664. ijerph19020664 PubMed DOI PMC

Korkmaz Aslan G, Kartal A, Turan T, Taşdemir Yiğitoğlu G, Kocakabak C. Association of electronic health literacy with health-promoting behaviours in adolescents. Int J Nurs Pract. 2021 Apr 22;27(2):e12921. doi: 10.1111/ijn.12921. PubMed DOI

Aesaert K, Van Nijlen D, Vanderlinde R, Tondeur J, Devlieger I, van Braak J. The contribution of pupil, classroom and school level characteristics to primary school pupils' ICT competences: a performance-based approach. Computers & Education. 2015 Sep;87:55–69. doi: 10.1016/j.compedu.2015.03.014. DOI

Mendoza K. Surveying parental mediation: connections, challenges and questions for media literacy. JMLE. 2013;1(1):jmle-1-1-3. doi: 10.23860/jmle-1-1-3. DOI

Vaala SE, Bleakley A. Monitoring, mediating, and modeling: parental influence on adolescent computer and internet use in the United States. Journal of Children and Media. 2015 Jan 07;9(1):40–57. doi: 10.1080/17482798.2015.997103. DOI

Sasson H, Mesch G. Parental mediation. In: Hobbs R, Mihailidisds P, editors. The International Encyclopedia of Media Literacy. Hoboken, NJ: Wiley; 2019. pp. 1–6.

Livingstone S, Ólafsson K, Helsper EJ, Lupiáñez-Villanueva F, Veltri GA, Folkvord F. Maximizing opportunities and minimizing risks for children online: the role of digital skills in emerging strategies of parental mediation. J Commun. 2017 Jan 11;67(1):82–105. doi: 10.1111/jcom.12277. DOI

Jiow HJ, Lim SS, Lin J. Level up! refreshing parental mediation theory for our digital media landscape. Commun Theor. 2016 Nov 22;27(3):309–328. doi: 10.1111/comt.12109. DOI

Kuldas S, Sargioti A, Milosevic T, Norman JOH. A review and content validation of 10 measurement scales for parental mediation of children's internet use. Int J Commun. 2021;15:4062–84.

Nielsen P, Favez N, Liddle H, Rigter H. Linking parental mediation practices to adolescents' problematic online screen use: a systematic literature review. J Behav Addict. 2019 Dec 01;8(4):649–663. doi: 10.1556/2006.8.2019.61. PubMed DOI PMC

Young R, Tully M. Autonomy vs. control: associations among parental mediation, perceived parenting styles, and U. S. adolescents’ risky online experiences. Cyberpsychology. 2022 Apr 14;16(2):CP2022-2-5. doi: 10.5817/CP2022-2-5. DOI

Sciacca B, Laffan DA, O'Higgins Norman J, Milosevic T. Parental mediation in pandemic: predictors and relationship with children's digital skills and time spent online in Ireland. Computers in Human Behavior. 2022 Mar;127:107081. doi: 10.1016/j.chb.2021.107081. S0747-5632(21)00404-0 PubMed DOI PMC

Livingstone S, Ólafsson K, Staksrud E. Risky social networking practices among “underage” users: lessons for evidence-based policy. J Comput-Mediat Comm. 2013 Mar 22;18(3):303–320. doi: 10.1111/jcc4.12012. DOI

Rodríguez-de-Dios I, van Oosten JM, Igartua J. A study of the relationship between parental mediation and adolescents’ digital skills, online risks and online opportunities. Computers in Human Behavior. 2018 May;82:186–198. doi: 10.1016/j.chb.2018.01.012. DOI

Garmendia M, Garitaonandia C, Martínez G, Casado del Rio MAA. The effectiveness of parental mediation. In: Livingstone S, Haddon L, editors. Children, Risk and Safety on the Internet. Bristol, UK: Policy Press; 2012. Jul, pp. 231–244.

Paus-Hasebrink I, Bauwens J, Dürager AE, Ponte C. Exploring types of parent–child relationship and internet use across Europe. Journal of Children and Media. 2013 Feb;7(1):114–132. doi: 10.1080/17482798.2012.739807. DOI

Mascheroni G, Cino D, Mikuska J, Lacko D, Smahel D. Digital skills, risks and wellbeing among European children: report on (f)actors that explain online acquisition, cognitive, physical, psychological and social wellbeing, and the online resilience of children and young people. Zenodo. 2020. [2025-05-31]. https://zenodo.org/records/5226902 .

