Limited Literacy Research Articles

A Study on Adult Learners of English as A Foreign Language in Vietnam: Motivations, Advantages, and Challenges

English has become highly popular in Vietnam, emerging as the preferred language for diverse purposes. The increasing attendance at English Training Centers and schools shows a surge in adult learners seeking language refinement. Motivated by career progression, job prerequisites, learning objectives, and communication needs, these learners encounter many difficulties. This article explores the obstacles Vietnamese English as a Foreign Language (EFL) learners face, providing practical solutions for both learners and educators. A comprehensive study involving 70 adult learners studying EFL at the University of Danang - University of Foreign Language Studies (UD-UFLS) utilized questionnaires and interviews, employing qualitative and quantitative analyses. The research revealed that despite high motivation driven by job and career goals, learners struggle due to time constraints, limited English literacy skills, and financial burdens, diminishing the effectiveness of their learning. In response to these difficulties, constructive recommendations are offered to enhance the learning experience and address the prevalent issues.

Clinical Evaluation of a Lay-Language Radiology Glossary Integrated into an Electronic Health Record System.

Radiology reports typically contain complex, technical language that can pose a barrier to patients, especially to those with limited educational attainment or literacy skills. PORTER-the Patient-Oriented Radiology Reporter system-incorporates a lay-language glossary to help patients understand radiology report content. The system displays illustrations and definitions of radiology terms when viewing a report. A large U.S. health system integrated PORTER into the patient portal of its electronic health record (EHR) system and evaluated its use during a 7-month study period. Of 4,664 concepts defined in its glossary, 4,607 (98%) were readable at the 8th-grade level. Of 10,859 patients who completed a single-question survey, 6,947 (64%) found the system to be helpful or very helpful. A system that integrates illustrations and lay-language definitions of medical terms into a patient portal can help patients better understand the reports of their radiology examinations. Such a system has potential to improve communication for patients with limited health literacy.

Health literacy and self-care among patients with chronic kidney disease in a primary care setting.

The study objective was to determine the levels of self-care and health literacy (HL) and their associations among patients with chronic kidney disease (CKD). This was a cross-sectional, questionnaire-based study conducted in a public primary care setting in Singapore. A total of 289 participants aged 21-80 years with hypertension were recruited. Self-care profiles were measured using the Hypertension Self-Care Profile (HTN-SCP; range 0-240, domain range 0-80). Health literacy was measured using the Short-Form Health Literacy Scale (HLS-SF12; range 0-50, limited literacy ≤33). The mean self-care score was 182.7 (standard deviation [SD] 23.2). The median HL score was 34.7 (interquartile range [IQR] 31.9-40.3), and 31.1% of participants had limited HL. Self-care was not associated with age, CKD status, household income and education, but was associated with gender and HL score. In the final regression model, lower HL scores (adjusted β = 1.03, 95% confidence interval [CI] 0.7 to 1.36, P < 0.001) and male gender (adjusted β = -5.29, 95% CI -10.56 to -0.03, P = 0.049) were associated with lower self-care scores. The HL scores were associated with self-care domains of self-efficacy (HL: β = 0.30, 95% CI 0.17 to 0.42, P < 0.001), motivation (HL: β = 0.40, 95% CI 0.26 to 0.53, P < 0.001) and behaviour (HL: β = 0.38, 95% CI 0.26 to 0.50, P < 0.001). Thirty-one percent of the participants had limited HL. Self-care was not associated with age, race, CKD status, household income or education. Male gender and limited HL were associated with lower self-care. Self-care was associated with self-efficacy, motivation and behaviour. Future research could focus on more targeted approaches to improve self-care and HL among patients with CKD.

Engagement and accessibility tools for pro-environmental action on air quality: the SOCIO-BEE paradigm

