Measuring digital health literacy and its associations with determinants and health outcomes in 13 countries
Year: 2025
Type: article
Abstract: Introduction: Digital health information sources are playing an increasingly prominent role in health promotion, public health and in healthcare systems. Consequently, digital health literacy skills are likewise becoming increasingly important. Methods: -DIGI, applied in the European Health Literacy Survey (2019-2021) of the WHO M-POHL network, analyzing data from 28,057 respondents from 13 countries. The instrument is a modified and extended version of the Digital Health Literacy Instrument (DHLI). Results: The scale displayed high internal consistency. Confirmatory factor analysis (CFA) strengthened the hypothesized one-factor structure. In most countries, the data displayed acceptable fit to the unidimensional Rasch partial credit model (PCM). Pearson correlation with a measure of general health literacy showed sufficient discriminant validity, and a social gradient was found. Testing for predictive validity showed that the scale score predicts health-related outcomes. Discussion: The study shows that considerable proportions of the general adult populations across countries in Europe have limited DHL skills. The level of DHL has direct potential consequences for some forms of health service utilization, in some countries. Implications of the study include recommendations for improving digital health literacy, promoting organizational health literacy and quality assurance for digital health information and resources.
Source: Frontiers in Public Health
Authors: Diane Levin-Zamir, Stephan Van den Broucke, Éva Bíró, Henrik Bøggild, Lucy Bruton, Saskia Maria De Gani, Hanne Søberg Finbråten, Sarah Gibney, Robert Griebler, Lennert Griese, Øystein Guttersrud, Zuzana Klocháňová, Zdenek Kucera, Christopher Le, Thomas Link, Julien Mancini, Dominika Miksova, Doris Schaeffer, Carlota Ribeiro da Silva, Kristine Sørensen, Christa Straßmayr, Miguel Telo de Arriaga, Mitja Vrdelja, Jürgen Pelikan
Institutions: Clalit Health Services, University of Haifa, UCLouvain, University of Debrecen, Aalborg University, Department of Health, Kalaidos University of Applied Sciences, University of Inland Norway, Bielefeld University, OsloMet – Oslo Metropolitan University, University of Oslo, University of Trnava, Norwegian Directorate of Health, Inserm, Aix-Marseille Université, Economic & Social Sciences, Health Systems & Medical Informatics, Institut de Recherche pour le Développement, Direcção-Geral da Saúde, Global Health Literacy Academy, Universidade Católica Portuguesa, National Institute of Public Health
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Funders: European Commission, Public Health Agency, Bundesamt für Gesundheit, Aalborg Universitet, Bundesministerium für Gesundheit, Ministero della Salute, Helse- og Omsorgsdepartementet, Magyar Tudományos Akadémia, Istituto Superiore di Sanità, Ligue Contre le Cancer, University of Haifa, Emberi Eroforrások Minisztériuma, Clalit Health Services, Helsedirektoratet, Høgskolen i Innlandet, Ministry of Health of the Russian Federation
Awards: G4294990157, G7692122778, G848022150
OpenAlex ID: W4408650106