Digital health usage patterns and digital health literacy: a deep dive onto the Portuguese reality through a cross-sectional study

Digital health usage patterns and digital health literacy: a deep dive onto the Portuguese reality through a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Digital health usage patterns and digital health literacy: a deep dive onto the Portuguese reality through a cross-sectional study Marta Estrela, Fátima Roque, Pedro Lopes Ferreira, Maria Teresa Herdeiro This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7028650/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose With the increasingly widespread use of digital health tools and services, ensuring equitable access while making sure that citizens have the needed skillset to navigate the digital health world is essential. This study aimed to explore the digital health literacy (DHL) levels of the Portuguese population, more specifically those who already report using digital health tools, while assessing whether sociodemographic characteristics have an influence on DHL levels. Methods A questionnaire containing sociodemographic questions and two DHL scales (HL-19-DIGI and TeHLI) was applied through a cross-sectional study. Multiple beta regression models were applied to assess the influence of sociodemographic characteristics on DHL. Results 1047 people participated in this study. Digital health usage varied considerably among respondents, with websites and social media being the most used platforms. In terms of DHL, almost half of the respondents reported excellent HL-19-DIGI scores. However, there were differences between TeHLI’s functional, communicative, critical, and translational dimensions. Multiple beta regression models revealed that DHL levels consistently decrease as age increases, and that frequently using digital health tools and services is associated with higher DHL scores. In some cases, educational attainment level, residence area, and income, also revealed influences in DHL levels. Conclusions Our study provides an assessment of DHL within the Portuguese adult population who engage with digital health, identifying several factors hindering or facilitating effective digital health use. As we recognize these factors may exist alone or in combination with several other factors, our results reinforce the need for evidence-based and citizen-centered interventions. Digital health Portugal Cross-sectional Digital health literacy Full Text Additional Declarations No competing interests reported. Supplementary Files S1STROBEcrosssectionalchecklist.docx S2modelsummariesandassumptions.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7028650","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":482051878,"identity":"42c1d4e1-5875-4649-ac8c-066b35c52eeb","order_by":0,"name":"Marta 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literacy","lastPublishedDoi":"10.21203/rs.3.rs-7028650/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7028650/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e\u003cp\u003eWith the increasingly widespread use of digital health tools and services, ensuring equitable access while making sure that citizens have the needed skillset to navigate the digital health world is essential. This study aimed to explore the digital health literacy (DHL) levels of the Portuguese population, more specifically those who already report using digital health tools, while assessing whether sociodemographic characteristics have an influence on DHL levels.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA questionnaire containing sociodemographic questions and two DHL scales (HL-19-DIGI and TeHLI) was applied through a cross-sectional study. Multiple beta regression models were applied to assess the influence of sociodemographic characteristics on DHL.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003e1047 people participated in this study. Digital health usage varied considerably among respondents, with websites and social media being the most used platforms. In terms of DHL, almost half of the respondents reported excellent HL-19-DIGI scores. However, there were differences between TeHLI\u0026rsquo;s functional, communicative, critical, and translational dimensions. Multiple beta regression models revealed that DHL levels consistently decrease as age increases, and that frequently using digital health tools and services is associated with higher DHL scores. In some cases, educational attainment level, residence area, and income, also revealed influences in DHL levels.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eOur study provides an assessment of DHL within the Portuguese adult population who engage with digital health, identifying several factors hindering or facilitating effective digital health use. As we recognize these factors may exist alone or in combination with several other factors, our results reinforce the need for evidence-based and citizen-centered interventions.\u003c/p\u003e","manuscriptTitle":"Digital health usage patterns and digital health literacy: a deep dive onto the Portuguese reality through a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-10 12:13:15","doi":"10.21203/rs.3.rs-7028650/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"02a86ca6-dc32-46f4-a0f6-ae0d469dba02","owner":[],"postedDate":"July 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-10T14:53:49+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-10 12:13:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7028650","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7028650","identity":"rs-7028650","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}