Accepted for/Published in: JMIR Human Factors
Date Submitted: Apr 4, 2025
Date Accepted: Jan 2, 2026
Digital Health Literacy and Tool Adoption in Post-Operative Care: A Mixed-Methods Analysis from a Safety-Net Hospital Population
ABSTRACT
Background:
Digital health tools are increasingly prevalent in post-operative care management, yet limited research exists on digital health literacy and tool adoption among safety-net hospital populations. Understanding these factors is crucial for developing effective digital health solutions for historically underserved communities.
Objective:
To evaluate digital health literacy, assess technology adoption readiness, and examine the relationship between patient-reported capabilities and demographic factors in a post-operative care context at a safety-net hospital.
Methods:
We conducted a mixed-methods study with 71 post-operative patients and 29 healthcare providers. Participants completed a modified eHealth Literacy Scale (eHEALS) assessment and demographic questionnaire, followed by usability testing of a digital health prototype. Digital health literacy was evaluated using a 10-point Likert scale, and correlations between demographic factors and digital health literacy were analyzed.
Results:
Despite common assumptions about technology barriers in safety-net populations, 69% of patients reported high confidence (score ≥3 on a 5-point scale) in finding health resources online, and 60.6% expressed confidence in using the internet for health-related questions. However, only 49.3% felt confident in using digital resources for health decision-making. Patient comfort with technology did not significantly correlate with age, but rather with prior technology exposure, with 78.9% reporting ≥10 years of digital device experience.
Conclusions:
Digital literacy and health literacy have been studied in safety-net contexts, but there is a dearth of research on digital health literacy in post-operative care and safety-net populations specifically. Our findings suggest that digital health tools may be more feasible in safety-net settings than previously considered. However, the gap between patients' ability to find health resources and their confidence in using these resources for health decision-making highlights the need for targeted support in translating digital capabilities into healthcare management skills.
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