Martins N, Matthews NL, Ratan RA. Playing by the rules: parental mediation of video game play. Journal of Family Issues. 2015 Oct 28;38(9):1215–1238. doi: 10.1177/0192513x15613822. DOI

Daneels R, Vanwynsberghe H. Mediating social media use: connecting parents’ mediation strategies and social media literacy. Cyberpsychology. 2017 Nov 23;11(3):CP2017-3-5. doi: 10.5817/CP2017-3-5. DOI

Dedkova L, Mýlek V. Parental mediation of online interactions and its relation to adolescents’ contacts with new people online: the role of risk perception. Information, Communication & Society. 2022 Nov 21;26(16):3179–3196. doi: 10.1080/1369118x.2022.2146985. DOI

Chang F, Chiu C, Chen P, Miao N, Lee C, Chiang J, Pan Y. Relationship between parental and adolescent eHealth literacy and online health information seeking in Taiwan. Cyberpsychol Behav Soc Netw. 2015 Oct;18(10):618–24. doi: 10.1089/cyber.2015.0110. PubMed DOI

Freeman JL, Caldwell PH, Scott KM. The role of trust when adolescents search for and appraise online health information. J Pediatr. 2020 Jul;221:215–223.e5. doi: 10.1016/j.jpeds.2020.02.074.S0022-3476(20)30289-4 PubMed DOI

Henderson EM, Keogh E, Eccleston C. Why go online when you have pain? A qualitative analysis of teenagers' use of the internet for pain management advice. Child Care Health Dev. 2014 Jul 12;40(4):572–9. doi: 10.1111/cch.12072. PubMed DOI

Symons K, Ponnet K, Walrave M, Heirman W. A qualitative study into parental mediation of adolescents' internet use. Computers in Human Behavior. 2017 Aug;73:423–432. doi: 10.1016/j.chb.2017.04.004. DOI

Symons K, Ponnet K, Vanwesenbeeck I, Walrave M, Van Ouytsel J. Parent-child communication about internet use and acceptance of parental authority. Journal of Broadcasting & Electronic Media. 2019 Oct 29;64(1):1–19. doi: 10.1080/08838151.2019.1681870. DOI

Smahelova M, Juhová D, Cermak I, Smahel D. Mediation of young children’s digital technology use: The parents’ perspective. Cyberpsychology. 2017 Nov 23;11(3):CP2017-3-4. doi: 10.5817/CP2017-3-4. DOI

Chen VHH, Chng GS. Active and restrictive parental mediation over time: effects on youths’ self-regulatory competencies and impulsivity. Computers & Education. 2016 Jul;98:206–212. doi: 10.1016/j.compedu.2016.03.012. DOI

Padilla-Walker Laura M, Coyne SM, Fraser AM, Dyer WJ, Yorgason JB. Parents and adolescents growing up in the digital age: latent growth curve analysis of proactive media monitoring. J Adolesc. 2012 Oct 15;35(5):1153–65. doi: 10.1016/j.adolescence.2012.03.005.S0140-1971(12)00044-9 PubMed DOI

Dedkova L, Smahel D. Online parental mediation: associations of family members’ characteristics to individual engagement in active mediation and monitoring. Journal of Family Issues. 2019 Nov 15;41(8):1112–1136. doi: 10.1177/0192513x19888255. DOI

Lee HY, Lee J, Kim NK. Gender differences in health literacy among Korean adults: do women have a higher level of health literacy than men? Am J Mens Health. 2015 Sep;9(5):370–9. doi: 10.1177/1557988314545485. 1557988314545485 PubMed DOI

Fam JY, Männikkö N, Juhari R, Kääriäinen M. Is parental mediation negatively associated with problematic media use among children and adolescents? A systematic review and meta-analysis. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement. 2023 Apr;55(2):89–99. doi: 10.1037/cbs0000320. DOI

Cote AC, Coles SM, Dal Cin S. The interplay of parenting style and family rules about video games on subsequent fighting behavior. Aggress Behav. 2021 Mar 06;47(2):135–147. doi: 10.1002/ab.21931. PubMed DOI PMC

Valkenburg PM, Piotrowski JT, Hermanns J, de Leeuw R. Developing and validating the perceived parental media mediation scale: a self-determination perspective. Hum Commun Res. 2013 Jun 27;39(4):445–469. doi: 10.1111/hcre.12010. DOI