AbstractThe involvement of citizens and all stakeholders is crucial in tackling environmental and social matters. This, addressing equity and diversity issues, although challenging, is a necessary condition for achieving positive outcomes and ensuring that no one is left behind. To help ease this challenge, this work presents a systematic approach to ensure inclusive participation and leverage non-technical and technical elements to maximise stakeholder engagement in scientific activities to successfully address sustainability concerns. For that, it builds on the interim results of the H2020 SOCIO-BEE project, a Citizen science (CS) proposal to reduce air pollution through inclusive community engagement and social innovation. As part of an interdisciplinary CS project, an abductive systematic combining methodology was employed, which allowed for dialogue and collaboration between theory and practice throughout the whole process, during which separate groups of experts and potential end-users were involved. The article presents (i) the stakeholder engagement strategy codified in the SOCIO-BEE toolkit as a robust, actionable and inclusive foundation of engagement to CS activities; and (ii) the digital platform UX that allows setting up campaigns for measurements and assignment to citizens, incorporating the requirements for flexibility, accessibility, limited digital literacy, inclusion and legal and ethical considerations. Their combination and mutual interaction aim to leverage the pros of CS and technology whilst reducing their cons to ensure the four pillars of applicability, scalability, actionability, and inclusion. This is supported by the presented hybrid model which combines physical and virtual spaces and individual and collective action.

Development of Strategic Management and Accounting Implementation at Village-Owned Enterprises Regard to Using Former Mining Land

This study aims to delve into the development of strategic management and financial implementation at Village-Owned Enterprises regard to using former mining land that must be managed for productivity in order to increase revenue villages and accounting procedures must be put in place to make financial reporting easier and of higher quality. Employing a qualitative method with a phenomenological approach and gathering data through literature analysis, direct observations, and intensive interviews. The site research in this study is at VillageOwned Enterprises Manunggal Dadi Mulyo in Kwadungan Gunung, Kledung, Temanggung, Central Java. The results of this study are: (1) The most suitable alternative strategies to be developed for Village-Owned Enterprises Manunggal Dadi Mulyo includes development and promotion strategies; and (2) VillageOwned Enterprises Manunggal Dadi Mulyo has not implemented accounting practices yet in accordance with the applicable accounting standards. This problem arises because of limited financial literacy of the Village-Owned Enterprises management regarding the importance of financial reporting

Perception of Physicians' Notes Among Parents of Different Health Literacy Levels.

To explore the benefits and challenges of accessing physicians' notes during pediatric hospitalization across parents of different health literacy levels. For this secondary analysis, we used semi-structured interviews conducted with 28 parents on their impressions of having access to their child's care team notes on a bedside table. Three researchers used thematic analysis to develop a codebook, coded interview data, and identified themes. Parent interviews and respective themes were then dichotomized into proficient or limited health literacy groups and compared. Nine themes were identified in this secondary analysis: 6 benefits and 3 challenges. All parents identified more benefits than challenges, including that the notes served as a recap of information and memory aid and increased autonomy, empowerment, and advocacy for their child. Both groups disliked receiving bad news in notes before face-to-face communication. Parents with proficient literacy reported that notes allowed them to check information accuracy, but that notes may not be as beneficial for parents with lower health literacy. Parents with limited literacy uniquely identified limited comprehension of medical terms but indicated that notes facilitated their understanding of their child's condition, increased their appreciation for their health care team, and decreased their anxiety, stress, and worry. Parents with limited health literacy uniquely reported that notes improved their understanding of their child's care and decreased (rather than increased) worry. Reducing medical terminology may be one equitable way to increase note accessibility for parents across the health literacy spectrum.

To read or not to read - A cross-sectional study of Swedish primary care patients' adoption of patient accessible electronic health records.

Patient-accessible electronic health records (PAEHR) were implemented in the Stockholm region of Sweden seven years ago. This study examines socio-demographic and psychographic factors associated with reading/not reading these records, as well as the common reasons for such behaviours. Patients or guardians of minors seeking face-to-face or digital primary healthcare in the Stockholm region responded to a questionnaire about whether they were aware that they could read their PAEHR, and if so, if they had read it and reasons for reading or not reading. We conducted a comparative analysis of readers and non-readers and a stepwise multiple logistic regression. The majority of participants were aware that they could read the PAEHR (86%) and among those aware, 77% had read it. The odds of reading decreased with increased age, unfavourable opinion of PAEHR, low information literacy and being single. Access to a smartphone increased the probability of reading. Participants who had read their PAEHR had commonly read it to get an overview of their health and care (65%) and to follow up on a healthcare visit (55%). Participants who had not read their PAEHR stated generally that they did not need to (63%) and/or had received sufficient information from their providers (38%). While most people were aware they could read the PAEHR and many had read it, a digital divide and several barriers to reading the PAEHR were identified. Efforts to increase PAEHR reading may be targeted at older people, people needing more informal support, those who may be excluded due to limited information literacy, and towards improving the patient portals' usability.

