An exploratory study of Facilitators and Barriers Among Ageing and Elderly Population of Udupi District on Digital Health literacy

Aim:

•       To access and understand the facilitators and barriers to digital health literacy among the ageing and elderly population of Udupi district, Karnataka.

Objectives:

•       To identify the facilitators contributing to digital health literacy among the ageing and elderly in Udupi district

•       To analyze the barriers hindering digital health literacy among the ageing and elderly population of Udupi district.

•       To develop and provide a digital health literacy info graphics

Justification for study (whether of national significance with rationale) :

•       Understanding facilitators is crucial for developingtargeted interventions that leverage existing strengths and resources, thereby effectively enhancing digital health literacy among the elderly. These facilitators can include community support, family assistance, or existing technological skills that, when identified and understood, can be harnessed to improve digital engagement and health outcomes.

•       Identifying barriers allows for the development of strategies to address the specific inequities and challenges that prevent the elderly from accessing and utilizing digital health tools, thus ensuring that interventions are inclusive and effective. These barriers might include limited access to technology, lack of digital skills, or psychological resistance to new technologies, which need to be understood and mitigated to improve digital health literacy.

•       Infographics provide a visually appealing and easy-to-understand format for conveying complex health information, making it more accessible for the elderly. By simplifying digital health concepts and providing clear, actionable steps, infographics can significantly enhance comprehension and engagement, leading to better adoption of digital health practices among the elderly.

•       Departments involved :

OPD , Kasturba hospital Manipal, Karnataka

•       Study period :

I year

Sample size :

Confidence level (Z)= I .96 for 95% confidence level Sample size :

Confidence level (Z) = I .96 for 95% confidence level

Margin of error (d) = 0.05 (or 5%)

Anticipated proportion of individuals with the outcome of interest (p) = assumed to be 0.5 (50%) as we assumed equal proportions between rural and urban areas initially.

Using the formula for estimating sample size in a cross-sectional study:

n Z2 xpx(I-p) / d2 n = (1.96)2xo.5x(1-o.5) / (0.05)2 n 3.8416xo.25 / 0.0025 n = 0.9604/0.0025 n = 384.16 n = 384 + 10% of non responders and partial responders n = 384+38 422

Materials and methods:

a) Inclusion and exclusion criteria:

Inclusion criteria:

•      Ageing and elderly population

•      mentally and physically stable participants

•      participants witling to the study.

Exclusion criteria:

•      Participants who are not physically and mentally stable

•      Inpatients or hospitalized patients

•      Individuals who are not willing to participate

Biological materials required (type - blood, tissue etc and quantity)

NilStatistical methods:

Descriptive variables analyzed using descriptive statistics, mean, frequency tables, graphs, percentage, proportion. Categorical variables analyzed using Chi-square test. Univariate analysis will be done to identify variables with p value less than 0.1 , variables with p < 0.1 will be included in a multiple linear regression model to perform adjusted analysis. Statistical analysis done using Jamovi version 2.3.28

Tools used:

Predesigned and validated e-heal questionnaires, which were previously used for a similar kind of study witl be used. We have email permission from the author to reuse the same questionnaire and use it by translating it into Indian local languages. And, a questionnaire with socio demographic data will be given

The eHEALS, or eHeaIth Literacy Scale, consists of 8 items, each evaluated on a 5-point Likert scale, where responses range from 1 to 5. The total possible score ranges from 8 to

40. A score exceeding 20 is considered indicative of good digital health literacy.

Detailed description of procedure processes:

I. The study will be a cross-sectional survey using the translated and validated eHEALS Survey tools to evaluate Digital Health Literacy. Permission to use this questionnaire has been secured.

2. Another questionnaire will collect socio-demographic data and identity factors affecting

Digital Health Literacy. It will be translated from English to Kannada, back-translated to Engtish, and then translated again to Kannada, involving translators for these processes.

3. The Informed Consent and Participant Information Sheet will also be translated into Kannada.

4. The study will receive approval from the Institutional Ethics Committee (IEC).

5. Participants will be recruited through ethical approval, direct approachwherepurpose the survey will be explained.

6. The survey will target individuals who are aged and elderly, who vis its Kasturba hospital and who are wilting to participate and provide consent.

7. Convenient sampling will be employed until the required sample size is reached.

8. Participants witl give written informed consent for the study.

9. Each participant will be assigned a unique code, ensuring their confidentiality and data

10.        Participants will complete a self-administered questionnaire, with assistance available to explain its contents if needed.

11.        Every participant will receive a printed infographic in Kannada about digital health literacy, covering both sides of the paper, focusing on managing misinformation, how to identify credible health information and to understand risks of misinformation.

OUTCOME MEASURES:

The key outcome measures for an exploratory study on the facilitators and barriers to digital health literacy among the aging and elderly population in the Udupi district of India could include:

•     Number and type of facilitators identified that significantly enhance digital health literacy among the elderly in Udupi district

•     The extent and nature of barriers quantified that impede digital health literacy among the elderly in Udupi district.

•     The percentage of elderly individuals reporting improved understanding and usage of digital health tools after exposure to the infographics.