Factors Associated with High E-Health Literacy Comparing between Seniors and Non-seniors in a Middle-Income Country (Preprint)

BACKGROUND Currently, the rapid aging of the population around the world, especially in low- and middle-income countries (LMICs), is leading to changing demands on healthcare systems. The preparation of the population for adequate e-health literacy and good digital health is one of the challenges of social policy. The willingness to understand e-health literacy and telemedicine use in the different age ranges of the population will help to understand the loopholes and bottlenecks in the implementation and help to develop appropriate solutions. Currently, studies on the status of e-health literacy in the different age ranges remain limited and scarce. OBJECTIVE In this study, we intend to investigate the prevalence and factors associated with low e-health literacy, including attitudes toward e-health literacy, by focusing on the different age ranges in Thailand, a middle-income country. METHODS We conducted a cross-sectional, observational study in January-July 2021. A total of 400 participants who visited the outpatient department of Siriraj Hospital were recruited and completed questionnaires, which measured demographic information, frequency of internet use, devices used for accessing the internet, and e-health literacy. E-health literacy was assessed using the eHAELS score. We applied univariable logistic regression analysis to elucidate the factors associated with e-health literacy. RESULTS Our study revealed that the senior participants had a lower level of e-health literacy compared to non-senior participants. Additionally, other crucial interesting factors in the senior group associated with low e-health literacy included a low level of knowledge about e-health for finding and utilizing health information to take care of themselves, and a lack of confidence in using information from the internet to make health decisions. Moreover, the attitude and interest toward telemedicine use were among the interesting factors that should be considered in the study. The participants in both groups with low e-health literacy expressed fear of not receiving treatment or being unable to complete treatment by a doctor. They were not confident in using technology correctly, feared not understanding how to use medication, and were more concerned about data security compared to participants with high e-health literacy. CONCLUSIONS Our study provides valuable information on the e-health literacy of seniors and non-seniors in a middle-income country, which may be used to guide further improvements and promote digital health in the aging societies.