Currently accepted at: Journal of Medical Internet Research
Date Submitted: Jul 9, 2025
Date Accepted: Oct 5, 2026
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/80373
The final accepted version (not copyedited yet) is in this tab.
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Health Literacy in the Age of Digitalization: Urgent Need for Action According to a Representative Population Survey in Switzerland
ABSTRACT
Background:
To adequately cope with the digital transformation and the corresponding challenges in the context of health and well-being, people need a sufficient level of digital health literacy (HL). Digital HL includes people’s knowledge, skills, and motivation to access, understand, critically appraise, and apply digital health-related information and services to manage their and other’s health and well-being. So far, however, there was no data on the level of digital HL in Switzerland.
Objective:
As part of the international HL survey 2019-2021 (HLS19), this study aimed to close this gap by investigating the digital HL, its determinants and consequences, as well as use of digital information sources in the general population in Switzerland. Moreover, it aimed at identifying population groups that are particularly affected by low digital HL to being able to derive future targeted and effective support measures.
Methods:
Digital HL of 2502 people was assessed between March and April 2020 as part of the HLS Switzerland (HLS19-21-CH) with an online questionnaire. Descriptive statistical analysis, Pearson’s chi-square test and Spearman’s Rho rank correlation coefficient were used to analyze the frequencies of the digital HL items and to investigate associations of digital HL with socio-demographic characteristics and health-related consequences.
Results:
Most of the respondents report inadequate (44.3%, 1034/2334) or problematic (27.9%, 651/2334) digital HL levels. People older than 75 years (81%, 128/158), people with more than one chronic disease (78.1%, 175/224), high financial deprivation (78.8%, 319/405) and low social status (79.6%, 129/162) on average report lower digital HL. Digital HL is related with self-assessed general health status (χ29 = 83.4, P<.001), management of chronic diseases (χ29 = 23.1, P=.006), use of emergency services (χ29 = 17.4, P=.04) and doctor’s visits (χ29 = 34.0, P<.001). Furthermore, people with higher digital HL tend to rely more on face-to-face information from healthcare professionals and to use digital sources less frequently (χ215 = 43.2, P<.001).
Conclusions:
This study offers first insights into the digital HL of the population in Switzerland and indicates that almost three quarters (72.2%) of the population have low digital HL. These results are in line with those of other European countries and clearly show that the urgency of measures are to improve digital HL, especially among certain population groups.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.