Abstract

BackgroundDigital technologies are shaping medicine and public health.ObjectiveThe aim of this study was to investigate the attitudes toward and the use of digital technologies for health-related purposes using a nationwide survey.MethodsWe performed a cross-sectional study using a panel sample of internet users selected from the general population living in Germany. Responses to a survey with 28 items were collected using computer-assisted telephone interviews conducted in October 2020. The items were divided into four topics: (1) general attitudes toward digitization, (2) COVID-19 pandemic, (3) physical activity, and (4) perceived digital health (eHealth) literacy measured with the eHealth Literacy Scale (eHEALS; sum score of 8=lowest to 40=highest perceived eHealth literacy). The data were analyzed in IBM-SPSS24 using relative frequencies. Three univariate multiple regression analyses (linear or binary logistic) were performed to investigate the associations among the sociodemographic factors (age, gender, education, and household income) and digital technology use.ResultsThe participants included 1014 internet users (n=528, 52.07% women) aged 14 to 93 years (mean 54, SD 17). Among all participants, 66.47% (674/1014) completed up to tertiary (primary and secondary) education and 45.07% (457/1017) reported a household income of up to 3500 Euro/month (1 Euro=US $1.18). Over half (579/1014, 57.10%) reported having used digital technologies for health-related purposes. The majority (898/1014, 88.56%) noted that digitization will be important for therapy and health care, in the future. Only 25.64% (260/1014) reported interest in smartphone apps for health promotion/prevention and 42.70% (433/1014) downloaded the COVID-19 contact-tracing app. Although 52.47% (532/1014) reported that they come across inaccurate digital information on the COVID-19 pandemic, 78.01% (791/1014) were confident in their ability to recognize such inaccurate information. Among those who use digital technologies for moderate physical activity (n=220), 187 (85.0%) found such technologies easy to use and 140 (63.6%) reported using them regularly (at least once a week). Although the perceived eHealth literacy was high (eHEALS mean score 31 points, SD 6), less than half (43.10%, 400/928) were confident in using digital information for health decisions. The use of digital technologies for health was associated with higher household income (odds ratio [OR] 1.28, 95% CI 1.11-1.47). The use of digital technologies for physical activity was associated with younger age (OR 0.95, 95% CI 0.94-0.96) and more education (OR 1.22, 95% CI 1.01-1.46). A higher perceived eHealth literacy score was associated with younger age (β=–.22, P<.001), higher household income (β=.21, P<.001), and more education (β=.14, P<.001).ConclusionsInternet users in Germany expect that digitization will affect preventive and therapeutic health care in the future. The facilitators and barriers associated with the use of digital technologies for health warrant further research. A gap exists between high confidence in the perceived ability to evaluate digital information and low trust in internet-based information on the COVID-19 pandemic and health decisions.

Highlights

  • The COVID-19 pandemic contributed to the development of new technologies and accelerated the digitization of various domains of daily lives worldwide

  • The participants were recruited from all 16 states in Germany (Figure 2) with the majority residing in urban regions with up to 500,000 inhabitants (622/1014, 61.34%) and in the states of the former West Germany (829/1014, 81.76%; Multimedia Appendix 1, Table S2)

  • The majority noted that digitization will be important for therapy and health care (898/1014, 88.56%), health promotion (704/1014, 69.43%), and health maintenance (668/1014, 65.88%) in the future (Figure 3; Multimedia Appendix 1, Table S3 and Figure S1)

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Summary

Introduction

The COVID-19 pandemic contributed to the development of new technologies and accelerated the digitization of various domains of daily lives worldwide. One such domain focuses on digital aspects of public health. Digital public health describes the entire field of development and application of digital technologies in the context of public health, especially with regard to prevention and health promotion [1]. The general aims of LSC DiPH are to provide a platform for networking and to support interdisciplinary projects in the field of digital public health, focusing on prevention and health promotion.

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