# Digital health literacy and sociodemographic characteristics of patients undergoing total hip or knee arthroplasty—a cross-sectional study

## TL;DR

This study explores digital health literacy among patients who had hip or knee replacement surgeries and finds that older age is strongly linked to lower digital health literacy.

## Contribution

The study provides new insights into how sociodemographic factors influence digital health literacy in patients undergoing THA or TKA.

## Key findings

- Digital health literacy scores were lowest in the domain of 'digital services that suit individual needs'.
- Older age was consistently associated with lower digital health literacy across both THA and TKA patients.
- Lower education levels were linked to reduced digital health literacy in specific domains.

## Abstract

Digital solutions may increase sustainability in healthcare for patients undergoing total hip or knee arthroplasty (THA, TKA). Little information exists on these patients' digital health literacy levels.

Describe digital health literacy in patients following THA or TKA and examine the associations between sociodemographic factors and digital health literacy levels.

In a cross-sectional survey, a total of 800 patients randomly drawn from the Norwegian Arthroplasty Register who had received THA or TKA during 2021 received information about the study. Of these, 383 (185 THA, 198 TKA) consented to participate and filled in a consent form and a paper questionnaire assessing age, sex, cohabitation status, work status, education level and the eHealth Literacy Questionnaire (7 domains, range 1–4; higher scores indicate better digital health literacy). Digital health literacy levels were compared by surgery type and sociodemographic characteristics using t-tests and associations were investigated using multivariable linear regression models.

Digital health literacy scores across the 7 domains ranged from 2.64 to 3.14 overall, with THA patients scoring slightly higher than TKA patients on two domains. Both surgical groups scored lowest on the domain “digital services that suit individual needs”. Due to differences by surgery type, analyses were stratified by type of surgery. In multivariable regression models, older age was associated with lower digital health literacy in all domains among TKA patients, and in four domains among THA patients. Lower level of education was associated with lower digital health literacy in three domains among THA patients, and in one domain for TKA patients. Work status was also associated with digital health literacy, but was omitted from multivariable analyses due to its strong association with age; sex and cohabitation status were not associated with digital health literacy in either surgical group.

Older age showed the strongest and most consistent associations with lower digital health literacy, while lower education had weaker and fewer associations. This pattern was evident in both surgical groups, and particularly among TKA patients.