There is sufficient evidence that interventions to improve digital health literacy are associated with positive improvements in social outcomes.
The findings below synthesize the results of the studies on interventions to improve digital health literacy across three domains of measurement:
Digital health literacy is a critical enabler to equitable healthcare access, as the use of digital health technologies, particularly telehealth, becomes integral to healthcare delivery[1]. Digital health technologies encompass a rapidly expanding range of tools, including wearables, electronic health records, telemedicine, mobile applications, and artificial intelligence-supported resources[2]. Poor digital health literacy can contribute to reduced healthcare utilization, delayed care, and quality gaps in healthcare provision[3].
Digital health literacy builds upon digital literacy[4], which is the ability to access, evaluate, and use digital information, while also requiring an understanding of health-specific language and the ability to navigate complex healthcare systems[5]. Consequently, individuals with limited digital literacy face compounded barriers to digital health literacy. According to a 2018 report from the United States Department of Education based on the Program for the International Assessment of Adult Competencies, approximately 31.8 million (16%) working-age adults in the United States (U.S.) lack digital literacy skills[6]. While 11% of White adults are digitally illiterate, the numbers are higher for Black adults (22%) and Hispanic/Latino adults (35%). Foreign-born adults reported a 36% rate of digital illiteracy, compared with 13% among U.S.-born adults. Young people between the ages of 16 and 24 are the least affected, with only 8% considered digitally illiterate, whereas the rate rises to 28% among those aged 55 to 65. While 5% of US adults with an associate’s degree or higher struggle with digital skills, this figure jumps to 41% for those without a high school diploma[7],[8].
Digital health literacy interventions are initiatives designed to improve an individual's ability to find, understand, and use health information from electronic resources and digital health technologies, which impacts their access to healthcare, health behaviors, and health outcomes[9],[10]. Interventions may include computer skills training, instruction on evaluating online health information, and guidance on using telehealth platforms.
These interventions have gained wide support. The American Medical Association adopted policies supporting digital health literacy as part of broader efforts aimed at improving health equity for marginalized populations[11],[12], while Healthy People 2030[13] established national objectives around telehealth access and health information technology use.
For contract year 2024, the Centers for Medicare & Medicaid Services (CMS) required Medicare Advantage organizations to develop and maintain procedures to offer digital health education to enrollees to improve access to medically necessary covered telehealth benefits. CMS emphasized that low digital health literacy, especially among populations experiencing health disparities, impedes telehealth access and worsens care gaps, particularly among older adults[14].
People with diabetes in Italy, Spain, and Sweden.
Nine massive open online courses (MOOCs), courses that are free and enable anyone to enroll—that aimed to improve digital health literacy among people with diabetes. The structure and format of the materials in each MOOC were adapted to the interests of the participants in each country, but all of them were comprised of four compulsory topics referring to subskills of digital health literacy: find, understand, appraise, and apply. In addition to the compulsory units, an introductory unit with an overview of the MOOC and an introduction to digital health literacy were strongly recommended. Units included texts, videos, images and infographics, and links to documents.
Pre-post analysis, descriptive study, and qualitative analysis. N = 86 (for the pre-post analysis of digital health literacy scores). N = 46 (for the descriptive study on acceptability). N = 28 (for the qualitative analysis). N = 149 (in the diabetes community of practice). N = 86 (for the descriptive study on experience during the co-creation process).
Social: The acceptability of the MOOCs was positive. Additionally, there was a significant improvement in digital health literacy in both adults and adolescents after using the MOOCs.
Pregnant and lactating individuals from Spain and Italy.
A massive open online course (MOOC) that aimed to improve digital health literacy (DHL).
Pre-post analysis and qualitative analysis. N = 113 (for the pre-post analysis), N = 17 (for the qualitative analysis) and N = 68 (for the descriptive analysis).
Social: There was a significant improvement in self-perceived DHL after using the MOOCs (p-value < 0.001). The acceptability of MOOCs was positively valued.
Older adults.
A four-week Italian eHealth training program (project ACCESS) comprised of five modules with both didactic and education techniques. As a prerequisite to participating in the study, access to both an internet connection and a computer or tablet were required. Course materials were sent to the participant after each lesson by email. Each training session was conducted virtually and lasted about 90 minutes. The three overall training competencies were: 1) awareness and critical knowledge of health and eHealth literacy; 2) to advance skills in relation to health and eHealth literacy for older adults’ interactions with digital tools; and 3) sustainability of skills developed and application in practice.
