eHealth literacy and health-related Internet use among Swedish primary healthcare visitors: Cross-sectional questionnaire study (Preprint)

Abstract

Digitalization has profoundly transformed healthcare delivery, especially within primary healthcare, as a crucial avenue for providing accessible and cost-effective care. While eHealth services are frequently highlighted for improving healthcare availability and promoting equality, it is essential to recognize that digitalization can inadvertently exclude individuals who lack the prerequisites to utilize eHealth services. Previous research has identified lower eHealth literacy among older individuals, those with lower educational levels, and those who use the Internet less frequently. However, in a Swedish context, only a few studies have investigated eHealth literacy.

This study investigated eHealth literacy and its association with health-related Internet use and sociodemographic characteristics among primary healthcare visitors.

This cross-sectional study employed a quantitative, descriptive approach. 172 Swedish-speaking patients visiting a primary healthcare center participated by answering the eHealth Literacy Questionnaire (eHLQ). The study compared mean scores using the Mann-Whitney U-test and Kruskal-Wallis-test. A logistic regression analysis also explored the associations between low eHealth literacy and significant independent variables identified in the univariate analyses.

The results showed that higher age and perceptions of health-related Internet information as not useful or important were the primary factors associated with lower eHealth literacy. The eHealth literacy domains in which participants scored highest—understanding of and engagement with health, and a sense of security and control—were not directly linked to utilizing and interacting with the eHealth system. Instead, the most challenging domains were related to motivation to use eHealth and aligning eHealth services with individual needs.

Healthcare professionals are crucial in addressing patients' attitudes and motivation towards eHealth use. Person-centered support can guide patients toward services that meet their individual needs, by recommending personalized websites and other eHealth services. To ensure that eHealth services effectively align with users' requirements, it is essential for eHealth developers and healthcare authorities to actively involve both patients and healthcare professionals in the development process.