Knapp C, Madden V, Wang H, Sloyer P, Shenkman E. Internet use and eHealth literacy of low-income parents whose children have special health care needs. J Med Internet Res. 2011 Sep 29;13(3):e75. doi: 10.2196/jmir.1697. v13i3e75 PubMed DOI PMC

Gordon Singh S, Aiken J. The effect of health literacy level on health outcomes in patients with diabetes at a type v health centre in Western Jamaica. Int J Nurs Sci. 2017 Jul 10;4(3):266–270. doi: 10.1016/j.ijnss.2017.06.004. S2352-0132(16)30142-9 PubMed DOI PMC

DeWalt DA, Hink A. Health literacy and child health outcomes: a systematic review of the literature. Pediatrics. 2009 Nov 27;124 Suppl 3(Supplement 3):S265–74. doi: 10.1542/peds.2009-1162B.124/Supplement_3/S265 PubMed DOI

Rini WNE, Rusdi M, Siburian J, Kalsum U. Systematic review and meta analysis: the effect of oral health literacy to increasing mother's knowledge. J Int Dent Med Res. 2023;16(4):1753–1757.

Cabello-Hutt T, Cabello P, Claro M. Online opportunities and risks for children and adolescents: the role of digital skills, age, gender and parental mediation in Brazil. New Media & Society. 2017 Aug 18;20(7):2411–2431. doi: 10.1177/1461444817724168. DOI

Kaarakainen M. ICT intentions and digital abilities of future labor market entrants in Finland. NJWLS. 2019 Jun 19;9(2):114803. doi: 10.18291/njwls.v9i2.114803. DOI

Metzger M, Flanagin A, Nekmat E. Comparative optimism in online credibility evaluation among parents and children. Journal of Broadcasting & Electronic Media. 2015 Aug 12;59(3):509–529. doi: 10.1080/08838151.2015.1054995. DOI

Aesaert K, van Braak J. Gender and socioeconomic related differences in performance based ICT competences. Computers & Education. 2015 May;84:8–25. doi: 10.1016/j.compedu.2014.12.017. DOI

Duvenage M, Correia H, Uink B, Barber BL, Donovan CL, Modecki KL. Technology can sting when reality bites: adolescents’ frequent online coping is ineffective with momentary stress. Computers in Human Behavior. 2020 Jan;102:248–259. doi: 10.1016/j.chb.2019.08.024. DOI

Schmid R, Petko D. Does the use of educational technology in personalized learning environments correlate with self-reported digital skills and beliefs of secondary-school students? Computers & Education. 2019 Jul;136:75–86. doi: 10.1016/j.compedu.2019.03.006. DOI

Schorr A. Pipped at the post: knowledge gaps and expected low parental IT competence ratings affect young women's awakening interest in professional careers in information science. Front Psychol. 2019 May 1;10:968. doi: 10.3389/fpsyg.2019.00968. PubMed DOI PMC

Chang F, Miao N, Lee C, Chen P, Chiu C, Lee S. The association of media exposure and media literacy with adolescent alcohol and tobacco use. J Health Psychol. 2016 Apr 01;21(4):513–25. doi: 10.1177/1359105314530451.1359105314530451 PubMed DOI

Levin-Zamir D, Lemish D, Gofin R. Media health literacy (MHL): development and measurement of the concept among adolescents. Health Educ Res. 2011 Apr 19;26(2):323–35. doi: 10.1093/her/cyr007.cyr007 PubMed DOI

Page R, Huong N, Chi H, Tien T. Smoking media literacy in Vietnamese adolescents. J Sch Health. 2011 Jan;81(1):34–41. doi: 10.1111/j.1746-1561.2010.00555.x. PubMed DOI

Chang L. Health literacy, self-reported status and health promoting behaviours for adolescents in Taiwan. J Clin Nurs. 2011 Jan 16;20(1-2):190–6. doi: 10.1111/j.1365-2702.2009.03181.x.JCN3181 PubMed DOI

lavaan 0.6-18. lavaan. [2025-05-30]. https://lavaan.ugent.be/about/about.html .

