Diagnostic Accuracy of eHealth Literacy Measurement Tools in Older Adults: A Systematic Review

Background: The COVID-19 pandemic necessitated the rapid uptake of virtual care. However, little is known about how to measure older adults’ electronic health (eHealth) literacy.MethodsWe completed a systematic review examining the validity of eHealth literacy tools compared to a reference standard or another tool. We searched MEDLINE, EMBASE, CENTRAL/CDSR, PsycINFO and grey literature for articles published from inception until January 13, 2021. We included studies where the mean population age was at least 60 years old. Two reviewers independently completed article screening, data abstraction, and risk of bias assessment using the Quality Assessment for Diagnostic Accuracy Studies-2 tool. We implemented the PROGRESS-Plus framework to describe the reporting of social determinants of health.ResultsWe identified 14940 citations and included two studies. Included studies described three methods for assessing eHealth literacy: computer simulation, eHealth Literacy Scale (eHEALS), and Transactional Model of eHealth Literacy (TMeHL). eHEALS correlated moderately with participants’ computer simulation performance ( r  = 0.34) and TMeHL correlated moderately to highly with eHEALS ( r  = 0.47–0.66). Using the PROGRESS-Plus framework, we identified shortcomings in the reporting of study participants’ social determinants of health, including social capital and time-dependent relationships.ConclusionsWe found two tools that will support clinicians in identifying older adults’ eHealth literacy, however, future research describing how social determinants of health impact the assessment of eHealth literacy would strengthen tool implementation in clinical practice.Protocol registrationOur systematic review of the literature was registered a priori with PROSPERO (CRD42021238365).