Pre-post analysis.
Social: The results showed a statistically significant difference between the eHealth Literacy Scale (eHEALS) mean values before and after the course. A significant negative correlation was found between eHEALS values after the course and both positive and total Survey of Technology Use (SOTU) scores, suggesting that participants who entered the training with less prior technology experience (lower SOTU scores) showed greater improvements in eHealth literacy. There is a strong positive and statistically significant relationship between satisfaction with the training and eHEALS. The results indicate that the intervention improved the participants’ digital competencies related to health.
Learners enrolled in a MOOC on cancer genomics.
A six-week massive open online course (MOOC) on cancer genomics designed to be accessible to a broad spectrum of learners, such as individuals receiving medical care, caregivers, students, and health care professionals.
Pre-post analysis, descriptive study, and qualitative analysis.
Social: The study found a statistically significant increase in the number of references cited by learners in their final written assignments for the course. The average number of references cited in the eighth run of the MOOC was significantly higher than in the first run. Learner comments from the seventh and eighth runs of the course indicated that a poll asking learners to choose the most reliable of four online resources effectively stimulated discussion on how to evaluate resource reliability.
Community leaders in Baltimore, Maryland. Participants were over age 18 (range 45 to >85 years), had served as a community member on a local research advisory council, and did not have regular access to the internet at their home or a digital tool beyond their phone to access the internet.
Implementation of a training course to bridge the digital divide and impart technological knowledge and tools to those at the risk of being excluded from research and community engagement initiatives during the COVID-19 pandemic. Each participant received an Amazon Fire tablet, as well as broadband internet access in their home. The training course first focused on ensuring that participants were comfortable with the basic functions of the tablet, including switching on and charging the tablet, and connecting to the internet. The program introduced free basic services such as Gmail and ensured that participants could open their email accounts as well as documents and calendar invitations sent through email. The second section of the training course focused on ensuring that participants were comfortable using videoconferencing and at least one application (“app”) of their choosing. Afterward, the program conducted one-hour video group meetings to review common areas of difficulty with the use of the tablet.
Descriptive study. N = 20.
Social: Results showed that the program was feasible to implement and worthwhile for participants (15/16, 94%). After the program, the participants perceived an increase in the frequency of technology use (z=2.76, P=.006). Additionally, participants attributed the program’s success to its technology training component but recommended that the program have a slower pace. From this, it was concluded that future programs should consider that populations with low literacy view technology training as a core element to decreasing technology disparity.
Japanese internet users. The sample was 49.8% female with a mean age of 40.2 years.
A 14-day intervention comprised of e-learning content presented to the participants in simple Japanese to facilitate comprehension. The content included text and images on the following topics: (1) reliability of information on the internet, (2) scientific research methods, and (3) cautions regarding health information posted on social networking websites.
Randomized control trial. N = 301, with 148 in the intervention and 153 in the control arm.
Social: There were no large differences at baseline between the intervention and control groups in the eHEALS, Healthy Eating Literacy scale, or skills for evaluating retrieved search results. However, at follow-up, scores on the eHEALS increased by 1.57 points due to the intervention effect. Skills for evaluating retrieved search results improved more in the intervention group than in the control group.
People who are HIV-positive receiving their primary care at one of three places: (i) University of California San Francisco Positive Health Practice at San Francisco General Hospital, (ii) HIV-positive Care Center at University of California San Francisco Medical Center, and (iii) the Tom Waddell Health Center. The study enrolled 18 participants (55.6% female; mean age 46 years; 61% of African descent, 27.8% White).
A 50-minute interactive class on basic computer skills, internet search skills, and eHealth evaluation methods.
Pre-post analysis. N = 18.
Social: Before the intervention, most respondents' assessment of their ability to access internet health information was unfavorable. Post-intervention, the majority of respondents agreed or strongly agreed that they were able to access and identify internet health information resources. The increase in self-assessed skill level was statistically significant for all eight items in eHEALS (P < 0.05). Scores for the three-month follow-up survey remained higher than pre-intervention scores for most items.
Older adults aged 56-91 at the Hyattsville and New Carrollton branch libraries of the Prince George’s County Memorial Library System in Prince George’s County, Maryland.
