JMIR Publications

ABSTRACT

Background:

With rapid advances in online information and communications technology, eHealth literacy is important for older adults to seek and evaluate online health information and support their healthy ageing.

Objective:

This study aims to assess the level of eHealth literacy and its associations with health behaviors and health-related outcomes among older adults in Hong Kong.

Methods:

We conducted the baseline analyses of the “Generations Connect” project. This is an ongoing large-scale quasi-experimental study, where we trained university students to conduct home visits and assess the health status of older adults (n=6,704) in Hong Kong. eHealth literacy was measured by the eHealth Literacy Scale (score: 8-40). Health behaviors measurements included the physical activity in metabolic equivalent of task minutes per week, smoking and drinking status, and eating habits. Mental well-being was measured by the World Health Organization-5 Well-being Index (percentage score: 0-100) and UCLA 3-item Loneliness Scale (score: 3-9). Physical health was assessed by self-report medical diagnosis of non-communicable diseases (Yes/No), including hypertension, diabetes, cardiovascular disease, and stroke. Adjusted unstandardized coefficients (b) and odds ratio (OR) were calculated for the associations between variables.

Results:

The mean age of participants was 77.8 years (±7.0). The mean score of eHealth literacy was 18.2 (±10.2), and 44.1% lacked eHealth literacy (score: 8-15.99). Increasing age (adjusted b: -0.32 [95% CI -0.35 to -0.28]; P<.001), supported by the social security allowance (adjusted b: -1.49 [95% CI -2.04 to -0.95]; P<.001), and living in public housing (adjusted b: -1.60 [95% CI -2.69 to -0.50]; P=.004) were associated with a lower score on the eHealth Literacy Scale. Participants with moderate eHealth literacy (score: 24-31.99) were less likely to be current smokers (adjusted OR: 0.60 [95% CI 0.38 to 0.95]; P=.04), more physically active (adjusted b: 39.83 [95% CI 2.04 to 77.62]; P=.04), more likely to be community health centre members (adjusted OR: 1.52 [95% CI 1.30 to 1.77]; P<.001), have healthy diets (adjusted b: 0.034 [95% CI 0.006 to 0.063]; P=.04), less likely to be diagnosed with diabetes (adjusted OR: 0.73 [95% CI 0.62 to 0.85]; P<.001), have a higher score on the WHO-5 Well-being Index (adjusted b: 2.89 [95% CI 1.42 to 4.36]; P<.001), and lower score on the UCLA 3-item loneliness scale (adjusted b: -0.26 [95% CI -0.37 to -0.15]; P<.001).

Conclusions:

The level of eHealth literacy was low among older adults in Hong Kong. eHealth literacy was associated with positive health behaviors and health-related outcomes. Interventions are warranted to boost their eHealth literacy in the future. Clinical Trial: Not applicable.