Navigating the digital divide: A systematic review of eHealth literacy in underserved populations in the United States

Abstract

eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria. Thirty-five of these studies were excluded due to international origin. Of the articles meeting the inclusion criteria, underserved populations assessed included immigrant women, the elderly, low-income, the un- and underemployed, and African-American and Hispanic populations. eHealth literacy assessments utilized included one or two item screeners, the eHEALS scale, health information competence and cognitive task analysis. Factors examined in relation to eHealth literacy included age, experience, overall health literacy, education, income and culture. The majority did not assess the impact of locality and those that did were predominately urban. These data suggest that there is a gap in the literature regarding eHealth literacy knowledge for underserved populations, and specifically those in rural locations, within the U.S.

• Access to healthcare
• eHealth literacy
• rural populations
• systematic review
• underserved populations

ACKNOWLEDGEMENTS

The authors would like to acknowledge and thank Kida Toy and Kyle Smothers for their assistance in this study. In addition, we would like to thank the faculty and staff from the University of Kansas School of Medicine, Wichita, Department of Family and Community Medicine for their collaborative support.

AUTHORS NOTE

Anne Burke is now at the Bureau of Epidemiology, Utah Department of Health. Jared Reyes is now at the Department of Communication Sciences and Disorders, Wichita State University.

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.