Improving Digital Health Literacy

As healthcare systems are providing more services remotely using technology, rural communities will need to address community needs related to digital health literacy. Digital health literacy describes the skills necessary to successfully navigate and use digital or electronic health information and patient resources. Several promising approaches for improving digital health literacy are included below.

Access to and Use of Digital Platforms

This approach focuses on educating individuals about using computers and other mobile devices to access medical information and interact with healthcare teams. This includes, for example, using electronic patient portals and technology for telehealth visits. Rural populations, especially people living in geographically remote locations, face increased digital barriers such as limited access to broadband internet and higher costs associated with accessing digital services.

Programs that help improve access to technology and educate about best methods for using health information have shown promise in rural communities. For example, research found providing equitable access to the internet and paid cellular devices improved educational and health outcomes for youth from seasonal farmworker families. Educating individuals on how to use computers, patient portals, and telehealth services to access medical information can improve health outcomes among rural patients with limited health literacy. It can also help individuals more easily identify trustworthy and reputable online sources of health information.

There are some technology-based interventions, or eHealth interventions, designed to help improve health literacy. Commonly, these interventions are delivered by computer and can be tailored for a variety of formats. These interventions are designed to deliver health education and information and build individual skills and behaviors. Some of the digital skills that programs can help people learn include:

Accessing and using online medical scheduling platforms to make appointments
Using and navigating electronic health records and patient portals
Receiving text message reminders from healthcare providers
Receiving digital health information instead of handouts (for example, information about medications, instructions for medication adherence)
Obtaining results of medical or diagnostic tests online
Searching for and evaluating online health information

Designing Health Literate Digital Content

This approach focuses on developing digital content using strategies to incorporate health literacy best practices. Best practices include using plain language and designing content that is simple and user-friendly.

Health Literacy Online is a research-based guide developed by the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. It provides a step-by-step guide to develop clear and accessible digital health content. Rural programs can use the guide to design user-friendly tools and websites.

For more information about digital health literacy definitions and rural considerations when planning programs, see A New Era of Health Literacy? Expanded Definitions, Digital Influences, and Rural Inequities in the Rural Monitor.

Examples of Programs Focusing on Improving Digital Health Literacy

Digital Inclusion and Health Literacy Resources for Farmworker Health is a North Carolina collaboration between East Carolina University's Laupus Library, the North Carolina Farmworker Health Program's Internet Connectivity Project, and other community partners. The project brings health literacy resources and digital access and technology to migrant and seasonal farmworkers.
The Network of the National Library of Medicine created All of Us Digital Health Literacy, a digital literacy training to support the health information needs of various communities.
Wisconsin Health Literacy provides materials such as a free downloadable digital health literacy curriculum including a slide deck with accompanying script and handouts. These materials can be used by programs who wish to conduct either virtual or in-person training sessions.

Program Clearinghouse Examples

University of Maryland Horowitz Center for Health Literacy, with support from the National Institutes of Health, developed a smartphone application known as HealthyMe/MiSalud. This app was developed by a research team that worked closely with African American and Spanish-speaking adults. The app is designed to help users meet their goals for healthy living by finding useful health information. For example, the app includes a feature to help users understand nutrition labels and prevention recommendations and find nearby healthcare providers.

Implementation Considerations

Early in the planning stage, organizations should determine what specific technology and resources are needed to implement a digital health literacy program. Programs using digital platforms, apps, and tools to support digital health literacy must ensure that these tools can be incorporated across the organization and that community members can access the technology. This may include access to high-speed internet and use of a mobile phone, tablet, or computer. Digital health interventions should be designed with the user in mind. They must be simple to use, have clear instructions, offer content in multiple formats, and be easily accessible. Programs using digital tools should also try to make them available in multiple languages to meet the needs of the community. Further, it may be necessary to provide training to both program staff and community members on a new digital platform or tool.

Resources to Learn More

Designing Inclusive Digital Solutions and Developing Digital Skills
Document
Offers guidelines and recommendations for digital solutions for populations with limited literacy levels and digital skills.
Organization(s): United Nations Educational, Scientific and Cultural Organization (UNESCO), Pearson
Date: 2018

Digital and Civic Literacy Skills
Website
Provides digital literacy information and resources for students and teachers including lessons, learning plans, strategies, videos, webinars, podcasts, and teaching aids. Materials are designed to help distinguish the difference between accurate and inaccurate information.
Organization(s): Learning for Justice

Digital Inclusion as a Social Determinant of Health
Document
Describes the link between digital literacy and internet connectivity and the social determinants of health (SDOH). Discusses the importance of access to health tools such as health apps, patient portals, and remote monitoring devices to improve care.
Author(s): Sieck, C.J., Sheon, A., Ancker, J.S., et al.
Citation: npj Digital Medicine, 4(52)
Date: 2021