Digital Health Literacy Among Elderly Dayak in Southern Sarawak: A Cross-sectional Study
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Abstract
Digital health literacy (DHL) is often perceived as low among the elderly, yet the specific status among Sarawak's elderly Dayak remains uncertain. Investigating DHL levels in the digital era has the potential to yield significant benefits for improving their health. Materials and methods: A cross-sectional study was conducted from March to June 2023 via an interviewer-assisted survey. The study employed a multistage sampling approach to recruit elderly Dayak individuals from Kuching, Samarahan, and Serian. The data were analysed using the Statistical Package for Social Sciences (SPSS) version 27. Results: A total of 275 elderly Dayak individuals were selected, with an average age of 68.0 (SD 6.61) years, ranging from 60 to 92 years. The mean digital health literacy score was 23.36 (SD 9.79). Factors significantly associated with high DHL levels were self-reported disability (AOR 24.54, 95% CI 4.06, 148.33), staying nearer to health facilities (AOR 2.83, 95% CI 1.21, 6.62), increased daily Internet usage time (AOR 1.62, 95% CI 1.19, 2.23), and perceived ease of using the Internet (AOR 3.92, 95% CI 1.16, 13.20). On the other hand, a moderate to higher frequency of receiving passive guidance from family members (AOR 0.09, 95% CI 0.01, 0.80) and self-reported difficulties preventing device usage (AOR 0.63, 95% CI 0.49, 0.80) were associated with low DHL. Conclusion: This study highlights the prevalence of digital device usage and internet engagement among the participants, with a substantial proportion demonstrating low DHL.
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Ministry of Women Family and Community Development. Guidelines for the implementation of the national elderly policy. Ministry of Women, Family and Community Development; 2011. Available from: https://www.kpwkm.gov.my/kpwkm/uploads/files/Dokumen/Dasar/Dasar%20Warga%20Emas_2011.pdf
Current population estimates, Malaysia, 2022 [press release]. Malaysia: Department of Statistic,s Malaysia, 29 July 2022 2022. Available from: https://www.dosm.gov.my/v1/index.php?r =column/pdfPrev&id =dTZXan V6UUdyUEQ0SH NWOVhpS XNMUT09.
World Health Organization. Ageing and health: World Health Organization; 2022 [updated 1 October 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.
Institute for Public Health. National health and morbidity survey 2018: Elderly health. In: National Institutes of Health (NIH), editor. Elderly Health Findings: Ministry of Health Malaysia; 2019. Available from: https://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2018/NHMS2018ElderlyHealthVolume2.pdf
Institute for Health Systems Research. National health and morbidity survey (NHMS) 2019. Malaysia: Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia; 2020. Available from: https://iku.gov.my/images/IKU/Document/REPORT/NHMS2019/Report_NHMS2019-HCD-eBook_p.pdf
Yunus N, Manaf NH, Omar A, Juhdi N, Omar MA, Salleh M. Determinants of healthcare utilisation among the elderly in Malaysia. Institutions and Economies. 2017;9:117-42. Available from: http://irep.iium.edu.my/48914/1/ELDERLY_KOREA.pdf
Shah SA, Safian N, Ahmad S, Nurumal SR, Mohammad Z, Mansor J, et al. Unmet healthcare needs among elderly malaysians. Journal of multidisciplinary healthcare. 2021;Volume 14:2931-40. doi: 10.2147/jmdh.s326209.
Senbekov M, Saliev T, Bukeyeva Z, Almabayeva A, Zhanaliyeva M, Aitenova N, et al. The recent progress and applications of digital technologies in healthcare: A review. International Journal of Telemedicine and Applications. 2020;2020:1-18. doi: 10.1155/2020/8830200.
Nielsen P, Sahay S. A critical review of the role of technology and context in digital health research. Digital health. 2022;8:205520762211095. doi: 10.1177/20552076221109554.
Choi NG, Dinitto DM. The digital divide among low-income homebound older adults: Internet use patterns, ehealth literacy, and attitudes toward computer/internet use. Journal of Medical Internet Research. 2013;15(5):e93. doi: 10.2196/jmir.2645.
Vassilakopoulou P, Hustad E. Bridging digital divides: A literature review and research agenda for information systems research. Information Systems Frontiers. 2021. doi: 10.1007/s10796-020-10096-3.
Norman CD, Skinner HA. eHealth literacy: Essential skills for consumer health in a networked world. Journal of Medical Internet Research. 2006;8(2):e9. doi: 10.2196/jmir.8.2.e9.
