Association between digital health literacy and physical activity levels among individuals with and without long-term health conditions: Data from a cross-sectional survey of 19,231 individuals

Graziella Zangger; Sofie Rath Mortensen; Lars Herman Tang; Lau Caspar Thygesen; Søren T Skou

doi:10.1177/20552076241233158

Association between digital health literacy and physical activity levels among individuals with and without long-term health conditions: Data from a cross-sectional survey of 19,231 individuals

Digit Health. 2024 Feb 25:10:20552076241233158. doi: 10.1177/20552076241233158. eCollection 2024 Jan-Dec.

Authors

Graziella Zangger^{1

2}, Sofie Rath Mortensen^{1

3}, Lars Herman Tang^{1

4}, Lau Caspar Thygesen⁵, Søren T Skou^{1

2}

Affiliations

¹ The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark.
² Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
³ Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁴ Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
⁵ National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.

Abstract

Objectives: This study explored associations between digital health literacy and physical activity levels and assessed potential interactions of long-term health conditions.

Methods: A cross-sectional survey was sent to 34,000 inhabitants in Region Zealand, Denmark. The survey included items on physical activity levels and three electronic Health Literacy Questionnaire (eHLQ) scales (1, 4, and 5). Associations were assessed by logistic regression and adjusted for confounders.

Results: A total of 19,231 participated in the survey. Positive associations were found between higher digital health literacy and being active >30 min./week at moderate-to-vigorous intensity (eHLQ 1: OR 1.24, p < 0.001; eHLQ 4: OR 1.13, p = 0.012; eHLQ 5: OR 1.25, p < 0.001), compliance with the World Health Organization minimum recommendations for physical activity (eHLQ 1: OR 1.33 p < 0.001; eHLQ 4: OR 1.08 p = 0.025; eHLQ 5: OR 1.32, p < 0.001), and self-reported physical active (eHLQ 1: OR 1.50 p < 0.001; eHLQ 4: OR 1.24 p < 0.001; eHLQ 5: OR 1.54 p < 0.001), even when fully adjusted for covariates. No significant interaction was found for long-term health conditions. However, individuals with more long-term health conditions exhibited the lowest digital health literacy scores (9% to 19% scored <2.0).

Conclusion: A higher digital health literacy is positively associated with higher physical activity levels. This highlights the importance of screening and promoting digital health literacy in managing digital health and digital physical activity interventions. Future research should explore strategies and targeted interventions to enhance digital health literacy and improve health outcomes.

Keywords: Digital health literacy; chronic conditions; cross-sectional; health survey; long-term health conditions; physical activity.