Electronic Health Literacy As a Source of Self-Efficacy Among Community-Dwelling Older Adults

Objectives: Multiple researchers have studied health-related factors in relation to self-efficacy, including perceived health status, health anxiety, and health literacy. As a result, they found that individuals’ knowledge of and perceptions of health were associated with their self-efficacy levels. While an increasing number of people rely on the internet in seeking health information, little is known about electronic health literacy and its impacts on self-efficacy. The present study aimed to understand whether electronic health literacy would play a similar role as traditional health literacy, particularly among people with lower digital literacy than others. For this aim, it examined the relationship between electronic health literacy and self-efficacy among community-dwelling older adults.

Methods: To conduct quantitative research, cross-sectional surveys were collected in the United States from June to October 2023. Nonprobability sampling method was used to invite survey participants, by distributing recruitment fliers at churches, senior centers, and community centers. When data collection was complete, the survey dataset consisted of 191 responses from individuals who were living in Ohio and were ages 65 or older. It provided information about the survey participants’ sociodemographic status, perceived health status, health anxiety, and electronic health literacy. Standardized measurement tools used to gather the information included eHealth Literacy Scale, General Self-Efficacy Scale, and the Whiteley Index. As for the analytic strategy, hierarchical linear regression was employed.

Results: When sociodemographic status (i.e., age, gender, ethnicity and race, education, income), perceived health status, health anxiety, and electronic health literacy were tested as explanatory variables, they altogether explained 19% of the variance of the outcome variable (i.e., self-efficacy). Electronic health literacy (β=.30, p<.001) was positively associated with self-efficacy, whereas health anxiety (β=-.24, p<.01) was negatively associated with self-efficacy.

Conclusions and Clinical Implications: These results highlight the importance of enhancing electronic health literacy in the older population. Greater electronic health literacy can help older adults maintain self-efficacy even if they have higher levels of health anxiety. As digital literacy is closely linked to electronic health literacy, social work interventions to reduce the digital divide are also called for. For example, adult learning centers can offer appropriate spaces for training programs. Should a community lack necessary resources, such as space and instructors, one-on-one mentoring often is a feasible strategy. Intergenerational one-on-one mentoring programs have successfully engaged technology-savvy youth volunteers to help older adults improve digital literacy. In conclusion, the present study suggests that practitioners in social work and other helping profession incorporate electronic health literacy into their work for older clients.