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Cited by 94Health Literacy and Information AccessibilityTechnology Use by Older AdultsHealth, Technology, Consumer Behavior

Digitization and Health in Germany: Cross-sectional Nationwide Survey

Open access
De Santis, Karina Karolina, Jahnel, Tina, Sina, Elida, Wienert, Julian, Zeeb, Hajo·2021·JMIR Public Health and Surveillance
DOI 10.2196/32951PMC PMC8612128

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Abstract

Background: Digital technologies are shaping medicine and public health. Objective: The aim of this study was to investigate the attitudes toward and the use of digital technologies for health-related purposes using a nationwide survey. Methods: We performed a cross-sectional study using a panel sample of internet users selected from the general population living in Germany. Responses to a survey with 28 items were collected using computer-assisted telephone interviews conducted in October 2020. The items were divided into four topics: (1) general attitudes toward digitization, (2) COVID-19 pandemic, (3) physical activity, and (4) perceived digital health (eHealth) literacy measured with the eHealth Literacy Scale (eHEALS; sum score of 8=lowest to 40=highest perceived eHealth literacy). The data were analyzed in IBM-SPSS24 using relative frequencies. Three univariate multiple regression analyses (linear or binary logistic) were performed to investigate the associations among the sociodemographic factors (age, gender, education, and household income) and digital technology use. Results: The participants included 1014 internet users (n=528, 52.07% women) aged 14 to 93 years (mean 54, SD 17). Among all participants, 66.47% (674/1014) completed up to tertiary (primary and secondary) education and 45.07% (457/1017) reported a household income of up to 3500 Euro/month (1 Euro=US $1.18). Over half (579/1014, 57.10%) reported having used digital technologies for health-related purposes. The majority (898/1014, 88.56%) noted that digitization will be important for therapy and health care, in the future. Only 25.64% (260/1014) reported interest in smartphone apps for health promotion/prevention and 42.70% (433/1014) downloaded the COVID-19 contact-tracing app. Although 52.47% (532/1014) reported that they come across inaccurate digital information on the COVID-19 pandemic, 78.01% (791/1014) were confident in their ability to recognize such inaccurate information. Among those who use digital technologies for moderate physical activity (n=220), 187 (85.0%) found such technologies easy to use and 140 (63.6%) reported using them regularly (at least once a week). Although the perceived eHealth literacy was high (eHEALS mean score 31 points, SD 6), less than half (43.10%, 400/928) were confident in using digital information for health decisions. The use of digital technologies for health was associated with higher household income (odds ratio [OR] 1.28, 95% CI 1.11-1.47). The use of digital technologies for physical activity was associated with younger age (OR 0.95, 95% CI 0.94-0.96) and more education (OR 1.22, 95% CI 1.01-1.46). A higher perceived eHealth literacy score was associated with younger age (β=–.22, P<.001), higher household income (β=.21, P<.001), and more education (β=.14, P<.001). Conclusions: Internet users in Germany expect that digitization will affect preventive and therapeutic health care in the future. The facilitators and barriers associated with the use of digital technologies for health warrant further research. A gap exists between high confidence in the perceived ability to evaluate digital information and low trust in internet-based information on the COVID-19 pandemic and health decisions.

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  1. [29]Okan O de Sombre S Hurrelmann K Berens E Bauer U Schaeffer D COVID-19 based health literacy in the German population Monitor Versorgungsforschung 2020 13 40 45 10.24945/MVF.03.20.1866-0533.2222 · DOI

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Authors
De Santis, K. K., Jahnel, T., Sina, E., Wienert, J., & Zeeb, H.
Affiliations
  • University of Bremen (DE)
  • Leibniz Institute for Prevention Research and Epidemiology - BIPS (DE)
ORCID
Venue
JMIR Public Health and Surveillance
Publisher
JMIR Publications Inc.
Published
2021-11-22
Volume
7
Issue
11
Pages
e32951
ISSN
2369-2960 (ISSN-L)
DOI
10.2196/32951
PMC
PMC8612128
OpenAlex
W3214851048
Cited by
94
References
34
Citations by year
2026: 19 · 2025: 21 · 2024: 30 · 2023: 11 · 2022: 13
FWCI
15.16
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Public Health and Surveillance (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Freie Hansestadt Bremen
  • Leibniz-Gemeinschaft (W4/2018)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Social Sciences › Demography › Technology Use by Older Adults
  • Health Sciences › Health Professions › Health Information Management › Health, Technology, Consumer Behavior
Keywords
digital health technologies, digital health literacy, COVID-19 contact tracing apps, physical activity, digital divide, sociodemographic factors, smartphone use, Germany, internet users, health information seeking, telecare, remote patient monitoring, telemedicine
MeSH terms
COVID-19, SARS-CoV-2, Cross-Sectional Studies, Female, Germany, Humans, Male, Health Literacy, Pandemics

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