Multi-Level Factors Influencing eHealth Literacy Among Chinese Older Adults: A Longitudinal Study.
Luyao Xie, Phoenix K H Mo
PMID 39755378WHAT IT FOUND
Older Chinese adults with chronic conditions, lower education, rural residence, or who live alone had persistently lower eHealth literacy over six months.
Those with more internet experience, better self-rated skills, and social support for online health use had higher literacy. Access alone does not guarantee effective use.
Key findings
01Participants with at least one chronic disease or taking long-term medication had significantly lower eHealth literacy over time after adjustment.
02Receiving informational and instrumental support when using the internet for health was associated with higher eHealth literacy over time after adjustment.
03Community health-related internet use training was associated with higher eHealth literacy over time after adjustment, while general internet training was not.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were recruited from one city in Jiangxi Province via neighbourhood committees and were volunteers, so findings may not generalise to other regions or populations. The survey was web-based, which may have excluded older adults with visual impairments or significant difficulties using online questionnaires. All data were self-reported, so social desirability and recall bias may affect the accuracy of internet use and support measures. The six-month follow-up may not capture longer-term changes in eHealth literacy. Most influencing factors were measured only at baseline, so their time-varying nature was not fully examined. Attrition was 24.1% at 6 months; those lost to follow-up at 3 months were more likely to live in cities, though other demographics did not differ significantly.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the associations as evidence that providing internet access, general technology training, or digital devices alone will improve eHealth literacy. The study found these were not significantly associated after adjustment, while specific health-related internet use training and social support were. Also, this is an observational study, so it cannot demonstrate that any factor caused changes in eHealth literacy.