JMIR Hum Factors. 2026 Feb 23;13:e75496. doi: 10.2196/75496.
ABSTRACT
BACKGROUND: Digital health tools are increasingly prevalent in postoperative care management, yet limited research exists on digital health literacy and tool adoption among safety-net hospital populations. Understanding these factors is crucial for developing effective digital health solutions for historically underserved communities.
OBJECTIVE: This study aimed to evaluate digital health literacy, assess technology adoption readiness, and examine the relationship between patient-reported capabilities and demographic factors in a postoperative care context at a safety-net hospital.
METHODS: We conducted a mixed methods study with 71 postoperative patients and 29 health care providers at a safety-net hospital. Participants completed a modified eHealth Literacy Scale (eHEALS) assessment and a demographic questionnaire, followed by usability testing of PocketDoc, a digital health prototype. The modified 7-item eHEALS demonstrated adequate internal consistency (Cronbach α=0.77). Qualitative data from think-aloud protocols during usability testing were collected for future analysis. This study focused on quantitative assessments of digital health literacy (using the modified eHEALS on a 5-point Likert scale) and technology adoption readiness (via usability metrics on a 10-point Likert scale) analyzed using nonparametric statistical tests. Correlations between demographic factors and digital health literacy were examined using Spearman rank-order correlation.
RESULTS: Despite common assumptions about technology barriers in safety-net populations, 69% (49/71) of patients reported high confidence (score of ≥3 on a 5-point scale) in finding health resources online, and 61% (43/71) expressed confidence in using the internet for health-related questions. However, only 49% (35/71) felt confident in using digital resources for health decision-making. Digital health literacy scores did not correlate with age or educational level, although 79% (56/71) of patients reported ≥10 years of digital device experience. Both patients and health care providers rated PocketDoc highly for ease of use (median 10, IQR 8-10) and task intuitiveness (median 10, IQR 8-10). Patients’ confidence in finding and using health resources online positively correlated with interface satisfaction (ρ=0.262-0.304 and ρ=0.010-0.027, respectively).
CONCLUSIONS: Our exploratory findings from 100 participants suggest that digital health tools may be more feasible in safety-net settings than previously considered, although the sample size and single-site design limit generalizability. However, the gap between patients’ ability to find health resources (49/71, 69% confident) and their confidence in using these resources for health decision-making (35/71, 49% confident) highlights the need for targeted support in translating digital capabilities to health management skills.
PMID:41730170 | DOI:10.2196/75496
