Socio-digital Determinants of eHealth Literacy and Related Impact on Health Outcomes and eHealth Use in Korean Older Adults: A Community-based Cross-sectional Survey (Preprint)

BACKGROUND eHealth literacy is an essential skill to pursue electronic health information, particularly for older people whose health needs increase with age. South Korea is now at the intersection of a rapidly digitalising society and an increasingly aged population. eHealth literacy enables older people to maximize the effective utilization of emerging digital technology for their health and quality of life. Understanding the eHealth literacy of Korean older adults is critical to eliminating the grey digital divide and inequity in health information access. OBJECTIVE This study aims to investigate factors influencing eHealth literacy in Korean older adults and its impact on health outcomes and eHealth use. METHODS This was a cross-sectional survey. Community-dwelling seniors aged 65 and above in two urban cities in South Korea were included. eHealth literacy was measured by the eHEALS scale. Ordinal Logistic regression was used to analyse factors associated with eHealth literacy and MANOVA for the impact of eHealth literacy on health outcomes and eHealth use. RESULTS 434 participants were analysed. 22.3% of participants had high eHealth literacy skills. Increasing age, higher monthly income, internet use, frequency and time spent on the internet were significantly associated with eHealth literacy(p<0.01), and social media users were 3.97 times more likely to have higher skill(p<0.002). Higher eHealth literacy was associated with better self-perceived health and frequent use of digital technologies for accessing health and care services(p<0.001). CONCLUSIONS Different levels of eHealth literacy skills derived from disparity of socioeconomic status and engagement on the internet and social media, with consequential impacts on health outcomes and eHealth utilisation. Tailored eHealth interventions, grounded on the social and digital determinants of eHealth literacy could facilitate eHealth information access among older adults and foster a digitally inclusive healthy ageing community.