Electronic Health Literacy among Linguistically Diverse Patients in the Los Angeles County Safety Net Health System

Abstract

Background: Electronic health (eHealth) literacy may affect telehealth uptake, yet few studies have evaluated eHealth literacy in underserved populations.Objective: The objective of this study was to describe technology access and use patterns as well as eHealth literacy levels among English-speaking and LEP patients in a Los Angeles safety net health system.Methods: Patients, aged ≥18 years with a diagnosis of diabetes mellitus and/or hyper­tension, and their caregivers were recruited from three primary care safety-net clinics in Los Angeles County (California) between June – July 2017. Participants’ electronic health literacy was assessed by the eHealth Literacy Scale (eHEALS); participants were also asked about technology access and use. We examined these measures in English-speaking and limited English proficient (LEP) Spanish-speaking patients.Results: A total of 71 participants (62 pa­tients and 9 caregivers) completed the ques­tionnaire. The mean age of the respondents was 56 years old. More than half of partici­pants used a phone that could connect to the Internet (67%). The mean score for 10 eHEALS items was in the moderate range (26/50 points). There was no difference in mean eHEALS between language groups. However, 47% of Spanish-speaking partici­pants “agreed/strongly agreed” that they knew how to use the Internet to answer their health questions, compared to 68% of English-speaking participants (P<.05).Conclusions: In this sample of patients from a diverse safety net population, perceived skills and confidence in engaging with electronic health systems were low, particularly among LEP Spanish-speakers, despite moderate levels of electronic health literacy. More studies are needed among diverse patient populations to better assess eHealth literacy and patients’ digital readi­ness, and to examine how these patient metrics directly impact telehealth utilization.Ethn Dis. 2022;32(1):21-30; doi:10.18865/ed.32.1.21