Hamaker EL, Mulder JD, van IJzendoorn MH. Description, prediction and causation: methodological challenges of studying child and adolescent development. Dev Cogn Neurosci. 2020 Dec;46:100867. doi: 10.1016/j.dcn.2020.100867. S1878-9293(20)30117-1 PubMed DOI PMC

Piaget J. Intellectual evolution from adolescence to adulthood. Human Development. 1972;15(1):1–12. doi: 10.1159/000271225. DOI

Hou Y, Benner AD, Kim SY, Chen S, Spitz S, Shi Y, Beretvas T. Discordance in parents' and adolescents' reports of parenting: a meta-analysis and qualitative review. Am Psychol. 2020 Apr;75(3):329–348. doi: 10.1037/amp0000463. 2019-31327-001 PubMed DOI PMC

Nikken P, Jansz J. Parental mediation of children’s videogame playing: a comparison of the reports by parents and children. Learning, Media and Technology. 2007 Jan 22;31(2):181–202. doi: 10.1080/17439880600756803. DOI

Beyens I, Valkenburg PM. Parental Media Mediation in Adolescence: A Comparative Study of Parent and Adolescent Reports. Journal of Broadcasting & Electronic Media. 2019 Oct 30;63(4):716–736. doi: 10.1080/08838151.2019.1680071. DOI

LWIN M, STANALAND A, MIYAZAKI A. Protecting children's privacy online: how parental mediation strategies affect website safeguard effectiveness. Journal of Retailing. 2008 Jun;84(2):205–217. doi: 10.1016/j.jretai.2008.04.004. DOI

Valcke M, Bonte S, De Wever B, Rots I. Internet parenting styles and the impact on internet use of primary school children. Computers & Education. 2010 Sep;55(2):454–464. doi: 10.1016/j.compedu.2010.02.009. DOI

Masten CL, Juvonen J, Spatzier A. Relative importance of parents and peers. The Journal of Early Adolescence. 2008 Nov 17;29(6):773–799. doi: 10.1177/0272431608325504. DOI

Shin W, Lwin MO. How does “talking about the Internet with others” affect teenagers’ experience of online risks? The role of active mediation by parents, peers, and school teachers. New Media & Society. 2016 Jan 27;19(7):1109–1126. doi: 10.1177/1461444815626612. DOI

Amuta AO, Jacobs W, Barry AE. An examination of family, healthcare professionals, and peer advice on physical activity behaviors among adolescents at high risk for type 2 diabetes. Health Commun. 2017 Jul 19;32(7):857–863. doi: 10.1080/10410236.2016.1177907. PubMed DOI

Jungmann SM, Witthöft Michael. Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: which factors are related to coronavirus anxiety? J Anxiety Disord. 2020 Jun;73:102239. doi: 10.1016/j.janxdis.2020.102239. S0887-6185(20)30053-0 PubMed DOI PMC

Riiser K, Helseth S, Haraldstad K, Torbjørnsen Astrid, Richardsen KR. Adolescents' health literacy, health protective measures, and health-related quality of life during the Covid-19 pandemic. PLoS One. 2020 Aug 28;15(8):e0238161. doi: 10.1371/journal.pone.0238161. PONE-D-20-19534 PubMed DOI PMC

Fan W, Williams CM. The effects of parental involvement on students’ academic self‐efficacy, engagement and intrinsic motivation. Educational Psychology. 2009 Dec 11;30(1):53–74. doi: 10.1080/01443410903353302. DOI

Bessant C. Parental approaches to protecting children from online harm: trust, protectionism or dialogue. In: Setty E, Gordon F, Nottingham E, editors. Children, Young People and Online Harms. Cham, Switzerland: Palgrave Macmillan; 2024. pp. 217–246.

Blackwell L, Gardiner E, Schoenebeck S. Managing Expectations: Technology Tensions among Parents and Teens. The 19th ACM Conference on Computer-Supported Cooperative Work & Social Computing (CSCW '16); February 27 to March 2, 2016; San Francisco, CA. New York,NY: Association for Computing Machinery; 2016. pp. 1390–1401. DOI

Wisniewski P, Xu H, Rosson M, Carroll J. Parents just don't understand: why teens don't talk to parents about their online risk experiences. The 2017 ACM Conference on Computer Supported Cooperative Work and Social Computing (CSCW '17); February 25 to March 1, 2017; Portland, OR. New York, NY: Association for Computing Machinery; 2017. pp. 523–540. DOI

Kuldas S, Sargioti A, Staksrud Elisabeth, Heaney Darran, Norman James O'Higgins. Are confident parents really aware of children's online risks? A conceptual model and validation of parental self-efficacy, mediation, and awareness scales. Int J Bullying Prev. 2024;6(3):252–266. doi: 10.1007/s42380-023-00157-x. 157 PubMed DOI PMC