Title : Redefining eHealth literacy for the digital age: A scoping review to advance equity, engagement, and behaviour change
Abstract:
Background/Objectives: Digital technologies are now central to health communication, yet outdated definitions of eHealth literacy fail to reflect the behavioural, social, and systemic complexities of digital health engagement. This scoping review aimed to: (1) synthesise how eHealth literacy has evolved over the past two decades, and (2) identify key domains necessary for equitable digital health access and use.
Methods: Guided by the PRISMA-ScR framework, we searched six academic databases and grey literature sources, screening over 8,000 papers and including 118 relevant sources. Data were charted and thematically analysed to identify conceptual trends, measurement approaches, and theoretical underpinnings.
Results: Five core domains emerged as essential to understanding modern eHealth literacy:
1. Knowledge – health information and technology comprehension, as well as health problem identification
2. Skills – cognitive, technical, critical, social, and application skills
3. Perceived Competence – self-efficacy and confidence in digital health use
4. Context – infrastructural, personal, and sociocultural factors
5. Purpose – motivation and meaningful, goal-driven digital engagement
Recent literature increasingly incorporates behavioural science frameworks (e.g., Self-Efficacy Theory, and Social Cognitive Theory), but most existing tools under-assess constructs such as trust, adaptability, and empowermentespecially among marginalised groups.
Conclusions: As digital health continues to advance and public health systems innovate globally, it is important that eHealth literacy be understood as a dynamic, multidimensional concept, not a static set of skills. A redefinition and reconceptualization can help ensure that digital health advances benefit all populations equitably and behaviour change interventions produce long-term change.
Keywords: eHealth literacy, digital health equity, behavioural science, public health innovation, scoping review, self-efficacy, preventive medicine
