Digital health usage patterns and digital health literacy: a deep dive into the Portuguese reality through a cross-sectional study

Objectives With the increasingly widespread use of digital health tools and services, ensuring equitable access while making sure that citizens have the needed skillset to navigate the digital health world is essential. This study aimed to explore the digital health literacy (DHL) levels of the Portuguese population, more specifically those who already report using digital health tools, while assessing whether sociodemographic characteristics have an influence on DHL levels. Methods A questionnaire containing sociodemographic questions and two DHL scales (HL-19-DIGI and TeHLI) was applied through a cross-sectional study. Multiple beta regression models were applied to assess the influence of sociodemographic characteristics on DHL. Results 1,047 people participated in this study. Digital health usage varied considerably among respondents, with websites and social media being the most used platforms. In terms of DHL, almost half of the respondents reported excellent HL-19-DIGI scores. However, there were differences between TeHLI’s functional, communicative, critical, and translational dimensions. Multiple beta regression models revealed that DHL levels consistently decrease as age increases, and that frequently using digital health tools and services is associated with higher DHL scores. In some cases, educational attainment level, residence area, and income also revealed influences in DHL levels. Exploratory analyses identified household income as a moderator across age, gender, and employment status. Conclusion Our study provides an assessment of DHL within the Portuguese adult population who engage with digital health, identifying several factors hindering or facilitating effective digital health use. As we recognize these factors may exist alone or in combination with several other factors, our results reinforce the need for evidence-based and citizen-centered interventions.