Sociodemographic determinants of digital health literacy: A systematic review and meta-analysis.

Marta Estrela, Guilherme Semedo, Fátima Roque, Pedro Lopes Ferreira, Maria Teresa Herdeiro

Journal: International journal of medical informatics 2023;177():105124

PMID: 37329766

Free Full Text on Elsevier Science View on PubMed

Plain Language Summary

Digital health tools such as wearable electronic devices, health-related apps and online medical resources are used to increase awareness about health-related aspects and make informed healthcare decisions. However, accessing digital health tools is challenging for the general population as it requires technology skills, literacy, numeracy and health literacy. Digital resources can play a crucial role in promoting and enhancing the health of the general population. Lack of health literacy can make people more vulnerable to misinformation about health, as the internet is flooded with unreliable information. Differences in health literacy between people contribute to social health inequalities and poorer health outcomes. Health literacy divide levels are related to socioeconomic status, age, sex, region, technology skills and health status. This systematic review and meta-analysis included thirty-six cross-sectional studies to evaluate the sociodemographic determinants of digital health literacy. The results of this study showed that digital health literacy levels are directly associated with age, education level, socioeconomic status, native language of the individual and social support, whereas, the sex and ethnicity of the individual were not associated with the level of digital health literacy. Healthcare professionals can use the results of this study to understand the factors related to digital health literacy. However, further robust studies are required due to the high heterogeneity in the study population.

Abstract

INTRODUCTION

Differences in digital health literacy levels are associated with a lack of access to digital tools, usage patterns, and the ability to effectively use digital technologies. Although some studies have investigated the impact of sociodemographic factors on digital health literacy, a comprehensive evaluation of these factors has not been conducted. Therefore, this study sought to examine the sociodemographic determinants of digital health literacy by conducting a systematic review of the existing literature.

METHODS

A search of four databases was conducted. Data extraction included information on study characteristics, sociodemographic factors, and the digital health literacy scales used. Meta-analyses for age and sex were conducted using RStudio software with the metaphor package.

RESULTS

A total of 3922 articles were retrieved, of which 36 were included in this systematic review. Age had a negative effect on digital health literacy (B = -0.05, 95%CI [-0.06; -0.04]), particularly among older adults, whereas sex appeared to have no statistically significant influence among the included studies (B = - 0.17, 95%CI [-0.64; 0.30]). Educational level, higher income, and social support also appeared to have a positive influence on digital health literacy.

DISCUSSION

This review highlighted the importance of addressing the digital health literacy needs of underprivileged populations, including immigrants and individuals with low socioeconomic status. It also emphasizes the need for more research to better understand the influence of sociodemographic, economic, and cultural differences on digital health literacy.

CONCLUSIONS

Overall, this review suggests digital health literacy is dependent on sociodemographic, economic, and cultural factors, which may require tailored interventions that consider these nuances.

Address: iBiMED-Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal; Department of Social, Political and Territorial Sciences, University of Aveiro, Portugal; Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal; Health Sciences Research Center, University of Beira Interior (CICS-UBI), Covilhã, Portugal. Electronic address: [email protected].; Medical Devices Department, Critical Catalyst, Matosinhos, Portugal.; Health Sciences Research Center, University of Beira Interior (CICS-UBI), Covilhã, Portugal; Research Unit for Inland Development, Guarda Polytechnic Institute (UDI-IPG), Guarda, Portugal.; Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal; Faculty of Economics, University of Coimbra, Coimbra, Portugal.; iBiMED-Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.

DOI: 10.1016/j.ijmedinf.2023.105124