Effectiveness of Self-Efficacy-Based Interventions to Improve eHealth Literacy Among Community-Dwelling Older Adults:...

eHealth literacy is essential for enabling older adults to access, evaluate, and use digital health information effectively. Self-efficacy, defined as confidence in one's ability to perform specific behaviors, is a key determinant of sustained health behavior change and has been widely applied in health education interventions. However, the effectiveness of self-efficacy-based interventions in improving eHealth literacy among community-dwelling older adults has not been systematically evaluated using high-quality evidence.

This systematic review aims to evaluate whether self-efficacy-based interventions aimed at improving eHealth literacy among community-dwelling older adults are effective in improving health-related outcomes, such as eHealth literacy and self-efficacy.

Following PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines, this review will include randomized controlled trials and cluster randomized controlled trials targeting community-dwelling adults aged ≥50 years, in which self-efficacy serves as the core theoretical framework. MEDLINE, the Cochrane Library, Embase, CINAHL, ClinicalTrials.gov, and International Clinical Trials Registry Platform will be searched without language or publication year limits. The primary outcome will be improvement in eHealth literacy measured using validated instruments such as the eHealth Literacy Scale, the eHealth Literacy Questionnaire, and the Digital Health Literacy Instrument. Secondary outcomes include self-efficacy, health behaviors, quality of life, and frailty. Two reviewers will independently and in duplicate screen studies, extract data, and assess risk of bias using the Cochrane Risk of Bias 2 tool. Where feasible, a meta-analysis using standardized mean differences will be conducted.

The review was registered in PROSPERO on September 7, 2025 (CRD420251139882). Literature screening, data extraction, and analysis are scheduled to be conducted between September 2025 and September 2026. The results will be synthesized using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and presented in summary of findings tables.

This review will clarify the effectiveness of self-efficacy-based interventions in enhancing eHealth literacy among older adults, thereby supporting the development of evidence-informed digital health education for this population.