Digital Health Literacy in School Physical Education: A Grounded Theory Framework for Teacher Competence

As digital technologies transform health information environments, digital health literacy has become a core professional competence for school-based health education. Physical education teachers play a critical role in shaping students’ health behaviours. However, the structural composition of their digital health literacy remains undertheorised.This qualitative study used a grounded theory approach to conduct semistructured interviews with 34 participants from 12 provinces in China. Interview data were analysed with NVivo 15.0 through open, axial and selective coding, which was supplemented by relevant literature and policy documents. The analysis generated a Digital Health Literacy Framework for Primary and Secondary School PE Teachers comprising three core dimensions: Digital Health Awareness and Critical Literacy, Digital Teaching Practice and Innovative Application Competence and Digital Security Ethics and Environmental Awareness Competence. These dimensions were further operationalised through eight categories, 40 concepts and 214 empirical statements, thus reflecting a multilevel structure from information appraisal and data-informed teaching to ethical and contextual judgement. The proposed framework conceptualises PE teachers’ digital health literacy as a systematic, interconnected competency system rather than a set of isolated skills. It provides a theoretical basis for designing assessment tools and targeted professional development and offers a reference point for international comparison and policy-making in digital health and PE.