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The Relationship of Health Literacy With Use of Digital Technology for Health Information: Implications for Public Health Practice

Manganello, Jennifer PhD, MPH; Gerstner, Gena MPH, MS; Pergolino, Kristen AST; Graham, Yvonne RN, MPH; Falisi, Angela MPH; Strogatz, David PhD

Journal of Public Health Management and Practice: July/August 2017 - Volume 23 - Issue 4 - p 380–387
doi: 10.1097/PHH.0000000000000366
Research Full Report

Objective: An understanding of the association of health literacy with patterns related to access and usage of digital technologies and preferences for sources of health information is necessary for public health agencies and organizations to appropriately target channels for health information dissemination.

Design: A cross-sectional telephone survey was conducted in New York State. Health literacy was assessed using the Morris Single-Item Screener, a self-report question. A weighted analysis was conducted utilizing Stata/SE.

Participants: The final sample size of New York State residents used for analysis was 1350.

Results: In general, self-report health literacy did not predict digital technology use (ie, Internet and smartphone use, text messaging) but was associated with certain digital activities. People with low self-report health literacy were less likely to use search engines (P = .026) but more likely to get health information from social networking sites (P = .002) and use health-related phone apps (P = .046). With respect to health information seeking, those with lower self-report health literacy reported greater difficulty with their most recent search for health information. Furthermore, they were more likely to prefer text messages (P = .013) and radio (P = .022), 2 text-limited communication channels, to receive health information than those with higher self-report health literacy.

Conclusions: While self-report health literacy does not appear to influence access to and use of digital technologies, there is a strong association with experiences searching for health information and preferences for health information sources. Public health agencies and organizations should consider the needs and preferences of people with low health literacy when determining channels for health information dissemination. They should also consider implementing interventions to develop health information–seeking skills in populations they serve and prepare information and materials that are easily accessible and understandable.

Supplemental Digital Content is Available in the Text.

Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, State University of New York (Dr Manganello and Ms Falisi); Office of Minority Health and Health Disparities Prevention, New York State Department of Health, Albany, New York (Mss Gerstner, Pergolino, Graham); Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York; and Center for Rural Community Health, Bassett Research Institute, Cooperstown, New York (Dr Strogatz).

Correspondence: Jennifer Manganello, PhD, MPH, School of Public Health, University at Albany, State University of New York, One University Place, #165 Rensselaer, NY 12144 (

This research was funded by the New York State Department of Health, Office of Minority Health and Health Disparities Prevention.

The authors acknowledge Siena Research Institute for data collection as well as Jessica Coyle for her contributions as a Graduate Student Intern from the University at Albany, School of Public Health. Student efforts were supported by the Empire State Public Health Training Center within the Center for Public Health Continuing Education at the University at Albany, School of Public Health.

Dr Manganello received salary support from the funder to lead the study. Mss Gerstner, Pergolino, and Graham work for the funder. Ms Falisi and Dr Strogatz have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.