Health literacy inequities in chronic kidney disease: A digital health education programme

Background: Chronic kidney disease requires ongoing patient engagement in complex self-management, yet limited health literacy remains a key barrier to effective disease management. Digital health education programmes can help address these gaps by providing accessible and structured learning resources. Aim: This study examined whether a digital health education programme could improve chronic kidney disease-specific health literacy and disease-related knowledge among adults living with chronic kidney disease. Method: A quasi-experimental study with experimental and comparison groups was conducted in two regional teaching hospitals in northern Taiwan. Participants in the experimental group received a 12-week digital health education programme in addition to the usual care, while those in the comparison group received usual care only. Assessments were conducted at baseline, post-intervention (3 months), and follow-up (6 months). Outcomes included chronic kidney disease-specific health literacy (functional, communicative, and critical domains) and chronic kidney disease-related knowledge, and programme usability was evaluated using the System Usability Scale. In addition, brief semi-structured interviews were conducted with a subset of participants in the experimental group after the intervention. Results: Of the 100 people living with chronic kidney disease enrolled in the study, 83 completed all three assessments. Analysis of covariance tests revealed that after controlling for pre-test, age, and education level, participants in the experimental group demonstrated greater improvements in functional, communicative, and critical health literacy compared with usual care. Gains in chronic kidney disease-related knowledge were also sustained at follow-up. Conclusions: Digitally delivered health education programmes may help reduce literacy-related inequities in chronic disease management and support informed participation among adults living with chronic kidney disease.