Electronic Health Literacy among Linguistically Diverse Patients in the Los Angeles County Safety Net Health System

Abstract

Background: Electronic health (eHealth) literacy may affect telehealth uptake, yet few studies have evaluated eHealth literacy in underserved populations.Objective: The objective of this study was to describe technology access and use patterns as well as eHealth literacy levels among English-speaking and LEP patients in a Los Angeles safety net health system.Methods: Patients, aged ≥18 years with a diagnosis of diabetes mellitus and/or hyper­tension, and their caregivers were recruited from three primary care safety-net clinics in Los Angeles County (California) between June – July 2017. Participants’ electronic health literacy was assessed by the eHealth Literacy Scale (eHEALS); participants were also asked about technology access and use. We examined these measures in English-speaking and limited English proficient (LEP) Spanish-speaking patients.Results: A total of 71 participants (62 pa­tients and 9 caregivers) completed the ques­tionnaire. The mean age of the respondents was 56 years old. More than half of partici­pants used a phone that could connect to the Internet (67%). The mean score for 10 eHEALS items was in the moderate range (26/50 points). There was no difference in mean eHEALS between language groups. However, 47% of Spanish-speaking partici­pants “agreed/strongly agreed” that they knew how to use the Internet to answer their health questions, compared to 68% of English-speaking participants (P<.05).Conclusions: In this sample of patients from a diverse safety net population, perceived skills and confidence in engaging with electronic health systems were low, particularly among LEP Spanish-speakers, despite moderate levels of electronic health literacy. More studies are needed among diverse patient populations to better assess eHealth literacy and patients’ digital readi­ness, and to examine how these patient metrics directly impact telehealth utilization.Ethn Dis. 2022;32(1):21-30; doi:10.18865/ed.32.1.21

Lessons learned from a multi-site collaborative working toward a digital health use screening tool

“…Like other social drivers of health, digital inclusion intersects with educational opportunities, employment, social connection, information networks, and housing ( 14 , 15 ). Although healthcare systems are expanding initiatives to address social needs ( 16 ), significant gaps remain in specifically addressing digital inclusion, especially among those populations that are at greatest risk of facing barriers ( 11 , 12 , 14 , 17 – 19 ). A large challenge to screening is the limited formative research and lack of validated, evidence-based screening tools evaluated in diverse populations.…”

The Los Angeles County Department of Health Services Health Technology Navigators: A novel health workforce to digitally empower patient communities in safety net systems

“…Such work revealed the need for dedicated patient guidance and navigation on digital health. 8 – 10 For example, we realized that front-line staff needed to pitch the importance of the technology and how digital tools would improve the quality of life for patients’ family and home network. We also recognized the need for safety nets to build patients’ digital literacy and confidence to use the technology—it was not enough to equip patients with Internet-connected devices.…”