The concept of Health Literacy evolved from a history of defining, redefining, and quantifying the functional literacy needs of the adult population. Along with these changes has come the recognition that sophisticated literacy skills are increasingly needed to function in society and that low literacy may have an effect on health and health care. The definitions and measurement of literacy have also changed, becoming more representative of the skills needed to function successfully in the current society.
Whether Health Literacy is considered a fixed or dynamic concept will impact not only its definition but its measurement as well. Consistent with a definition of literacy more generally, an individual's health literacy would be considered relatively fixed. People can improve their literacy skills only through intensive interventions such as adult education classes so that generally an individual's literacy level would not be likely to change markedly in adulthood, absent such interventions. Corresponding to this conceptualization, an individual's health literacy level would generally only need to be measured once. However, some experts consider health literacy to be dynamic. Zarcadoolas et al. (Citation2005) state that health literacy is “the wide range of skills….that people develop to use health information.” This implies that individuals' health literacy can change as they gain experience with the various health circumstances and choices that they face and therefore their health literacy level would need to be measured and reevaluated repeatedly. We believe that conceptualizing health literacy as dynamic is inevitable. Viewing health literacy as static was primarily an artefact of its origins in prose literacy ability and related to limitations in existing measurement tools. We expect future movement to be toward the dynamic viewpoint, corresponding to increased sophistication in the field.
The development of instruments that go beyond static measures of literacy and numeracy has lagged behind the attention more recently paid to defining and conceptualizing health literacy. A few instruments have been commonly used in studies to directly measure an individual's literacy or health literacy in relation to health outcomes. These include the Rapid Estimate of Adult Literacy in Medicine (REALM) (Davis et al., Citation1993) and the Test of Functional Health Literacy in Adults (TOFHLA) (Parker et al., Citation1995). The REALM and the TOFLHA focus primarily on reading-related skills (Berkman et al., Citation2004) and thus, are not considered comprehensive measures of the skills needed by individuals in the health care environment. The National Assessment of Adult Literacy (NAAL) is considered the most comprehensive tool; however, it is not publically available and thus cannot be used in research or intervention studies. It seems that health literacy has been in large part limited by progress in developing measurement tools, more so than definitions and conceptualizations.
The terms “literacy” and “health literacy” have been defined, refined, and measured in a variety of ways over the years, responding to changing demands in an increasingly complex society. During the recent period of growing interest in health literacy as an integral component of health communication, advancements have been made in defining the term. A lack of consensus about the definition of health literacy could potentially handicap progress in its measurement or delay solutions to significant problems. On the other hand, the range of definitions reflects an appreciation for the complexity of the construct and the possibility that different definitions may be needed depending on one's goals. The field of health literacy is growing rapidly, broadening to involve a larger and more interdisciplinary audience, and with that, there is a greater recognition of its complex and multifaceted nature (Berkman et al., 2010)
Health literacy is crucial for informed health decisions and outcomes in the digital era. Health Literacy is the ability to obtain, comprehend, and apply health information to make informed health decisions. Digital tools like mobile health apps, telemedicine, and online health information resources can significantly enhance Health Literacy. Mobile apps can provide personalized health information, reminders for medication, and tools for self-management of chronic conditions. Telehealth services can improve access to healthcare, especially in remote areas, and provide real-time health information and consultations. Websites and online portals can offer reliable health information, educational materials, and interactive tools to help users understand and manage their health. Addressing issues related to access to technology and internet connectivity, especially in rural and underserved communities is crucial. Ensuring that digital health platforms are secure and that users' personal health information is protected is necessary to enhance privacy and security. Creating digital content that is easy to understand, using plain language, and incorporating visuals to enhance comprehension can solve the problems for elderly and less educated people of society to use the Digital platform of Health Literacy. Highlighting new technologies like virtual reality and interactive learning methods that engage users and enhance health literacy are the areas to be concentrated. Exploring the potential of emerging technologies to further improve Health Literacy should be focussed. Discussing the role of policy in promoting digital Health Literacy and ensuring equitable access to digital health tools is essential to adopting and advocating for policies to improve the Digital platforms for Health Literacy (Improving Digital Health Literacy - RHIHub Health Literacy Toolkit, n.d.) (“Digital Health Interventions’ Impact on Health Literacy: A Systematic Review,” n.d.)(Mancone et al., 2024)(Fitzpatrick, 2023).
With the increasing adoption of eHealth services, individuals are increasingly expected to engage in appropriate self-care and self-management of their conditions through eHealth. Health consumers must therefore have sufficient health literacy within the context of eHealth. eHealth literacy comprises “a set of skills and knowledge that are essential for productive interactions with technology-based health tools”.Individuals with low health literacy tend to use fewer preventive services and less eHealth, which are associated with poor health outcomes [12]. Low health literacy is related to delayed diagnoses, poor adherence to treatment regimens, increased morbidity and mortality [13], and increased rates of hospitalization and poor health outcomes [14]. Individuals with low health literacy have difficulties in effectively utilizing and interacting with eHealth.(“Health Literacy in the eHealth Era: A Systematic Review of the Literature,” n.d.) Barriers to access to and use of online health information can result from the readability of content and poor usability of eHealth services. We need new health literacy screening tools to identify skills for adequate use of eHealth services. Mobile apps hold great potential for eHealth and mHealth services tailored to people with low health literacy.
Implementation of eHealth is now considered an effective way to address concerns about the health status of healthcare consumers. Creating eHealth interventions to improve health literacy will aid in extended duration and quality of life for patients. Overall, compared to control interventions, the interventions using technology reported significant outcomes or showed promise for future positive outcomes regarding health literacy in a variety of settings, for different diseases, and with diverse samples. Several employed a variety of modalities for delivering content. Interactive media delivered via eHealth interventions and applications provide opportunities for patients to act as engaged users instead of passive receivers of information. Interventions delivered via technology should provide culturally relevant health information and decision support to consumers with low literacy.
Understanding and measuring patients’ health literacy concerning behavioural risk factors is an important goal in the prevention, detection, and management of chronic diseases. A concern is the fact that overall health literacy rates are poor and even poorer for individuals from lower socioeconomic and/or ethnic minority backgrounds. Improving health literacy through digital platforms is a multifaceted approach that leverages technology to enhance individuals' understanding and management of their health.
In conclusion, improving health literacy through digital platforms involves a combination of strategies that leverage technology to make health information more accessible, understandable, and actionable. Key approaches include utilizing mobile health apps, expanding telemedicine services, providing reliable online health resources, addressing the digital divide, ensuring privacy and security, designing user-friendly content, and exploring innovative technologies. By implementing these strategies, we can enhance individuals' ability to make informed health decisions and ultimately improve health outcomes.
Health literacy in the eHealth era: A systematic review of the literature. (n.d.). Science Direct. //www.sciencedirect.com/science/article/abs/pii/S0738399117300150
Fitzpatrick, P. J. (2023). Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Frontiers in Digital Health, 5. //doi.org/10.3389/fdgth.2023.1264780
Mancone, S., Corrado, S., Tosti, B., Spica, G., & Diotaiuti, P. (2024). Integrating digital and interactive approaches in adolescent health literacy: a comprehensive review. Frontiers in Public Health, 12. //doi.org/10.3389/fpubh.2024.1387874
Posted : January 28, 2025 2:02 pm
