Assessment of electronic health literacy and its associated factors among internet -using primary health care attendees in Mansoura district, Egypt: a cross-sectional study.

BACKGROUND: People need electronic health literacy (eHealth literacy) to find and assess reliable health information. Little research has been conducted on eHealth literacy in low- and middle-income countries (LMICs) including Egypt compared to developed countries. This study aimed to assess e Health literacy level, its associated factors and explored perceived barriers among internet using primary health care (PHC) attendees. METHODS: A cross-sectional analytical study was carried out among 532 adult internet using PHC attendees selected by systematic random sampling technique. A structured valid Arabic questionnaire was used including data about socio-demographic and internet use characteristics, Arabic ehealth literacy Scale (Ar-eHEALS), and barriers of e Health literacy. Multiple logistic regression analysis was used to detect the significant factors of e Health literacy. RESULTS: The mean age of study participants was 24.6 ± 8.9. The majority of them were females (75%). More than two-thirds (67.3%) of participants experienced adequate e Health literacy, while 32.7% had limited one. Female sex (AOR = 1.8, 95% CI (1.1-3), perceived internet usefulness (AOR = 5.6, 95% CI (2.9-10.7), perceived internet importance (AOR = 5, 95% CI (1.8-13.3), better self -rated health status (AOR = 3.7, 95% CI (1.6-8.9), and having higher general health knowledge (AOR = 2.9, 95% CI (1.4-5.9) were independently associated factors of adequate e Health literacy. Low basic literacy, limited technology skills, lack of health care providers' interaction, and cultural aspects perceived as the most frequently barriers. CONCLUSION: Despite a significant percentage of participants having adequate e Health literacy, there are still considerable barriers perceived among participants. Improving technology skills, empowering person-provider interaction, and providing culturally sensitive electronic health means are vital to enhance e Health literacy and reduce disparities to access a reliable online health content. The non-representative sample limit the generalizability to all PHC attendees.