Older Adults’ Electronic Health Literacy: Insights from a Cross-sectional Research among Iranian Population

Abstract

Background and Aim: Digital technology has profoundly transformed way of life, making the ability to access and understand information through modern technologies increasingly important—especially for older adults. This study aims to assess e-Health Literacy among Iranian older adults in 2025. Materials and Methods: This cross-sectional study was conducted between 2024 and 2025 among 420 older adults attending comprehensive health service centers affiliated with Shahid Beheshti University of Medical Sciences in Tehran. Participants were enrolled using a multi-stage random sampling method. Inclusion criteria were age ≥ 60 years, Iranian nationality, literacy and ability to complete the questionnaire, willingness to participate, having a household file in the covered health centers, and absence of cognitive impairment at the time of the study. Older adults with incomplete questionnaire responses were excluded. Data were collected using the standardized e-Health Literacy Scale (eHEALS), with scores ranging from 8 to 40. Statistical analyses were performed using independent t-tests and ANOVA in SPSS version 16. Findings: The mean e-Health Literacy score was 17.88 ± 7.60, which was below the acceptable level. Higher e-Health Literacy was observed among younger older adults aged 60–64 years, those who were married, employed, and had higher educational attainment (P < 0.001). In addition, better economic status, daily Internet use, and higher skills in using digital devices were significantly associated with higher e-Health Literacy levels (P < 0.001). Although men showed a higher mean score than women, no statistically significant association was found between gender and e-Health Literacy (P = 0.270). Conclusion: The level of e-Health Literacy among older adults was below average and unacceptable, representing an unfavorable status for this vulnerable and growing group. This attempt, by providing valuable data, can be a suitable scientific basis for designing targeted interventions to promote e-Health Literacy in older adults.

Keywords: Electronic health literacy, Digital health, Health literacy, Older Adults