Malaysian Communications and Multimedia Commission. Internet users survey 2020. 2020, https://www.mcmc.gov.my/skmmgovmy/media/General/pdf/IUS-2020-Report.pdf
Normawati A, Abu Bakar R, Noorlaile J, Kamarul Zaman S, Siti Nur Farhana H, Manimaran K, et al. Usage of internet for health information seeking among elderly in Malaysia. EPRA International Journal of Multidisciplinary Research (IJMR). 2020:187-93. doi: 10.36713/epra4422.
Levy H, Janke AT, Langa KM. Health literacy and the digital divide among older americans. Journal of General Internal Medicine. 2015;30(3):284-9. doi: 10.1007/s11606-014-3069-5.
Hong YA, Zhou Z, Fang Y, Shi L. The digital divide and health disparities in china: Evidence from a national survey and policy implications. Journal of Medical Internet Research. 2017;19(9):e317. doi: 10.2196/jmir.7786.
Arcury TA, Sandberg JC, Melius KP, Quandt SA, Leng X, Latulipe C, et al. Older adult internet use and ehealth literacy. Journal of Applied Gerontology. 2020;39(2):141-50. doi: 10.1177/0733464818807468.
Choi EY, Kim Y, Chipalo E, Lee HY. Does perceived ageism widen the digital divide? And does it vary by gender? The Gerontologist. 2020;60(7):1213-23. doi: 10.1093/geront/gnaa066.
Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly. 1989;13(3):319. DOI: 10.2307/249008.
Arcury TA, Quandt SA, Sandberg JC, Miller Jr DP, Latulipe C, Leng X, et al. Patient portal utilization among ethnically diverse low income older adults: Observational study. JMIR Medical Informatics. 2017;5(4):e47. doi: 10.2196/medinform.8026.
Lawton MP. Behavior-relevant ecological factors. K. Warner Schaie, Schooler C, editors. Hilldale, New Jersey: Lawrence Erlbaum Associates; 1989. doi: 10.4324/9780203771228. Available from: https://dx.doi.org/10.4324/9780203771228.
Wong SS, Lim HM, Chin AJZ, Chang FWS, Yip KC, Teo CH, et al. eHealth literacy of patients attending a primary care clinic in Malaysia and its associated factors: A cross-sectional study. DIGITAL HEALTH. 2022;8:20552076221135392. doi: 10.1177/20552076221135392.
Norman CD, Skinner HA. eHEALS: The eHealth literacy scale. Journal of Medical Internet Research. 2006;8(4):e27. doi: 10.2196/jmir.8.4.e27.
Tennant B, Stellefson M, Dodd V, Chaney B, Chaney D, Paige S, et al. eHealth literacy and web 2.0 health information seeking behaviors among baby boomers and older adults. Journal of Medical Internet Research. 2015;17(3):e70. doi: 10.2196/jmir.3992.
Paige SR, Miller MD, Krieger JL, Stellefson M, Cheong J. Electronic health literacy across the lifespan: Measurement invariance study. Journal of Medical Internet Research. 2018;20(7):e10434. doi: 10.2196/10434.
Edwards M, Wood F, Davies M, Edwards A. The development of health literacy in patients with a long-term health condition: the health literacy pathway model. BMC Public Health. 2012;12(1):130. doi: 10.1186/1471-2458-12-130.
Ahmad NA, Mohamad Kasim N, Mahmud NA, Mohd Yusof Y, Othman S, Chan YY, et al. Prevalence and determinants of disability among adults in Malaysia: results from the National Health and Morbidity Survey (NHMS) 2015. BMC Public Health. 2017;17(1). doi: 10.1186/s12889-017-4793-7.
Berkowsky RW. Exploring Predictors of eHealth Literacy Among Older Adults: Findings From the 2020 CALSPEAKS Survey. Gerontology and Geriatric Medicine. 2021;7:233372142110642. doi: 10.1177/23337214211064227.
Liu S, Zhao H, Fu J, Kong D, Zhong Z, Hong Y, et al. Current status and influencing factors of digital health literacy among community-dwelling older adults in Southwest China: a cross-sectional study. BMC Public Health. 2022;22(1). doi: 10.1186/s12889-022-13378-4.
Dunn P, Hazzard E. Technology approaches to digital health literacy. International Journal of Cardiology. 2019;293:294-6. doi: https://doi.org/10.1016/j.ijcard.2019.06.039.