Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Sep 03, 2025)
Date Submitted: Dec 18, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Intergenerational Correlation of eHealth Literacy: A Mixed-Methods Study
ABSTRACT
Background:
With the acceleration of digital health care, older adults face significant challenges in health management due to the "digital divide". Younger family members, as primary users of digital technology, may play a crucial role in assisting older adults with using electronic health tools.
Objective:
This study aimed to explore the intergenerational correlation of eHealth literacy between older patients and their younger relatives, as well as the factors influencing this relationship.
Methods:
A mixed-methods design was employed, combining a cross-sectional survey and qualitative interviews. The quantitative component included 105 family pairs (older adults aged ≥60 and younger family members aged 18–60), with eHealth literacy assessed using the Chinese version of the eHealth Literacy Scale (eHEALS). Pearson correlation analysis was used to assess intergenerational correlations, while subgroup analyses explored the influence of age, gender, and education level. In-depth semi-structured interviews with a subset of participants were conducted to gather qualitative insights into the role of family members in supporting older adults' digital health engagement.
Results:
Younger family members exhibited significantly higher eHealth literacy scores than older adults (28.17 ± 4.81 vs. 23.96 ± 5.73, p < 0.01), with a significant positive correlation between their eHealth literacy (r = 0.7215, p < 0.01). Subgroup analysis showed stronger correlations in older adults aged ≥80, male, or with lower education levels. The strongest correlation was observed in the information access dimension, followed by information evaluation and application. Qualitative findings revealed that younger family members often took on the role of guiding older adults through the use of digital tools, explaining how technology could be applied to health management, and addressing challenges related to technology adoption.
Conclusions:
A significant intergenerational correlation in eHealth literacy exists between older patients and their younger family members, especially in patients with older age and lower education levels. Further research is needed to explore the mechanisms behind this correlation and inform strategies to improve older adults' health literacy.
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