JMIR Publications

ABSTRACT

Background:

Digital technologies are shaping medicine and public health.

Objective:

This study aimed to investigate the attitudes towards and the use of digital technologies for health-related purposes using a nationwide survey.

Methods:

We conducted a cross-sectional study using a panel sample of Internet users selected from the general population living in Germany. Responses to a survey with 28 items were collected using computer-assisted telephone interviews conducted in October 2020. The items were divided into four topics: 1) general attitudes towards digitization, 2) COVID-19 pandemic, 3) physical activity, and 4) perceived digital health (eHealth) literacy measured with the eHealth Literacy Scale (eHEALS; sum score of 8=lowest to 40=highest perceived eHealth literacy). The data were analyzed in IBM-SPSS24 using relative frequencies. Three univariate multiple regression analyses (linear or binary logistic) were conducted to investigate the associations among the sociodemographic factors (age, gender, education and household income) and the digital technology use.

Results:

The participants were 1014 Internet users (52% female) aged 14 to 93 years (mean=54; SD=17). Of those 66% completed up to secondary education and 45% reported a household income of up to 3,500 Euro/month. Over half (57%) reported having used digital technologies for health-related purposes. The majority (89%) noted that digitization will be important for therapy, healthcare and health-related behavior (promotion and maintenance of health) in the future. Only 26% reported interest in smartphone apps for health promotion/prevention and 43% downloaded the contact-tracing app. While 52% reported that they come across inaccurate digital information on the COVID-19 pandemic, 78% were confident in their ability to recognize such inaccurate information. Among those who use digital technologies for moderate physical activity, 85% found such technologies easy to use and 64% reported using them regularly (at least once a week). While the perceived eHealth literacy was high (eHEALS mean=31 points; SD=6), less than half (43%) were confident in using digital information for health decisions. The use of digital technologies for health was associated with higher household income (OR=1.28 [95% CI: 1.12-1.48]). The use of digital technologies for physical activity was associated with younger age (OR=.95 [.94-.96]) and more education (OR=1.17 [1.00-1.37]). Higher perceived eHealth literacy score was associated with younger age (β=-.22, P<.001), higher household income (β=.21, P<.001) and more education (β=.14, P<.001).

Conclusions:

Internet users in Germany expect that digitization will affect preventive and therapeutic healthcare in the future. The facilitators and barriers associated with the use of digital technologies for health warrant further research. A gap exists between high confidence in the perceived ability to evaluate digital information and low trust in Internet-based information on the COVID-19 pandemic and health decisions.