Associations between DigComp 2.2-based digital competence and multidimensional health literacy among older adult learners in Shanghai Universities of the Third Age: a cross-sectional study.

BACKGROUND: Digital competence may influence older adults' engagement with health information in increasingly digitalized societies. However, evidence on the association between DigComp 2.2-based digital competence and multidimensional health literacy remains limited. This study examined digital competence levels and its associations with health literacy domains among older adult learners in Shanghai Universities of the Third Age. METHODS: A cross-sectional study was conducted from September to December 2024 in four public Universities of the Third Age in Shanghai, China. A total of 600 learners were recruited using convenience sampling, and 558 valid responses were analyzed. Digital competence was assessed using a 22-item DigComp 2.2-based scale covering five competence areas. Health literacy was measured using the 44-item Health Literacy Questionnaire (HLQ) with nine independent scales. Descriptive analysis, correlation analysis, and multiple linear regression were performed. Digital competence was modeled per 10-point increase. RESULTS: The mean digital competence score was 63.4 (SD = 12.4), with communication and collaboration being the highest and digital content creation the lowest. HLQ scores varied across domains. All DigComp competence areas were positively correlated with HLQ scales (r = 0.285-0.538). Information and data literacy showed stronger correlations with health information-related HLQ domains. After adjustment, higher digital competence was significantly associated with appraisal of health information (B = 0.16, β = 0.284), navigating healthcare systems (B = 0.21, β = 0.312), finding good health information (B = 0.24, β = 0.338), and understanding health information (B = 0.19, β = 0.271; all p < 0.001). CONCLUSION: DigComp 2.2-based digital competence is positively associated with key domains of health literacy among older adult learners in Shanghai, particularly information appraisal, seeking, healthcare navigation, and understanding. Universities of the Third Age may serve as effective settings for integrated digital and health literacy education. Longitudinal and intervention studies are needed to confirm causality.