BACKGROUND
Individuals' eHealth literacy directly impacts consumers' use of eHealth. Numerous studies have investigated the status of eHealth literacy and its influencing factors among different populations. This offered us an opportunity to systematically review and synthesize evidence from the literature to gain a better understanding of eHealth literacy status and its influencing factors.
OBJECTIVE
This study aims to summarize the current status of eHealth literacy worldwide and explore the influencing factors of eHealth literacy.
METHODS
The standardized Joanna Briggs Institute (JBI) critical appraisal tool prepared for cross-sectional studies was used for methodological validity assessment and data extraction. We demonstrated the meta-analytic measure of association using pooled standardized beta coefficient (β), 95% confidence interval (CI) and heterogeneity by I2 tests. Predictors of eHealth literacy were aggregated and integrated according to the Literacy and Health conceptual framework and the Technology Acceptance Model (TAM).
RESULTS
69 studies were included in the geographic infographic and 17 studies met the search criteria for the meta-analysis. Participants in most countries/regions showed adequate eHealth literacy, especially in the developed countries. However, countries with a larger elderly population or in aging societies tend to have lower levels of eHealth literacy. The significant influencing factors of higher eHealth literacy including actions: internet usage (β = 0.24, 95% CI 0.06–0.42, I2 = 87.1%); determinants including: (i) age (β = -0.11, 95% CI -0.19– -0.01, I2 = 80.3%),(ii) ethnicity (β = -2.61, 95% CI -4.11– -1.11, I2 = 80.2%), (iii) income (β = 0.49, 95% CI 0.11– 0.86, I2 = 82.3%), (iv) employed status (β = -1.63, 95% CI -2.32– -0.95, I2 = 99.7%), (v) education (β = 0.18, 95% CI 0.16– 0.19, I2 = 58.2%); personal capabilities: perceived usefulness(β= 0.83, 95%CI 0.13-1.52, I2 = 68.2%) and self-efficacy (β=0.18, 95%CI 0.13-0.23, I2 = 0.0%); health status factor: disease (β= -0.15, 95%CI -0.8- -0.16, I2=84.2%).
CONCLUSIONS
The current review summarizes participants in most countries/regions showed adequate eHealth literacy. But most of the identified factors are inalterable social determinants of health and demographic factors. Thus, we propose that future eHealth technologies can be developed with a more targeted and adaptive approach by categorizing consumers based on their characters. Additionally, interventions aimed at enhancing consumers' self-efficacy and improving their perceived usefulness of the applications can be implemented to promote eHealth literacy.
CLINICALTRIAL
The study had registered in PROSPERO, with the ID: CRD42022383384