JMIR Publications

ABSTRACT

Background:

In a world of rapid digital technology development, the lack of digital health literacy (DHL) among older people cannot be ignored. DHL is becoming an essential competency that can facilitate the health status and health management of older adults. DHL interventions that are feasible and appropriate can be implemented on a large scale through the healthcare system for older people.

Objective:

The purpose of this meta-analysis was to assess the effectiveness of DHL interventions for older adults.

Methods:

English publications in the PubMed, Web of Science, Embase, and The Cochrane Library databases were searched from inception to November 20, 2022. Two reviewers independently completed the data extraction and quality assessment. Review Manager version 5.4 software was used for all meta-analyses.

Results:

A total of 7 studies conducted on 710 older adults were considered as eligible. e-HEALS scores at the baseline and post intervention were considered as the primary outcome. Knowledge, self-efficacy, and skills were the secondary outcomes. Of the 7 studies, 3 used face-to-face instruction, while 4 adopted online interventions. Among them, 4 of the interventions were conducted using theoretical guidance, while 3 were not. Intervention duration varied from 2 to 8 weeks. In addition, the studies included were all conducted in developed countries, mainly in the United States. Pooled analysis presented that DHL interventions had positive effects on eHealth literacy efficacy (standardized mean difference 0.94, 95% CI 0.26 to 1.61; P=.007). Subgroup analysis revealed that DHL interventions that chose face-to-face teaching (standardized mean difference 2.15, 95% CI 0.90 to 3.40; P<.001), were guided by a conceptual framework (standardized mean difference 1.55, 95% CI 0.43 to 2.67; P=.007), were sustained over 4 weeks (standardized mean difference 1.57, 95% CI 0.36 to 2.78; P=.01) and had a more significant effect. Moreover, the outcomes showed moderate gains in knowledge (standardized mean difference 0.76, 95% CI 0.33 to 1.20; P<.001) and self-efficacy (standardized mean difference 0.77, 95% CI 0.07 to 1.47; P=.03). No statistically significant effect was found for skills. The small number of studies, variable study quality and heterogeneity are some limitations of this review.

Conclusions:

Digital health literacy (DHL) interventions have positive effects on health status and health management of older adults. Practical and effective DHL interventions are crucial for the use of modern digital information technology in managing the health of older people. Clinical Trial: It registered in PROSPERO (CRD42023410204).