JMIR Publications

ABSTRACT

Background:

eHealth literacy is essential for enabling older adults to access, evaluate, and use digital health information effectively. Self-efficacy, defined as confidence in one’s ability to perform specific behaviors, is a key determinant of sustained health behavior change and has been widely applied in health education interventions. However, the effectiveness of self-efficacy–based interventions to improve eHealth literacy among community-dwelling older adults has not been systematically evaluated using high-quality evidence.

Objective:

This systematic review aims to evaluate whether interventions aimed at improving eHealth literacy among community-dwelling older adults, based on the theory of self-efficacy, are effective in improving health-related outcomes, such as eHealth literacy and self-efficacy.

Methods:

Following PRISMA-P guidelines, this review will include randomized controlled trials and cluster randomized controlled trials targeting adults aged ≥50 years in which self-efficacy serves as the core theoretical framework. MEDLINE, Cochrane Library, EMBASE, and CINAHL will be searched without language or publication year limits. The primary outcome will be eHealth literacy improvement measured by eHEALS. Secondary outcomes include self-efficacy, health behaviors, quality of life, and frailty. Two reviewers will independently screen studies, extract data, and assess risk of bias using Cochrane methods. Meta-analysis will be performed where feasible.

Results:

The results of this review will be synthesized using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and presented in Summary of Findings tables.

Conclusions:

This review will clarify the effectiveness of self-efficacy–based interventions to enhance eHealth literacy in older adults, supporting the development of evidence-based digital health education and reducing digital health disparities. Clinical Trial: PROSPERO CRD420251139882