Digital health literacy among urban community-dwelling older adults in China: Current status and determinants

Objective To investigate the current status and influencing factors of digital health literacy (DHL) among older adults in China, providing evidence to guide interventions for improving DHL in this population. Methods A cross-sectional survey was conducted in November 2024 in Xuzhou using a multistage stratified cluster sampling method. A total of 1,005 valid questionnaires were collected. The survey included demographic information, the Chinese version of the DHL scale, self-rated health status, and activities of daily living. Random forest modeling and binary logistic regression were employed to identify predictors of DHL. Results A total of 1,005 adults aged 60 years and older were recruited; the mean DHL score was 24.75 ± 11.74. Only 40.6% of the participants ( n = 408) reached the adequate level. High DHL was observed among older adults with smartphone use proficiency ( β = 2.684, p < 0.001), higher educational attainment ( β = 0.890, p = 0.013), and very good self-rated health status ( β = 1.628, p = 0.040). In contrast, low DHL was associated with the absence of daily use of digital health services ( β = −0.996, p < 0.001) and a lack of household Internet access ( β = −2.220, p < 0.001). Conclusions The results revealed that DHL among older adults is relatively low, primarily due to a substantial gap between the rapid expansion of Internet services and limited digital competencies. Targeted interventions, including enhancing household Internet access, implementing age-friendly DHL training, and promoting supportive and inclusive community-based activities, are recommended.