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Personal, environmental, and behavioral factors influence digital health literacy among stroke patientsKey factors influence digital health literacy in stroke patients

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Key Takeaway
Recognize personal, environmental, and behavioral factors as key determinants of digital health literacy in stroke patients.

This mixed-methods systematic review synthesized 16 studies (12 quantitative and 4 qualitative) to identify factors influencing digital health literacy among stroke patients. The analysis categorized these influences into three primary domains: personal, environmental, and behavioral.

Personal factors include sociodemographic and health-related characteristics, psychological and self-regulation traits, and technology-related attitudes and capabilities. Environmental factors involve family and social support systems alongside the information and service environment. Behavioral factors encompass proactive information behaviors as well as interactive and communication behaviors. The review does not report specific effect sizes or p-values for these predictors.

The authors note that higher quality studies are required to inform precise intervention strategies. These findings may assist clinicians in identifying barriers to digital engagement, potentially supporting the development of targeted interventions for patients who are digitally disadvantaged. However, as a systematic review of observational and qualitative data, results indicate associations rather than direct causality.

How this fits prior evidence

This finding addresses a gap in understanding how stroke survivors navigate digital health resources. While previous coverage noted that Chinese stroke policy is shifting toward system-embedded governance with a focus on quality improvement, this review identifies specific individual and environmental barriers to digital literacy. It also complements the recognition of multifaceted management strategies for post-stroke fatigue by identifying factors that could facilitate remote monitoring or educational access.

After a stroke, managing health can feel overwhelming. Many patients turn to the internet or mobile apps to find answers, but not everyone finds it easy to navigate these digital spaces. This is known as digital health literacy. A review of 16 different studies looked at what makes it easier or harder for stroke survivors to use these tools effectively.

The findings show that a person's ability to use digital health tools depends on three main areas. Personal factors like their age, education, and attitude toward technology play a big role. Environmental factors, such as having a supportive family and easy access to reliable information services, are also vital. Finally, behavioral habits, like how proactively a patient seeks out info or interacts with online platforms, impact their success.

While these findings help experts understand who might need more help, the evidence is still early. Because this was a review of various types of studies, it shows patterns rather than exact numbers. More high-quality research is needed to create specific programs that help stroke patients overcome digital barriers and find the information they need.

What this means for you:
Personal traits, social support, and proactive habits all shape how well stroke survivors use digital health tools.

Common questions

What makes it easier for stroke patients to use digital health tools?

Several factors help stroke patients navigate digital health information. These include personal traits like a positive attitude toward technology and self-regulation skills. Environmental support from family and friends, along with a helpful information environment, also plays a major role in helping patients succeed with online tools.

What are the main barriers for stroke survivors using digital health?

Barriers can come from personal factors like sociodemographic characteristics or limited digital capabilities. Additionally, a lack of social support or an unhelpful information environment can make it harder for stroke patients to find and use online health resources effectively.

How do behaviors affect how stroke patients use technology?

A patient's behavior significantly impacts their experience. Specifically, proactive information seeking and active communication behaviors help determine how well a stroke survivor can interact with digital platforms to manage their health needs.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
BackgroundDigital health literacy is crucial for stroke patients to effectively access and utilize digital health information and services, thereby facilitating health management and improving health outcomes. However, digital health literacy among stroke patients is often inadequate and influenced by multiple factors. This study aimed to systematically identify the factors associated with digital health literacy in stroke patients, so as to provide evidence for the development of tailored intervention strategies.MethodsEight databases (PubMed, Cochrane Library, Web of Science, Embase, SinoMed, China National Knowledge Infrastructure, Wanfang, VIP) were searched from inception to April 2026. The eligible studies were synthesized using the convergent integrated approach recommended by the Joanna Briggs Institute (JBI), and the integrated findings were subjected to thematic analysis guided by the Social Cognitive Theory (SCT).ResultsA total of 16 studies were included (12 quantitative studies and 4 qualitative studies). Guided by the Social Cognitive Theory, the synthesized findings indicated that the factors influencing digital health literacy in stroke patients could be classified into three dimensions: personal, environmental, and behavioral factors. Personal factors encompassed sociodemographic and health-related characteristics, psychological and self-regulation characteristics, and technology-related attitudes and digital health capability. Environmental factors included family and social support as well as the information and service environment. Behavioral factors comprised proactive information behaviors and interactive and communication behaviors.ConclusionDigital health literacy in stroke patients is influenced by the combined effects of personal, environmental, and behavioral factors. In clinical practice, particular attention should be given to digitally disadvantaged populations, and targeted interventions tailored to patients’ individual characteristics and digital health needs should be implemented to improve their digital health literacy and capacity to use digital health resources. Further high-quality studies are warranted to inform the development of precise intervention strategies and the optimization of rehabilitation management.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261412446, identifier PROSPERO (CRD420261412446.
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