Abstract Background Digital health technologies (DHT) are increasingly integrated into cardiovascular care, yet patients’ perceived eHealth literacy skills (eHEALS) vary. Understanding the factors influencing these skills is crucial for to enhance self-management in cardiovascular patients and to optimize the effective use of DHT. Objective This study investigates the factors associated with perceived eHEALS among users of the Hypertension.App, a digital health application specifically designed for cardiovascular care patients. Methods A secondary analysis was conducted reusing data from Hypertension.App users in Germany. This cross-sectional study examined factors influencing eHeals total scores using Bayesian model averaging (BMA). Collinear covariates were excluded (variance inflation factor 2.5). Variables associated with eHEALS total scores in Bayesian univariate linear regression analysis (region of practical equivalence ≤5%) were considered in the BMA. All analyses were stratified by sex and age (54 years and ≥ 54 years). Results A total of 250 hypertension patients (109 females, 139 males, and 2 non-binaries) who were on average 53.6 years (SD: 13.8 years) were included. On average, patients had an eHEALS total score of 31 (SD: 4.91). Twenty-three determinant factors were identified (Fig. 1), with notable differences between sex and age groups. Lower eHEALS scores (Fig. 2.) were associated with using the app for 1−6 months or less often than once a month, being a male, having difficulty performing physical activity for at least 30 min 5 to 7 days per week, having experienced a heart attack or stroke. In contrast, higher eHEALS scores were associated with owning a smartwatch or fitness tracker, having the app integrated into medical treatment for medication adjustment by a physician based on patient entries, strongly agreeing that most people can quickly learn how to use the app, wanting a voucher, living in the Berlin federal state, and using the app’s diary function. Conclusions This study identifies key factors influencing perceived eHEALS among Hypertension.App users in cardiovascular care. These findings highlight/emphasize that eHealth literacy is shaped not only by demographic and health-related factors, but also by the context of app usage, user motivation, engagement, and perceived usability. Taken together, these insights can inform the design and implementation of digital health interventions to better support cardiovascular patients.Figure 1 Figure 2
Spethmann et al. (Sat,) studied this question.