The Impact of Excessive Internet Usage on the Emotional Maturity of Adolescents: A Case Study in Pakistan

Background: Excessive internet usage has become a significant issue among adolescents and young adults, affecting their physical, mental, social, and emotional well-being. In the Pakistani context, this trend is particularly concerning due to limited digital literacy and awareness of the negative effects of internet overuse. Aim: This study aims to explore the impact of excessive internet usage on the emotional maturity of adolescents in Pakistan, analyzing how limitless internet access contributes to physical, mental, and social challenges among this age group. Methodology: The research adopts a qualitative approach, reviewing existing literature on internet abuse and its repercussions on the physical, mental, and emotional health of Pakistani adolescents. The study analyzes key factors contributing to the decline in emotional maturity due to excessive internet use. Results: The findings indicate that high levels of internet usage are closely associated with reduced emotional maturity among adolescents. This reduction is manifested through various issues, including increased mental stress, decreased physical activity, and deteriorated social relationships. Conclusion: The study concludes that excessive internet usage can significantly impact the emotional development and maturity of adolescents, leading to a range of mental, physical, and social problems. It underscores the need for interventions that promote balanced internet use and enhance emotional resilience among Pakistani youth.

Assessing the Potential of Digital Tools to Enhance Transparency and Traceability in The Cocoa Value Chain in Ivory Coast

Problem The cocoa industry in Ivory Coast faces significant challenges related to market access, income and transparency despite being the leading global cocoa exporter. Research Aim Therefore, this mixed-methods study aimed to assess digital solutions to address these issues by improving traceability and empowering Ivorian cocoa producers. Research Method Surveys and interviews were conducted with 12 farmers in Lôh Djiboua, 5 buyers, and 3 experts. Results The key findings revealed that 72.7 per cent of farmers were willing to adopt a mobile app to enhance productivity and connect with buyers. However, barriers like limited digital literacy and poor rural infrastructure were identified. Implications and Recommendations The findings in this research would be highly relevant to cocoa cooperatives and associations, cocoa buyers and exporters in Ivory Coast, government agencies and policymakers, international development organizations, and academic researchers. In addition, the recommendations include expanding digital networks through partnerships, implementing training programs for farmers, and ensuring user-friendly app interfaces. Further research should evaluate improvements in the value chain after application implementation. Conclusions Overall, the study demonstrated that tailored mobile-based innovations can benefit cocoa value chain actors by increasing transparency.

A gendered perspective on ride-hail use in Los Angeles, USA

Gender differences in travel are pervasive throughout the world. While gender gaps have narrowed in many social spheres, such is generally not the case for travel. In this study, we examine whether gender differences persist on a relatively new travel mode: ride-hail. We do this by examining the use patterns, experiences, and opinions of nearly 300 travelers in metropolitan Los Angeles, California, USA. Our survey responses show that ride-hail service offers a convenient travel option for women – one that enables many of them to access needed destinations in their daily lives. Women in carless or car-deficit households in particular benefit from using ride-hail services to meet their travel needs, which differ, on average, from men’s. For example, more women use ride-hail services for household-serving trips than men. However, ride-hail is not free of challenges for women. Concerns about safety, fear of personal and financial information leakage, and limited digital literacy and access to financial resources can inhibit or prevent some women from using these services. Compared to men, a larger share of women takes ride-hail trips booked by someone else in the household and/or travels with a companion. These findings suggest that public policy should seek to ensure that the option to use ride-hail is extended to as many people – regardless of gender – as possible, including those without mobile devices with data plans and credit or debit accounts. Riders should also be able to easily report problematic behaviors by drivers or fellow passengers to public authorities, in addition to reviews of and reports to ride-hail companies.

Factors Influencing Stock Price Prediction: Demographics, Mental State, Company Origin, and Past Performance

This study investigates the interplay between socio-demographic factors, mental state, and stock price prediction behavior among a sample of 150 individuals in Ulaanbaatar, Mongolia. Participants were tasked with completing incomplete graphs, varying in context in three survey groups, allowing for an exploration of how age, gender, and past value perceptions, and contextual things influence prediction patterns. The research aims to understand the cognitive biases underpinning investment decisions, particularly in a context of limited financial literacy. By analyzing completed graphs, the study identifies distinct decision-making tendencies across age and gender groups. Additionally, it examines whether the type of given context of the graph impacts prediction behavior in a certain way. While emotional bias was found to be less influential, the study reveals significant differences in predictions based on contextual differences, also the study revealed certain age and gender group tendencies bias proneness for certain biases. These findings contribute to a deeper understanding of investor psychology and provide insights for financial advisors seeking to tailor strategies based on client demographics.

