Addressing and evaluating health literacy in mHealth: a scoping review

Area of Science:

• Digital Health
• Health Communication
• Human-Computer Interaction

Background:

• Low health literacy affects a significant portion of the adult population, leading to adverse health outcomes.
• Mobile health (mHealth) offers vast information but poses challenges for users with varying literacy levels.
• Health literacy is a complex, multi-faceted concept influenced by individual and societal factors.

Purpose of the Study:

• To explore how health literacy is currently addressed in the development of mHealth applications.
• To identify methods used for evaluating health literacy within mHealth app design and modification.

Main Methods:

• A scoping review of 5 peer-reviewed databases was conducted.
• Articles focused on general, digital, or mHealth literacy and its incorporation into app development.
• The U.S. government's "Health Literacy Online" (HLO) guide served as a framework for analysis.

Main Results:

• Thirty-two articles were reviewed, with most addressing specific HLO categories but none covering all.
• Engagement and testing of mHealth content were the most frequently addressed aspects of health literacy.
• While some studies used formal assessment tools, most evaluations were end-user focused and lacked comprehensive assessment for diverse literacy needs.

Conclusions:

• Consistent recommendations can inform the development of mHealth health literacy evaluation tools.
• Efforts to reduce mHealth barriers for individuals with literacy deficits are evident but require more pragmatic evaluation.
• Future mHealth literacy tool development must prioritize end-user engagement in design and testing.