Development of a Digital Health Literacy Assessment Framework for Older Adults: Delphi-Based Study.

Area of Science:

• Gerontology
• Digital Health
• Health Literacy

Background:

• Older adults face significant barriers to digital health literacy (DHL), limiting their access to eHealth services.
• A contextually relevant assessment tool is needed to understand and address these barriers.

Purpose of the Study:

• To develop a theoretically grounded and content-valid assessment framework for DHL among older adults in China.
• To establish a foundation for measuring DHL and informing targeted interventions.

Main Methods:

• A multiphase, theory-informed approach combining literature review, qualitative focus groups, and Delphi consultations.
• Development of a dual-pathway framework based on expert consensus and validated through a pilot cross-sectional survey.

Main Results:

• The "individual competency-environmental support" framework includes 6 domains and 27 indicators.
• The framework demonstrated excellent internal consistency (Cronbach α 0.913-0.987) and strong criterion validity (r=0.891).
• The framework successfully differentiated DHL levels based on educational attainment.

Conclusions:

• A validated framework for assessing DHL in older adults was developed.
• This tool can guide needs assessments, intervention design, and evaluation of digital inclusion initiatives.
• Further validation is recommended to enhance generalizability and practical application.