Volunteer Online Counseling during COVID-19: Insights, Practices, and Future Directions

This study investigated the transition to online counseling by 34 counselors during the COVID-19 pandemic, addressing the gap in access to mental health services due to restrictions of in-person interactions. The research employed online questionnaires and a virtual focus group discussion to gather qualitative data, which were analyzed using thematic analysis. Counselors reported addressing various client issues, including anxiety, depression, academic challenges, suicidal ideation, and family conflicts. The primary technical challenges identified were connectivity issues, clients' lack of technological resources, and limited digital literacy. Effective online counseling was associated with active listening, adaptability, trustworthiness, and technological competence. Although valued for accessibility, convenience, and confidentiality, online counseling poses challenges, such as impersonal communication and online fatigue. The findings underscore the need for improving tele-counseling practices, particularly in overcoming technological and communication barriers, to ensure the continued growth and development of the field.

A Systematic Literature Review of E-Government Implementation in Developing Countries: Examining Urban-Rural Disparities, Institutional Capacity, and Socio-Cultural Factors in the Context of Local Governance and Progress towards SDG 16.6

This systematic literature review examines the implementation of e-government initiatives in developing countries, focusing on their impact on public service delivery and progress towards Sustainable Development Goal 16.6. Through a comprehensive analysis of peer-reviewed articles, policy documents, and case studies, the research explores the interplay between institutional capacity, socio-cultural factors, and the digital divide in shaping e-government outcomes across urban and rural contexts in countries including Ghana, South Africa, Kenya, India, Nigeria, Brazil, and Indonesia. Following a rigorous search strategy and inclusion criteria, the review synthesizes findings from multiple sources, highlighting significant advancements in e-government adoption, particularly in urban areas, while identifying persistent challenges in rural regions due to inadequate infrastructure, limited digital literacy, and resource constraints. The systematic review of literature underscores the potential of e-government to enhance transparency, reduce corruption, and improve service delivery, as exemplified through successful initiatives in countries like Rwanda and Estonia. However, the synthesized evidence also reveals uneven progress, exacerbated through the urban-rural digital divide and varying institutional capacities. Systematically analyzing and integrating existing research, this review concludes with evidence-based recommendations for bridging these gaps, emphasizing the need for targeted infrastructure development, digital literacy programs, inclusive design approaches, and context-specific solutions to ensure equitable access to e-government services and accelerate progress towards effective, accountable, and transparent institutions at all levels.

ANALISIS PEMANFAATAN TEKNOLOGI INFORMASI TASPEN KEPADA PESERTA DI KANTOR PT. TASPEN (PERSERO) KANTOR CABANG KEPULAUAN NIAS

&#x0D; &#x0D; &#x0D; &#x0D; Abstract. Utilization of information technology is the behavior of technology employees with their duties, measurement, based on frequency of use in the diversity of applications used. Information technology is the study, design, development, implementation, support or management of computer-based information systems, especially software applications and computer hardware. Lack of use of information technology in the PT area. Taspen (Persero) Nias Islands Branch Office causes obstacles related to information, rights and obligations for Taspen participants, especially for participants who have entered the Retirement Age Limit. Because this obstacle often becomes a problem for a company, where when participants do not know their rights as Taspen participants, the company will be involved in the investigation process for Taspen participants who have obstacles or obstacles in managing their rights. This research aims to find out how information technology is used by participants at PT Taspen (Persero) Nias Islands Branch Office. Based on the research results, it was concluded that PT Taspen (Persero) Nias Islands Branch Office had taken significant steps in utilizing Information Technology (IT) to overcome the obstacles faced by retired participants, such as device non-uniformity, limited digital literacy, and electricity stability problems. However, there are still several challenges that need to be overcome. Improving participants' understanding of applications and web portals, as well as improvements in technical aspects and data security policies, is essential. Outreach and education are key in helping participants, especially older ones, understand the full benefits of IT in managing their retirement. Efforts to improve customer service with faster responses are also needed. With an ongoing commitment to increasing participants' technological understanding, improving the onboarding process, and maintaining strict data security standards, PT. Taspen (Persero) Nias Islands Branch Office can maximize the benefits of IT, provide a positive experience for participants, and maintain a high level of trust in the company.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Enhancement of Financial Management of MSMEs in Cilawu District to Support the Halal Ecosystem

