Background and problem: Health information is among the most searched topics on the internet. Whereas internet websites and social network sites offer the general population accessibility to a wide range of helpful online health information, a lot of it is aimed to serve commercial interests. This information is often cleverly disguised as if it is provided by healthcare professionals or by “authentic” lay users, who share their (presumably unbiased) opinions or personal experiences, without disclosing their commercial motives, referred to as the “native advertising phenomenon”. Therefore, in this era of consumerism it is important to develop an understanding of and tools for consumer digital health literacy by utilizing components from four types of literacies: health, media, digital and consumer. Toddlers' parents are an important population to study for this purpose because they are predisposed to search for online health information concerning their children and are highly exposed to disguised commercially motivated content.  

Objectives and Methods: To develop an understanding of consumer digital health literacy needs by studying how parents of toddlers’ understand, evaluate, and criticize online health information and how they perceive its’ influence on their behavior and opinions. A qualitative study, which includes two types of 40 semi-structured interviews with parents of toddlers: One focusing on attitudes and perception regarding the phenomenon of “native advertising” and its ethics, and the second, a simulation in which Interviewees are asked to evaluate and criticize examples of health native advertising from websites and social network sites and explain how they conduct their critical assessment.  

Results: Parents in the simulation interviews mainly failed to recognize at least one of the native advertising examples. However, they overestimated their consumer digital health literacy skills. Both types of interviews revealed a “Third Person Effect”: most interviewees thought they can identify and are not influenced by native advertising, but assumed other people are.  

Conclusions: There is a need to develop tools for consumer literacy in addition to the established digital health literacy skills. Because of its potential influence, it is particularly important to study and develop tools to address the phenomenon of native advertising regarding health issues.