# Association of Electronic Health Literacy With Self-Care and Health Outcomes Among Patients With Type 2 Diabetes Mellitus: Cross-Sectional Study

## TL;DR

This study shows that higher eHealth literacy in type 2 diabetes patients is linked to better self-care and lower diabetes distress, though it doesn't strongly predict blood sugar control.

## Contribution

The study is one of the first to examine eHealth literacy's specific impact on diabetes self-care and outcomes in Hong Kong's population.

## Key findings

- 65.1% of patients had high eHealth literacy, which was linked to better self-care and self-efficacy.
- Higher eHealth literacy was associated with lower diabetes distress but not significantly with better HbA1c control.
- Adjusting for sociodemographic factors reduced the significance of eHealth literacy's impact on HbA1c.

## Abstract

Diabetes mellitus (DM) continues to be a critical public health issue in Hong Kong. Although self-care behaviors help promote health among patients with DM, adherence remains suboptimal. More attention should be paid to eHealth literacy with the development of modern technologies.

This study aims to assess the level of eHealth literacy among patients with DM and examine its association with self-care and health outcomes.

A cross-sectional study was conducted among patients with type 2 DM from the DM clinic of a public hospital in Hong Kong. Data on eHealth literacy, self-care, self-care self-efficacy, diabetes distress, glycated hemoglobin (HbA1c) control, and sociodemographic information were collected. Multivariable regression analyses were performed, adjusting for relevant sociodemographic and medical variables.

Among the 427 patients with DM recruited, around two-thirds (65.1%) were classified as having a high level of eHealth literacy. Compared to those with lower eHealth literacy, participants with higher eHealth literacy demonstrated significantly higher levels of self-care (P<.001) and self-care self-efficacy (P<.001) and lower levels of diabetes distress (P<.001). Higher eHealth literacy was also associated with greater odds of achieving ideal HbA1c control (<7%) in unadjusted analyses (odds ratio 1.90, 95% CI 1.15-2.81); however, this association was not statistically significant after adjustment for sociodemographic and medical covariates (adjusted odds ratio 1.57, 95% CI 0.99-2.52; P=.07).

This study evaluated eHealth literacy levels among patients with DM and examined the associations between eHealth literacy and health outcomes (eg, self-care, self-care self-efficacy, diabetes distress, and HbA1c control). Assessing eHealth literacy in patients with DM could be useful in identifying those who are vulnerable to poorer health outcomes. Promoting eHealth literacy among patients with DM may be important.