Most of the small traders in Cilawu District, Garut, are trapped by loan sharks. It happens due to their limited literacy and legal sources of capital. Those traders do not seem to have taken advantage of the loans offered by Sharia Banks since it takes effort and time for them to gain confidence in Sharia financial service products. This study concludes that the enhancement of the ability of UMKM financial management in Cilawu District to support the halal ecosystem is to increase the literacy of small traders in financial management, from planning to preparing financial reports, as the level of financial literacy of traders is still low and they do not have confidence in financial service institutions and financial service products. In addition, the provision of literacy in Islamic financial institutions and their financial products and services for traders is necessary since it can directly boost the activities of Islamic financial institutions and contribute to the development of the halal ecosystem.

Enhancement of Financial Management of MSMEs in Cilawu District to Support the Halal Ecosystem

Most of the small traders in Cilawu District, Garut, are trapped by loan sharks. It happens due to their limited literacy and legal sources of capital. Those traders do not seem to have taken advantage of the loans offered by Sharia Banks since it takes effort and time for them to gain confidence in Sharia financial service products. This study concludes that the enhancement of the ability of UMKM financial management in Cilawu District to support the halal ecosystem is to increase the literacy of small traders in financial management, from planning to preparing financial reports, as the level of financial literacy of traders is still low and they do not have confidence in financial service institutions and financial service products. In addition, the provision of literacy in Islamic financial institutions and their financial products and services for traders is necessary since it can directly boost the activities of Islamic financial institutions and contribute to the development of the halal ecosystem.

The Role of Online Shopping in Supporting and Promoting Agricultural Development in Backward Areas of China

This essay tries to explain how online shopping aids and fosters agricultural growth in Chinas underdeveloped regions. The essay first explains the idea of online shopping and discusses its state of growth both domestically and internationally before analyzing the value and benefits of online shopping for agricultural development. Based on this, the article suggests various online shopping applications for agriculture, such as online shopping platforms, rural online shopping, cross-border online shopping, etc., and explores the particular contributions that each of these applications has made to the advancement of agriculture in underdeveloped regions. The paper claims that by extending sales channels, reducing distribution costs, and improving the efficiency of agricultural product circulation, online shopping may considerably assist agricultural development. Online shopping can help farmers understand market demand better, improve the added value of agricultural products, and effectively address issues with information asymmetry and poor logistics. As a result, farmers incomes will rise, and the agricultural and industrial structures will be optimized and modernized. Backward regions are especially guilty of this. The article also emphasizes the challenges that online shopping still has in promoting agriculture in impoverished areas, including a lack of proper policy support, poor infrastructure, and limited farmer network literacy. In summary, online shopping plays a significant supporting and boosting role in the growth of agriculture in Chinas underdeveloped regions. Through in-depth research and practice, we can find more online shopping application modes and provide more effective ways for agricultural development in backward areas.

Tailoring community preventive care to personal health needs: a data-driven and participatory approach

