Journal of Health Literacy

Journal of Health Literacy

Digital Health Literacy and Its Determinants among Adults Aged 45 Years and Above in Udupi Taluk, Coastal Karnataka, India: A Cross-Sectional Study

Articles in Press

Document Type : Original Article

Authors
Usha Rani 1
Neha S 1
Panjala Mounika 2
1 Department of Healthcare and Hospital Management, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka – 576104, India.
2 Department of Applied Statistics and Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka – 576104, India.
10.22038/jhl.2026.96410.1997
Abstract
Background and Objective: Digital health services increasingly require people to locate, understand, evaluate, and use health information through electronic platforms. Evidence on these competencies among middle-aged and older populations in coastal Karnataka remains limited. To assess digital health literacy and factors associated with eHEALS scores among adults aged ≥45 years in Udupi Taluk, coastal Karnataka, India.

Material and Methods: A community-based cross-sectional study was conducted among 385 adults aged ≥45 years recruited purposively outside community clinics in Udupi Taluk during January–February 2025. Digital health literacy was assessed using the eHealth Literacy Scale (eHEALS), and an investigator-developed structured questionnaire captured sociodemographic characteristics, morbidity, digital access, technology use, online health-information practices, and AI-related awareness. Data were analysed using descriptive statistics, group comparisons, and multivariable linear regression.

Results: The mean eHEALS score was 18.9 ± 9.63. Smartphone ownership was reported by 62.6% of participants and 67.0% had internet access at home, whereas only 25.2% reported obtaining information about health conditions online. Among 251 participants who accessed online health information, 63.7% did not verify the information. In multivariable analysis, smartphone ownership (B=7.11; 95% CI:5.35–8.86; p<0.001) and confidence in internet use (B=3.88; 95% CI:1.92–5.84; p<0.001) were independently associated with higher eHEALS scores; frequency of digital-device use and higher educational attainment were also independently associated with eHEALS scores.

Conclusion: Digital health literacy among adults aged ≥45 years in Udupi Taluk was associated with smartphone ownership, internet-use confidence, frequency of digital-device use, and higher educational attainment. Interventions should therefore prioritize practical digital-health skills, confidence, and critical appraisal of online health information rather than access alone.
Keywords
Digital Divide
Health Information Seeking Behavior
India
Middle Aged
Older Adults
Telemedicine

Acknowledgements: The authors would like to express their sincere gratitude to the Department of Community Medicine, Kasturba Medical College and the District Administration, Udupi for their support in approving and facilitating this research project. Additionally, we extend our heartfelt thanks to all the participants who generously contributed their time and insights to make this study possible.


Availability of Data and Materials: The datasets and materials supporting this study are available from the corresponding author upon reasonable request. 


Conflicts of interest: The authors declare that there is no conflict of interest in this article.


Consent for publication: Not applicable. 


Ethics Approval and Consent to Participate: This study received ethical approval from the Ethics Committee of Kasturba Medical College (IEC2–625/2024). The study was conducted in accordance with the principles of the Declaration of Helsinki. Participants completed the questionnaires anonymously and were assured of the confidentiality of their responses.


Funding: This research did not receive any funding from any agencies in the public, commercial, or not-for-profit sectors.


Author contributions: Usha Rani: Conceptualization, Formal Analysis, Project Administration, Resources, Supervision, Validation, Visualization, Writing, Review and Editing. Neha S: Data Curation, Formal Analysis, Investigation, Methodology, Writing, And Original Draft. Panjala Mounika: Methodology, Formal Analysis, Visualization, Results and Formatting the Manuscript.
Artificial Intelligence Disclosure Statement: In the preparation of this manuscript, the authors utilized Claude (Anthropic, San Francisco, CA, USA), a large language model-based artificial intelligence tool (Claude Sonnet 4.6), to assist in refining the language and structure of the manuscript. AI assistance was limited to improving the readability, coherence, and academic presentation of content; all data collection, statistical analysis, interpretation of findings, and intellectual conclusions were performed exclusively by the authors. The authors have thoroughly reviewed, critically evaluated, and revised all AI-assisted content to ensure accuracy, contextual appropriateness, and alignment with the study's findings. The authors take full and sole responsibility for the integrity and accuracy of the entire manuscript, including any content generated with AI assistance. This disclosure is made in accordance with the Committee on Publication Ethics (COPE) position statement on the use of artificial intelligence tools in research and scholarly publishing.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 10 October 2026