Digital health literacy and its determinants among community dwelling elderly people in Taiwan

Tu T Tran; Peter Ws Chang; Jenn-Ming Yang; Tso-Hsiao Chen; Chien-Tien Su; Diane Levin-Zamir; Orna Baron-Epel; Efrat Neter; Shih Feng Tsai; Bryan Lo; Tuyen V Duong; Shwu-Huey Yang

doi:10.1177/20552076241278926

Digital health literacy and its determinants among community dwelling elderly people in Taiwan

Digit Health. 2024 Sep 9:10:20552076241278926. doi: 10.1177/20552076241278926. eCollection 2024 Jan-Dec.

Authors

Tu T Tran^{1

2

3}, Peter Ws Chang^{4

5}, Jenn-Ming Yang^{6

7}, Tso-Hsiao Chen^{8

9}, Chien-Tien Su^{10

11}, Diane Levin-Zamir^{12

13}, Orna Baron-Epel¹², Efrat Neter¹⁴, Shih Feng Tsai¹⁵, Bryan Lo⁵, Tuyen V Duong^{1

16}, Shwu-Huey Yang^{16

17

18}

Affiliations

¹ International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
² Department of Internal Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam.
³ Department of Nephro-Urology and Dialysis, Thai Nguyen National Hospital, Thai Nguyen, Vietnam.
⁴ Department of Occupational Medicine, Chang Bing Show Chwan Memorial Hospital, Chang Hua, Taiwan.
⁵ School of Medicine, Tufts University, Boston, MA, USA.
⁶ Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁷ Department of Obstetrics and Gynecology, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan.
⁸ Department of Nephrology, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
⁹ Department of Nephrology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
¹⁰ School of Public Health, Taipei Medical University, Taipei, Taiwan.
¹¹ Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
¹² School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa, Israel.
¹³ Department of Health Education and Promotion, Clalit Health Services, Tel Aviv, Israel.
¹⁴ Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel.
¹⁵ Applied English Department, National Taichung University of Science and Technology, Taichung, Taiwan.
¹⁶ School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
¹⁷ Research Center of Geriatric Nutrition, Taipei Medical University, Taipei, Taiwan.
¹⁸ Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan.

Abstract

Background: Digital Health Literacy (DHL) is crucial in navigating digital health environments, yet few studies focus on older adults.

Objective: Explore the associations of digital health information and resource utilization, IT-related social support, and barriers/enhancers to digital health service usage with DHL among older adults.

Methods: A cross-sectional study was conducted from January 2022 to April 2023, involving 417 individuals over the age of 60 who were interviewed using an instrument for collecting data on DHL, social support, barriers/enhancers influencing use of digital health resources and personal/demographic data. Multi-regression models were used to examine the associations.

Results: Higher DHL scores were associated with daily use of digital interaction with healthcare (B = 0.28; 95% confidence interval [CI] = 0.07, 0.49; p = .01), daily use of other digital health resources (B = 0.22; 95% CI = 0.05, 0.40; p = .01), ease in finding assistance for online navigation (B = 0.27; 95% CI = 0.08, 0.45; p = .01), self-perceived digital proficiency ("usually very good at surfing the internet," B = 0.35; 95% CI = 0.18, 0.52; p = .01), assistance from relatives/others in internet browsing (B = 0.20; 95% CI = 0.02, 0.37; p = .02), and having access to a computer, tablet, or smartphone (B = 0.29; 95% CI = 0.11, 0.47, p = .01). Conversely, barriers like "no access to a computer, tablet, or phone at all times" (B = -0.19; 95% CI = -0.34, -0.04; p = .01), "difficulty understanding online content" (B = -0.22; 95% CI = -0.36, -0.07; p = .01), and "believing to be too old for online services" (B = -0.18; 95% CI = -0.32, -0.03; p = .02) were associated with lower DHL scores.

Conclusions: Engagement with digital health platforms, including making online appointments and accessing personal health records, is associated with higher DHL levels. Support from relatives or others, a modifiable attribute, is also associated with elevated DHL among older adults.

Keywords: Digital health literacy; IT-related social support; adding self-generated content; determining relevance; evaluating reliability; information searching.