Digital literacy as a new determinant of health: A scoping review

Abstract

Introduction: Harnessing new digital technologies can improve access to health care but can also widen the health divide for those with poor digital literacy. This scoping review aims to assess the current situation of low digital health literacy in terms of its definition, reach, impact on health and interventions for its mitigation.

Methods: A comprehensive literature search strategy was composed by a qualified medical librarian. Literature databases [Medline (Ovid), Embase (Ovid), Scopus, and Google Scholar] were queried using appropriate natural language and controlled vocabulary terms along with hand-searching and citation chaining. We focused on recent and highly cited references published in English. Reviews were excluded. This scoping review was conducted following the methodological framework of Arksey and O'Malley.

Results: A total of 268 articles were identified (263 from the initial search and 5 more added from the references of the original papers), 53 of which were finally selected for full text analysis. Digital health literacy is the most frequently used descriptor to refer to the ability to find and use health information with the goal of addressing or solving a health problem using technology. The most utilized tool to assess digital health literacy is the eHealth literacy scale (eHEALS), a self-reported measurement tool that evaluates six core dimensions and is available in various languages. Individuals with higher digital health literacy scores have better self-management and participation in their own medical decisions, mental and psychological state and quality of life. Effective interventions addressing poor digital health literacy included education/training and social support.

Conclusions: Although there is interest in the study and impact of poor digital health literacy, there is still a long way to go to improve measurement tools and find effective interventions to reduce the digital health divide.

Fig 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA] flow diagram for the scoping review of digital health literacy.

Fig 2. Nationality of the population of origin in the selected articles.

This figure shows the geographic gap in relation to the origin of the selected articles. If we consider that the determinants of poor digital health literacy (age, level of education, belonging to an ethnic minority) could be the same globally, this figure is indicative of the recognition and interest of the problem in the different countries. Figure created using the Natural Earth base layer from www.naturalearthdata.com under the PDDL license https://opendatacommons.org/licenses/pddl/.