A theory-driven eHealth literacy intervention for older adults. The intervention involved two weeks of learning about using the National Institutes of Health’s SeniorHealth.gov website to access reliable health information and took place at public libraries.
Randomized control trial. N = 146.
Healthcare Cost, Utilization & Value: Regardless of the specific learning method used, participants had overwhelmingly positive attitudes toward the intervention and reported positive changes in participation in their own health care as a result of the intervention.
Social: Overall, participants’ knowledge, skills, and electronic health literacy efficacy improved significantly from pre- to post-intervention. Collaborative learning did not differ from individualistic learning in affecting the learning outcomes. Group composition based on gender, familiarity with peers, or prior computer experience had no significant main or interaction effect on the learning outcomes.
Consumers accessing health information online.
Interventions for enhancing consumers’ online health literacy (skills to search, evaluate, and use online health information).
Systematic review. Two citations were found to meet the review criteria and included for analysis. Of the two, one citation was a randomized controlled trial (RCT), and one was a controlled before and after study.
Social: The systematic review concluded that due to the small number of included studies and their variable methodological quality, there was low quality evidence that such interventions may improve some outcomes relevant to online health literacy in certain populations. Additionally, the evidence was too weak to draw any conclusions about implications for the design and delivery of interventions for online health literacy.
Vulnerable populations during the COVID-19 pandemic (e.g., older adults or Indigenous people living on reservations).
E-services for supporting digital health literacy.
Scoping review. Five articles were found to meet inclusion criteria and included in the final review.
Social: The reviewed articles included e-services that aimed to increase disease knowledge, digital health literacy and social media usage, help in coping with changes in routines and practices, decrease fear and anxiety, decrease health literacy barriers, and increase technology acceptance in specific groups. Specifically, the review found various facilitators for digital health literacy-enabling e-services for pregnant individuals and their families, as well as for older adults and people with low-income. From this, the review concluded that the literature on the topic is scarce, sparse, and immature. Additionally, there is an urgent need to pursue research on digital health literacy and develop digital platforms to help solve current and future COVID-19-related health needs.
Healthcare consumers. Samples were multicultural and the ages of participants ranged from 11 years to adults aged 65 years and older.
eHealth intervention strategies designed to improve health literacy among consumers in a variety of settings.
Systematic review. 12 articles were found to meet review inclusion criteria and included for analysis.
Social: Compared to control interventions, those 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.
Individuals or populations using digital health interventions.
Digital health literacy interventions. These included training for healthcare providers to improve their communication skills, evidence-based electronic tools for patient decision-making, and health coaching using technology, customized education for rehabilitation, appropriate digital literacy programs for different cultures, and patient-centered interventions for managing chronic conditions like diabetes.
Systematic review. Eight studies were included in the analysis.
Social: The study found that digital health literacy interventions typically result in enhanced health literacy, improved medication adherence, and higher self-confidence, particularly benefiting marginalized communities. Nevertheless, certain studies highlighted limitations in the usefulness and lasting impact of the interventions.
Individuals or populations using digital health interventions.
eHealth literacy interventions.
Systematic review. A total of 35 studies were included in this review.
Health: Clinical outcomes showed significant improvements in most studies. Interventions were associated with reduced liver fat content, perceived stress and depression, and tooth decay in children. Participants demonstrated improved bone health status, patient activation, and average blood glucose levels.
Social: Most eHealth literacy interventions significantly improved participants' perceived eHealth literacy, technology literacy, and health knowledge including disease-specific knowledge. The interventions enhanced health behaviors, self-management, self-care behaviors, and health-promoting lifestyles.
Adults over 50 years of age. Participant age varied considerably across the studies, with the mean participant age ranging from 61 to 84 years. Many studies’ participants (17/23, 74%) were majority female. Of studies reporting race or ethnicity, five studies (22%) reported majority Black participants, four (17%) reported majority White participants, and one reported a Latino/Hispanic majority.
eHealth literacy interventions for older adults.
Systematic review. 23 articles were included in the final review. The studies used a variety of research designs; just under half (11/23; 48%) used designs with pretest and post-test of a single condition, while one study used a quasi-experimental design. RCTs were used in seven studies (30.4%). One study (4.3%) conducted a post-hoc analysis of RCT data, while another (4.3%) was an observational study that used survey questionnaires and in-depth interviews to evaluate participants from the experimental group of an RCT. The last two (9%) were cross-sectional survey studies.
