JMIR Publications

ABSTRACT

Background:

Type 2 diabetes (T2D) is one of the most pressing global public health challenges. Among individuals at risk, a significant proportion of T2D cases can be prevented through healthier lifestyle choices. The rise of digital technologies offers promising opportunities for leveraging eHealth literacy in preventive interventions.

Objective:

This study aims to investigate the impact of eHealth literacy interventions on the prevention of T2D in at-risk populations. Specifically, we address the following research questions:（1）How does eHealth literacy impact the prevention of type 2 diabetes in at-risk populations? What specific approaches are involved?（2）How do the various dimensions of eHealth literacy contribute to the prevention of type 2 diabetes in at-risk populations?（3）Is prevention through eHealth literacy interventions feasible for at-risk populations? What are the levels of participation and health outcomes?

Methods:

This systematic review followed the PRISMA guidelines (registration number CRD42025630395). We searched Scopus, Web of Science, and PubMed for English-language articles published between 2000 and 2024 using predefined keywords and eligibility criteria. Of the 1,237 initial publications, 719 remained after removing duplicates, and 19 studies (1.53%) met the inclusion criteria. Risk of bias was assessed using the MMAT tool. A qualitative, research question–driven thematic analysis was conducted to extract insights on intervention strategies, mechanisms, and outcomes.

Results:

Six key themes emerged from the eHealth literacy interventions: knowledge and skill training, self-logging, physical activity promotion, goal setting, motivation and social interaction, and digital monitoring. Health literacy (95%) and computer literacy (89%) were the most frequently addressed dimensions, followed by information (53%), traditional (32%), scientific (32%), and media literacy (26%). Most interventions were found to be feasible and well-accepted by participants. Four outcome themes were identified: weight control,improvement of pre-diabetes-related indicators, rationalize exercise and dies, and increased knowledge of disease prevention.

Conclusions:

eHealth literacy plays an indirect yet significant role in T2D prevention among at-risk populations, with high participation and acceptability. However, few interventions treat eHealth literacy as a unified construct, and more attention is needed on its multidimensional nature. Future research should integrate emerging technologies such as AI to design more comprehensive, long-term preventive strategies.