Evaluating digital health literacy interventions for adults 45+ years: a scoping review

Abstract

Digital health literacy is increasingly vital for equitable healthcare, yet adults aged 45+ may face age-related and psychosocial barriers that limit digital engagement. Interventions targeting these barriers are crucial. This review mapped the design and effectiveness of current digital health literacy interventions for adults 45+ years, assessing how they addressed biological, psychological, and social (biopsychosocial) dimensions and key outcomes. The review followed Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Five databases were searched for English-language studies published between 2015 and 2025. Twenty-four studies met inclusion criteria, comprising randomized controlled trials, quasi-experimental studies, qualitative research, and systematic and scoping reviews. Data were synthesized and thematically mapped against biopsychosocial dimensions and effectiveness outcomes, including competence, critical thinking, empowerment, sustained engagement, and health outcomes. Most interventions were associated with improvements in digital skills, confidence, and self-efficacy, particularly when delivered face-to-face, in small groups, or through blended formats. However, most focused on psychological factors, with biological and social dimensions addressed inconsistently. Only one study incorporated all three biopsychosocial dimensions, and none assessed all effectiveness outcomes simultaneously. There was limited evidence for improvements in sustained engagement, critical thinking, and longer-term health outcomes following intervention. Digital health literacy interventions for adults aged 45+ years may therefore benefit from extending beyond a focus on technical skills to address the broader range of age-related biopsychosocial barriers. In this context, a biopsychosocial–digital framework appears to offer a more comprehensive foundation for the design and evaluation of interventions aimed at supporting meaningful and sustained health outcomes.