Digital health literacy and access: A rapid review (Preprint)

BACKGROUND Digital health literacy has emerged as a critical skillset to navigate the digital age. OBJECTIVE This review sought to broadly summarise the literature on associations between digital health literacy and: (a) socio-demographic characteristics, (b) health resource use, and (c) health outcomes in the general population, patient groups, or parent/caregiver groups. METHODS A rapid review of literature published between January 2016 and May 2022 was conducted through a search of four online databases. Inclusion criteria for articles were: participants were from countries where English was primary language; research was either cross-sectional, longitudinal, prospective or retrospective, and published in English. RESULTS Thirty-six articles met the inclusion criteria. Evidence on the associations between digital health literacy and sociodemographic characteristics varied (27 of 36 included studies; 75%), with higher education (16 of 21 studies that examined the association; 76.2%) and younger age (12 of 21 studies; 57.1%%) tending to predict higher digital health literacy, however, other studies found no associations. No differences between genders were found across the majority of studies. Evidence across ethnic groups was too limited to draw conclusions; some studies showed those from minority groups had higher digital health literacy than Caucasians, while other studies showed no associations. Higher digital health literacy was associated with digital health resource use in the majority of the 20 studies (20/36; 55.6%) that examined this relationship. In addition, higher digital health literacy was also associated with health outcomes across three areas (psychosocial outcomes; chronic disease and health management behaviours; physical outcomes) across the 17 included studies (17/36; 47.2%) that explored these relationships. However, not all studies on the relationship between digital health literacy and health resource use and health outcomes were in the expected direction. CONCLUSIONS The review presents mixed results regarding the relationship between digital health literacy and sociodemographic characteristics, although studies broadly found that increased digital health literacy was positively associated with improved health outcomes and behaviours. Further investigations of digital health literacy on chronic disease outcomes are needed, particularly across diverse groups. Empowering individuals with the skills to critically access and appraise reliable health information on digital platforms and devices is critical, given emerging evidence that suggests those with low digital health literacy seek health information from unreliable sources. Identifying cost-effective strategies to rapidly assess and enhance digital health literacy capacities across community settings thus warrants continued investigation.