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Impact of Digital Health Literacy Education on Digital Health Service Utilization among Adults in Nigeria

Abstract

The increasing use of digital technologies in healthcare has created new opportunities for individuals to access health information, communicate with healthcare providers, obtain health-related services, manage appointments, access electronic health resources, and participate in remote healthcare. However, effective use of digital health services requires adequate digital health literacy, including the ability to locate, understand, evaluate, and appropriately use health information and digital healthcare platforms. Digital health literacy education provides adults with knowledge and practical skills for identifying credible digital health information, navigating digital health platforms, protecting personal health information, communicating with healthcare providers through approved digital channels, accessing telemedicine and other digital health services, evaluating the reliability of online health information, and using digital tools appropriately for healthcare purposes. Digital health service utilization refers to individuals' actual use of digital healthcare services, including telemedicine, electronic appointment systems, health-information platforms, mobile health applications, electronic communication with healthcare providers, and other appropriate digital health services. In Nigeria, limited utilization of digital health services may be associated with inadequate digital health literacy, limited awareness of available services, concerns about privacy and security, lack of confidence in digital platforms, limited access to appropriate devices and internet connectivity, and uncertainty about the credibility of online health information. Effective digital health literacy education may improve adults' knowledge, confidence, and ability to use available digital health services appropriately. Against this background, this study investigates the impact of digital health literacy education on digital health service utilization among adults in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Technology Acceptance Model. The Health Belief Model provides a framework for understanding adults' decisions to use digital health services through perceived susceptibility to health problems, perceived severity, perceived benefits of digital healthcare, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, environmental conditions, and health-related behaviour in shaping digital health service utilization. The Technology Acceptance Model explains how perceived usefulness and perceived ease of use influence individuals' acceptance and utilization of digital technologies for healthcare. Collectively, these theoretical perspectives provide a suitable framework for explaining how digital health literacy education may influence digital health service utilization among adults in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adults in selected communities in Nigeria using a structured interviewer-administered questionnaire, digital health literacy assessment, and digital health service utilization assessment tool. A multistage sampling technique will be employed to select states, local government areas, communities, households, and eligible adult participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Adults in the intervention group will receive structured digital health literacy education covering credible digital health information sources, evaluation of online health claims, navigation of digital health platforms, telemedicine, electronic appointment systems, mobile health applications, online communication with healthcare providers, protection of personal health information, privacy and cybersecurity awareness, and appropriate use of digital health services. Digital health service utilization will be assessed using indicators such as use of telemedicine services, mobile health applications, electronic appointment systems, digital health-information platforms, online communication with healthcare providers, electronic health resources, and other approved digital healthcare services. Where feasible, self-reported utilization will be complemented by available service-use records or platform data. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, access to digital devices and internet services, previous exposure to digital health education, digital health literacy scores, and digital health service utilization patterns. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression or logistic regression analysis, will be used to determine the impact of digital health literacy education on digital health service utilization. Where appropriate, utilization before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that digital health literacy education has a significant positive impact on digital health service utilization among adults in Nigeria. Adults exposed to structured digital health literacy education are expected to demonstrate improved ability to identify credible digital health information, navigate digital healthcare platforms, communicate with healthcare providers through appropriate digital channels, and utilize available digital health services. Education may increase confidence in using telemedicine, mobile health applications, electronic appointment systems, and other digital healthcare resources while reducing uncertainty about the reliability and usefulness of digital health services. Practical demonstrations involving registration, navigation of digital platforms, appointment scheduling, and evaluation of online health information are expected to strengthen participants' digital health skills. However, education alone may not guarantee sustained utilization because adults may continue to experience barriers such as limited internet access, high data costs, inadequate electricity supply, lack of suitable digital devices, poor digital infrastructure, privacy concerns, limited availability of digital health services, and varying levels of digital competence. Consequently, digital health literacy education may be most effective when supported by affordable internet connectivity, accessible digital devices, reliable digital infrastructure, user-friendly digital health platforms, adequate healthcare-provider capacity, strong data-protection systems, and supportive digital-health policies. The study is expected to contribute to the literature on digital health literacy, digital health education, digital healthcare utilization, e-health, m-health, telemedicine, health promotion, and public health in Nigeria by providing empirical evidence on the impact of digital health literacy education on digital health service utilization among adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, healthcare institutions, digital health providers, telemedicine organizations, public health practitioners, community health workers, health educators, technology developers, development partners, and policymakers regarding strategies for improving appropriate use of digital healthcare services. The study will also provide evidence-based recommendations for integrating digital health literacy education into community and primary healthcare programmes, strengthening public awareness of available digital health services, improving digital-health skills among adults, enhancing access to user-friendly digital healthcare platforms, strengthening data privacy and cybersecurity protections, and reducing digital barriers to healthcare utilization in Nigeria.

Keywords: Digital health literacy education, digital health service utilization, adults, Nigeria, digital health, e-health, m-health, telemedicine, digital healthcare, health education, digital health literacy, healthcare utilization, health promotion, public health.