The Role of Electronic Health (eHealth) Literacy in Patient Activation: A Sequential Block Regression Analysis Controlling for Sociodemographic Factors

Patient activation is defined by the knowledge, skills, and confidence to manage one's health; it has been linked to better health outcomes and lower healthcare utilization. Despite its well-established benefits, the factors influencing patient activation are complex and not fully understood. One such factor, electronic health (eHealth) literacy, remains underexplored, particularly in underserved populations. eHealth literacy, which refers to the ability to access, understand, and apply health information from electronic sources, is increasingly vital in the modern healthcare environment. This study investigates the link between eHealth literacy and patient activation in adults with chronic diseases and lower socioeconomic status (SES). Data were drawn from 334 participants in a larger randomized controlled trial evaluating a mobile app for chronic disease self-management. eHealth literacy was measured using the eHealth Literacy Scale, while patient activation was assessed with the Patient Activation Measure (PAM), ten-item version (PAM-10). Sequential block regression analyses showed that eHealth literacy was significantly related to patient activation, after controlling for age, gender, and race. This has important implications for the design and delivery of healthcare interventions, suggesting that targeted efforts to improve digital health literacy could help bridge the activation gap, especially in socioeconomically disadvantaged groups. As healthcare increasingly shifts toward digital platforms, enhancing eHealth literacy could play a critical role in reducing health disparities and improving clinical outcomes in vulnerable groups.