Currently submitted to: JMIR Nursing
Date Submitted: Mar 5, 2026
Open Peer Review Period: Mar 23, 2026 - May 18, 2026
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Digital health literacy as a predictor of telehealth adoption among nursing students in Saudi Arabia: Implications from a Cross-Sectional Study
ABSTRACT
Background:
Nursing students are the future workforce, and their readiness to use digital health is important. Prior studies focus on knowledge and attitudes; however, they do not examine the wide range of digital health literacy levels that may influence the attitudes of nursing students toward using telehealth in clinical settings.
Objective:
This study aimed to determine the relationship between nursing students’ literacy of digital health and their attitudes toward adopting telehealth in practice.
Methods:
A cross-sectional design was employed, and the sample for this study consists of undergraduate nursing students who are pursuing a Bachelor of Nursing at a selected Saudi Arabian University. An online survey was used with two scales, which are the Digital Health Care Literacy Scale and the Nurse's Attitudes Towards the Use of Telehealth Scale.
Results:
A total of 273 students participated (mean age 21.3 years, SD1.9). Most of the nursing students demonstrated a high digital health literacy level (184/273, 67.4%; mean DHLS score 11.9/15). Digital health literacy was a significant predictor of positive telehealth attitudes (AOR=1.48, 95% CI 1.28–1.71; P<.001). Male students were significantly less likely to report positive attitudes compared with females (AOR=0.62, 95% CI 0.39–0.97; P=.038). However, academic year and participation in telehealth workshops and informatics courses were not associated with higher literacy levels.
Conclusions:
Higher levels of literacy appear to be associated with more positive attitudes toward telehealth usage in practice. However, current formal education and workshops were not associated with influencing digital health literacy. This demonstrates the necessity of providing restructured digital training and development in nursing education. These may enhance telehealth readiness and support future digital healthcare delivery.
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