eHealth Literacy and associated factors among Danish adults in the Central Denmark Region: a cross-sectional study (Preprint)

BACKGROUND If the full potential of digital health information is to be realized, it is necessary to consider whether recipients have the required abilities to access, understand and use the information. Digitization has moved information delivery into a digital context, demanding both sufficient health literacy (HL) and digital literacy (DL). Limited HL is quite prevalent, associated with poorer health outcomes and is found to have a negative social gradient. The level of DL is an important determinant for the use of digital services; however, it is not always related to age, gender, or education. OBJECTIVE The objective was to characterise variations concerning the level of HL and DL among a patient population to provide insight into specific areas to be addressed when communicating health information using digital media, helping to accommodate specific needs by personalising the content. METHODS This was a cross-sectional study. From September to December 2020, participants were included from nine hospital departments at three sites. Adult participants (18+) or adult parents or guardians of a child were included if they were summoned for examination, treatment, or hospitalisation and if they could read and understand Danish. The survey consisted of a questionnaire soliciting sociodemographic data and the eHLA toolkit. Data analysis included descriptive and exploratory statistical analyses and K-mean clustering to develop profiles. RESULTS A total of 923 participants participated, of whom 54.2% were female. The mean age was 61.5 years (range 18-93). Most participants presented vocational training (28.4%). Most participants were cohabitating (75.2%), and 61.2% indicated having a chronic disease. Five profiles were developed. Three of these, equivalent to one-third of the participants, experienced difficulties accessing health information in a digital context. CONCLUSIONS In three profiles, approximately one-third of the total participants may experience difficulties accessing health information in a digital context. Individuals with a higher age and lower level of education are more prevalent in profiles with low eHL compared to those with high eHL. Females at a lower age seem more inclined to obtain health information than males. At a higher age; however, not in a digital context. Having a chronic illness can provide a discrepancy in HL scores, as illness can provide knowledge of health concepts, and lack of illness the opposite. To minimise the risk of inequity introduced by digitalization and unrecognised inadequate levels of eHL amongst patients, it is essential for a successful exploitation of digital health information that efforts are made to motivate and engage the patients to seek out and engage with online health resources, and that the approach is individualised and accommodates the skillset of the recipients.