A digital platform with tools for health promotion was developed as a proof of concept in co-creation with all relevant stakeholders involved: citizens, caregivers, and local policy makers, aiming to optimize community preventive care.&#x0D; The platform, referred to as BIBOPP, was developed as a proof of concept focusing on prevention and health promotion for citizens, local policy makers but also for primary care givers wanting to offer personalized follow up. To this end, we set up multiple co-creation sessions with different target groups of end users, including those with expected limited digital literacy skills, eg. older adults and people with no or low formal educational background. Based on this input, the functionalities of the tools were designed and developed and afterwards tested with a new group of end-users.&#x0D; The online prevention platform offered citizens from 5 Flemish municipalities a digital screening, allowing them to evaluate their health and lifestyle. This screening is the Domus Medica Health Guide (GGDM), an evidence-based tool predicting personal risk for chronic diseases. The outcome of the screening is linked to the electronic medical health record hosted by the general practitioner, notifying the latter in case of excessive risk and involving him in the process of disease prevention and health promotion.&#x0D; Based on the personalized lifestyle advice resulting from the survey responses, end users then received an overview of activities and primary care providers in their community, tailored to their personal risk profile and preferences.&#x0D; The data collected with consent from the end users, yielded insights on the self-reported lifestyle and health of these participants. On an aggregated level, this tool has the potential to provide data for population health management.&#x0D; First lessons learned indicate that the platform did require significant digital literacy skills from end-users, as indicated by the participants younger age and relatively healthy lifestyle (eg. less than 10% smokers, +50% daily physical activity, …). However, in a co-creation session group with older adults, they indicated that digital skills were not a threshold when peer support was available. Furthermore, they recognized that the tool helped them in the self-management of their health and that they trusted the data governance. People with low to no formal educational background on the other hand were more suspicious about the tool and data governance unless this was offered to them through their trusted care providers. Also, older adults indicated that support with the interpretation of the advices by a health professional could be of added value.&#x0D; Next steps for BIBOPP now are involving these health professionals, and more specifically primary care actors in onboarding and guiding people to and through the platform.&#x0D; To conclude, this data-driven proof of concept co-designed with end-users, has promise to deliver personalized services, strengthen community preventive care, and optimize the local health policy.&#x0D; &#x0D;

RHYTHM AND NATURE: APPLYING TRAUMA-INFORMED APPROACHES TO RESEARCH TO PRIORITIZE CHOICE, EXPRESSION, AND JUSTICE

Abstract Trauma-informed approaches are widespread in direct clinical and particularly in social work practice, and have gained momentum in other areas such as research, organizational culture, supervision, and leadership. Given the recent collective global trauma of the pandemic and the cumulative effects of historic and ongoing racial injustice, a trauma-informed approach to research with older adults, especially with those who have disabilities, such as relating to dementia, can contribute to the movement for access, justice, equity, and inclusion for all. Closely aligned with practices of community-based participatory action research, trauma-informed research pays particular attention to the consideration of the design of studies, the analytical and theoretical frameworks, collaboration among researchers and participants, data collection methods, research questions that capture the knowledge and experiences of participants’ resiliency, strengths, and challenges, and the processes of reflexivity. Rhythm &amp; Nature was a 10-week pilot study designed to incorporate trauma-informed research approaches to promote principles of safety, trustworthiness, collaboration, choice, self-expression, and justice. We created a modifiable drumming and nature-based intervention to promote opportunities for self-expression and confidence. Before and after each drumming and nature-based session, we collected data using emojis (e.g., to increase access for people with limited language or literacy) to indicate how participants felt in the moment and used their ongoing feedback to continuously tailor the program to their unique abilities and needs. Both quantitative and qualitative results of this pilot study and implications for future research, policy, practice and education with older adults, particularly with disabilities, will be discussed.

Virtual Care and Social Support for Refugee Mothers during COVID-19: A Qualitative Analysis

Introduction: The intersection of gender, motherhood, and migration status creates distinct challenges for refugee mothers, but social support can facilitate their navigation of migration and motherhood. Taking a Salutogenic Theory approach (Antonovsky, 1979), we examined refugee mothers’ access to virtual social support during the COVID-19 pandemic. Our objective is to understand the provision of virtual social support for refugee mothers from the perspective of service providers and recently arrived refugee mothers to Canada. Methods: Virtual semi-structured interviews were conducted with three service providers and five refugee mothers in one settlement agency in Ontario, Canada. Data were subjected to thematic analysis. Six main themes emerged. Results: From interviews with service providers the themes include: virtual adaptation of services; unique barriers to virtual services emerging from the intersection of gender, culture, and migration status; and supporting women’s agency and independence. From interviews with mothers, we identified the following themes: gratitude for instrumental support; organization as a link between self and society; and usefulness of virtual support, but preference for in-person support. Discussion: Providers acknowledged clients’ diverse circumstances. They developed flexible strategies to identify client needs and help them build skills. Clients found virtual services essential to resettlement, if not ideal. Conclusion: With tailored programming, virtual services can be effective in providing support. Moreover, refugee mothers acquired digital skills to independently navigate virtual resources, despite limited digital literacy. This demonstrates the value of using of virtual services for vulnerable or hard to reach populations.