Health: The overall results of the review found that there was a significant gap in the literature for eHealth literacy interventions evaluating health outcomes as the outcome of interest, a lack of theory-based interventions, and few studies with high-quality research design.
[1] Deoli, A. and Zeng, B. (2022, December). Digital Literacy, Telehealth Equity, and Healthcare Access are Interrelated: Here is How. New Jersey State Policy Lab. https://policylab.rutgers.edu/publication/digital-literacy-telehealth-equity-and-healthcare-access-are-interrelated-here-is-how/
[2] Wamala Andersson, S., & Gonzalez, M. P. (2025). Digital health literacy-a key factor in realizing the value of digital transformation in healthcare. Frontiers in digital health, 7, 1461342. https://doi.org/10.3389/fdgth.2025.1461342
[3] Yuen, E., Winter, N., Feby Savira, Huggins, C. E., Nguyen, L., Cooper, P., Peeters, A., Anderson, K., Rahul Bhoyroo, Crowe, S., & Ugalde, A. (2023). Digital health literacy and its association with sociodemographic characteristics, health resource use and health outcomes: A rapid review (Preprint). Interactive Journal of Medical Research, 13. https://doi.org/10.2196/46888
[4] Deoli, A. and Zeng, B. (2022, December). Digital Literacy, Telehealth Equity, and Healthcare Access are Interrelated: Here is How. New Jersey State Policy Lab. https://policylab.rutgers.edu/publication/digital-literacy-telehealth-equity-and-healthcare-access-are-interrelated-here-is-how/
[5] Seidel E., Cortes T., Chong C. Digital Health Literacy. (2023). Digital Health Literacy. Patient Safety Network. https://psnet.ahrq.gov/primer/digital-health-literacy
[6] Mamedova S., Pawlowski E. (2018). National Center for Education Statistics. A description of U.S. adults who are not digitally literate (NCES 2018-161). U.S. Department of Education. https://nces.ed.gov/pubs2018/2018161.pdf
[7] Schwartzbach, K. (2022, July 8). Addressing Digital Literacy and Other Reasons for Non-Adoption of Broadband. Rockefeller Institute of Government. https://rockinst.org/blog/addressing-digital-literacy-and-other-reasons-for-non-adoption-of-broadband/
[8] National Center for Education Statistics. (2018). A description of U.S. adults who are not digitally literate (NCES 2018-161). U.S. Department of Education. https://nces.ed.gov/pubs2018/2018161.pdf
[9] Mukhtar, T., Babur, M. N., Abbas, R., Irshad, A., & Kiran, Q. (2025). Digital Health Literacy: A systematic review of interventions and their influence on healthcare access and sustainable development Goal-3 (SDG-3). Pakistan journal of medical sciences, 41(3), 910–918. https://doi.org/10.12669/pjms.41.3.10639
[10] Qiu, C. S., Tetiana Lunova, Greenfield, G., Kerr, G., Ömrüm Ergüven, Beaney, T., Hayhoe, B., Mayer, E., Majeed, A., & Neves, A. L. (2025). Determinants of digital health literacy: An international cross-sectional study (Preprint). Journal of Medical Internet Research, 27, e66631–e66631. https://doi.org/10.2196/66631
[11] American Medical Association. (2023). Addressing equity in telehealth and health technology (H-480.937). Retrieved from https://policysearch.ama-assn.org/policyfinder/detail/telehealth?uri=%2FAMADoc%2FHOD.xml-H-480.937.xml
[12] American Medical Association. (2023). Health literacy (H-160.931). Retrieved from https://policysearch.ama-assn.org/policyfinder/detail/health%20literacy?uri=%2FAMADoc%2FHOD.xml-0-746.xml
[13] Office of Disease Prevention and Health Promotion. (n.d.). Health literacy - Healthy People 2030. U.S. Department of Health and Human Services. Retrieved September 24, 2025, from https://odphp.health.gov/healthypeople/priority-areas/health-literacy-healthy-people-2030
[14] Centers for Medicare & Medicaid Services. 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F) | CMS. (2023, April 5). Www.cms.gov. https://www.cms.gov/newsroom/fact-sheets/2024-medicare-advantage-and-part-d-final-rule-cms-4201-f
