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eHealth Literacy Assessment Instruments: Scoping Review
To study the current situation of individuals’ e Health literacy levels and design a corresponding intervention to improve their e Health literacy, a systematically conducted e Health literacy assessment is the foundation and prerequisite.
J Med Internet Res 2025;27:e66965
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Interventions focused on family literacy offer a clear example. Family literacy can be defined as the way families use literacy in their homes and communities, including during typical routines [15-17]. Families already engage in a wide range of literacy activities that are present in many health-related routines (eg, reading food labels).
JMIR Pediatr Parent 2025;8:e60764
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The mental health literacy scale consists of 31 questions used to measure the mental health literacy of individuals [35]. The first 15 items were measured using a 4-point scale from 0 to 3, with 0 indicating “very unlikely” or “very unhelpful” and 3 referring to “very likely” or “very helpful.” The rest of the questions were scored on a 5-point scale from 0 to 4, with 0 indicating “strongly disagree” and 4 indicating “strongly agree.”
JMIR Hum Factors 2025;12:e60628
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The American Medical Association (AMA) recommends a maximum fifth-grade reading level for health literacy materials directed toward Medicaid enrollees [21].
Additionally, we assessed the performance of less commonly used consumer chatbots, such as Google Bard, Bing AI, and Claude AI, which have not been as rigorously assessed as those of Chat GPT.
J Med Internet Res 2024;26:e60291
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Digital Health Readiness: Making Digital Health Care More Inclusive
Initial assessments of digital health literacy in the mid-2000s focused on the ability to use the internet, but they have since expanded to encompass smartphones, mobile apps, and social media [12,13]. As a construct, digital health literacy has also grown to reflect multiple domains of health technology use, including personal aspects like prior experiences, digital self-efficacy, motivation to use digital health, and access to technology [14].
JMIR Mhealth Uhealth 2024;12:e58035
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“Digital readiness” encompasses digital access, use, literacy, and the competency to engage with digital health services [7]. It emerges as a pertinent metric to assess disparities in digital health service use [7].
Existing digital health literacy scales have primarily focused on specific aspects. For instance, the Digital Health Literacy Instrument evaluates internet usage skills related to health on the web and computers but does not consider aspects related to mobile usage [6].
J Med Internet Res 2024;26:e58497
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Social media literacy programs aimed at improving body image–related outcomes should be implemented not only in the context of ED prevention but also in rehabilitation [3]. According to Fitzsimmons-Craft et al [10], only 20% of therapists have asked patients with ED about the perceived impact of social media on their body image experiences.
J Med Internet Res 2024;26:e53334
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Poor health literacy affects negative health outcomes as well as reduced satisfaction with health care services [15]. Recently, in the digital era, the concept of e Health literacy, also known as digital health literacy, has emerged to assess individuals’ competence in using the Internet to navigate health care resources and access health information [16].
JMIR Form Res 2024;8:e48783
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However, if only a limited number of people participate in or use the e Health tools, the goal of universalization for these tools is compromised; accordingly, it is important to assess users’ capability and literacy level to provide them with appropriate e Health tools to enhance their health literacy.
Norman and Skinner [15] introduced the e Health Literacy Lily Model (Figure 1), which consists of 2 categories, analytic and context-specific.
J Med Internet Res 2024;26:e47017
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In a systematic review evaluating the association between health literacy, digital health literacy, and physical health outcomes [12], digital health literacy was found to be associated with perceived and reported better communication with health care providers, health-promoting behaviors, and self-management of health needs [13,14]. As for mental health, Lincoln et al [15] found that low health literacy was associated with negative mental health outcomes such as depressive symptoms.
JMIR Form Res 2024;8:e43770
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