Introduction: Digital technologies like electronic health records, telemedicine, and digital health applications have become ubiquitous to patient care over the last 25 years. While digital technology can be seen as a tool for health management, concerns persist regarding the exclusion of vulnerable populations. Digital health literacy (DHL), defined as an individual’s ability to use digital information and tools to manage their health, is a skill that is important for chronic disease management, particularly among patients with cerebrovascular disease. This study aims to assess DHL and determine its associations with cognitive function and sociodemographic factors among patients with stroke and transient ischemic attack (TIA). Methods: Data was collected from patients with stroke and TIA enrolled into the Video-based Intervention to reduce treatment and hypertension outcome disparities in adults with stroke (VIRTUAL) clinical trial. Participants were enrolled prior to hospital discharge, and baseline sociodemographic assessments were obtained prior to randomization. DHL was assessed using the Digital Health Care Literacy Score (DHLS), a validated 3-item measure of DHL that reflects an individual’s own perception of their knowledge and skills in using digital healthcare tools, where higher scores reflect higher DHL. Cognition was assessed with the T-MOCA-short, where higher scores denoted greater cognitive function. Results: Among 247 participants with DHLS, median age was 61, 45% were female, 77% were U.S-born, 83% preferred English as written language, and 45% have some college or more (Table 1). The median DHL score was 9 6, 12, with 7% scoring 0 and 30% scoring 12 (Table 2). In univariate analysis using DHLS tertiles or treating DHLS as an ordinal variable, older age, Hispanic ethnicity, non-US born status, non-English language preference, lower education, lower cognition, and lower health literacy were significantly associated with lower DHLS (Table 3). In multivariable analysis using ordinal DHLS, older-age, non-US born status, having a lower T-MOCA short score and lower health literacy were significantly associated with lower DHL. Conclusion: DHL plays a role in patient care and is influenced by a multitude of sociodemographic factors. Future studies investigating the impact of low DHL on patient care may help identify populations with the highest need and target interventions focused on closing the digital divide among patients with stroke and TIA.
Mai et al. (Thu,) studied this question.