Digital Health Literacy and Care-seeking Behavior in Rural India: Evidence from a Community-based Mixed-methods Study in Karnataka

Objective: The objective is to determine the level of digital health literacy (DHL) among adults in a rural community in Karnataka, examine its association with health-seeking behavior, and identify perceived barriers and facilitators influencing the use of digital platforms for health information and care-seeking. Materials and Methods: A community-based cross-sectional study was conducted among 246 adults residing in a rural village in Kolar District, Karnataka. Participants were selected using systematic random sampling. Data were collected through interviewer-administered questionnaires consisting of the eHealth Literacy Scale, questions assessing health-seeking behavior, and open-ended items capturing barriers and facilitators. Descriptive statistics, Chi-square tests, and binary logistic regression were performed. Qualitative responses were analyzed thematically. Results: Among the respondents, 41.9% demonstrated high DHL, 26.0% moderate, and 32.1% low. Individuals with lower DHL had significantly poorer health-seeking behavior, including delays in seeking professional care ( P < 0.001). On multivariable logistic regression, participants with low DHL had higher odds of inadequate health-seeking behavior (adjusted odds ratio 8.33; 95% confidence interval: 2.54–27.0; P = 0.0005). Major barriers included limited access to smartphones or Internet connectivity, low digital skills, difficulty judging information credibility, and concerns regarding privacy. Support from family members and community networks facilitated digital health information use. Conclusion: DHL remains suboptimal in this rural setting and is strongly linked to timely and appropriate care-seeking. Strengthening digital literacy through community-based training and integrating digital support strategies into primary healthcare programs could help promote equitable access to credible health information and informed decision-making.