O conceito de letramento digital em saúde: revisão de escopo

Abstract

Introduction: the advancement of information and communication technologies, along with their integration into digital health, highlights digital health literacy (DHL) as a potential tool for empowering users. However, the concept of DHL, as introduced in 2006, does not adequately address the essential skills users need to effectively navigate today’s digital health environments. Examining how this concept has been explored in the literature over time can help map the evidence base, identify knowledge gaps, and support the creation of a focused research agenda. Objective: to map the concept of digital health literacy within the context of digital health. Method: a structured scoping review was conducted following the JBI method. The research question, formulated using the PCC mnemonic framework, was: "What conceptual definitions of digital health literacy have been used in the context of digital health up to the present day?" The review focused on digital health literacy, guided by the eHealth literacy framework introduced by Norman & Skinner in 2006, setting the study period from 2006 to 2023. There were no restrictions on language, and a wide range of sources and materials were included in the analysis. A comprehensive search strategy was implemented on September 22, 2023, targeting PubMed and adapted for various databases, including LILACS, BDENF, and other resources from the Regional Portal of the Virtual Health Library (BVS); SCIELO; SCOPUS; MEDLINE via PubMed/NLM; CINAHL/EBSCO; Cochrane Library/Wiley; PsycINFO/APA; ERIC/U.S. Department of Education; PMC, Embase, and Web of Science Core Collection/Clarivate through CAPES journals. Grey literature sources such as Global ETD Search and Google Scholar were also included, along with the references of selected studies. The selection process followed eligibility criteria, using a double-independent blinded review for both publication selection and data extraction. Disagreements between reviewers were resolved by a third reviewer and through consultation with an online team panel. Results: the searches identified 24,632 publications, of which 171 were selected for full-text review. Ultimately, nine studies were included in the final sample. The inclusion process was detailed using a flow diagram in line with the PRISMA-ScR Checklist. Most studies were conducted in Asia (four studies) and Europe (four studies), with English being the dominant publication language (78%), followed by German (11%) and Korean (11%). The majority of the studies were theoretical. Over time, the concept of digital health literacy (DHL) evolved and adapted to incorporate emerging technologies in digital health. New essential skills were introduced to enable individuals to engage effectively with digital health, such as identifying, defining, and communicating health problems; exchanging, validating, and creating health information; recording, protecting, or sharing personal data; and managing online criticism. Conclusions: the integration of these skills has not been accompanied by significant advancements in the concept of digital health literacy, as only a limited number of studies have empirically evaluated their applicability within the field. Therefore, it is reasonable to question whether all the skills included in DHL definitions are equally relevant to all individuals, regardless of context or location