Our college project of community medicine #Learn_to_Research

1. A Study of Digital Health Literacy
among patients attending Outpatient
Department in a Tertiary care center of
Delhi
BATCH - A (2021)
GROUP -B

2. Supervisors:
Dr. Nidhi Singh Ma’am (Senior Resident, Department of Community Medicine)
Dr. Shweta Charag Ma’am (Post graduate Resident 3, Department of Community Medicine)
Dr. Seema Verma Ma’am (Post graduate Resident 2, Department of Community Medicine)
Dr. Sneha Kumari Ma’am (Assistant professor, Department of Community Medicine)
MENTORS
Faculty Incharge :

3. PRESENTERS
1.Aarushi Sachdeva (21001) 9.Apurva Tyagi (21020)
2.Abheer Tanwar (21003) 10.Ashish (21025)
3.Adeeb Ur Rahman (21005) 11.Dinesh (21036)
4.Aditya Kumar Chaudhary (21007) 12.Divya (21037)
5.Adnan (21008) 13.Divya kalra (21038)
6.Akshat Mohan (21010) 14.Gajjala Samiehana Reddy(21039)
7.Alankrit Chawla (21011) 15.Gandharv (21040)
8.Anugya (21017) 16.Gaurav (21041)

4. OUTLINE OF PRESENTATION
INTRODUCTION REVIEW OF LITERATURE METHODOLOGY
DATAANALYSIS AND
ETHICAL CONSIDERATIONS
RESULTS CONCLUSION
OUTLINE OF PRESENTATION
AIM AND OBJECTIVES

5. ❏ World health organisation defines Health Literacy as the “The cognitive and social skills which determine
the motivation and ability of individuals to gain access to understand and use information in ways which
promote and maintain good health”[1]
❏ Recent research imply that "Digital Literacy" serves as the foundation for digital health.
❏ According to the framework for digital health literacy skills, a person's digital health behavior is mostly
determined by their digital skills, knowledge, and health knowledge reserves.
❏ People may now track and access their health records whenever they need to, thanks to the advancement of
digital technology, which have made it possible to save personal health information online.
INTRODUCTION
1]. World Health Organization. Health Promotion Glossary. Switzerland: Geneva World Health Organization; 1998. Report No.: WHO/HPR/HEP/98.1

6. ❏ According to a 2014 European Union study, almost 60% of people who regularly browse the internet do so in
order to look up health-related information. In 2019, the internet constituted the primary source of health
information for over 70% of US adults.[2]
❏ According to the "2023–2027 Global Digital Medical Industry Economic Development Blue Book," the global
digital health market surpassed $211 billion in 2022.[3]
❏ The World Health Organization considers a national web-based personal health record (PHR) a vital
component of universal health coverage.
❏ According to WHO, when used appropriately, people-centered digital solutions have the potential to assist
Member States in meeting the health-related Sustainable Development Goals by 2030 and to make a significant
contribution to advancing universal health coverage, protecting the public in times of emergency, and
improving health and well-being.[4]
GLOBAL INSIGHTS
[2] Liu P, Yeh LL, Wang JY, Lee ST. Relationship Between Levels of Digital Health Literacy Based on the Taiwan Digital Health Literacy Assessment and Accurate Assessment of Online Health
Information: Cross-Sectional Questionnaire Study. J Med Internet Res. 2020
[3] Li S, Cui G, Zhang X, Zhang S, Yin Y. Associations Between Digital Skill, eHealth Literacy, and Frailty Among Older Adults: Evidence From China. J Am Med Dir Assoc. 2024 Sep 19:105275. doi:
10.1016/j.jamda.2024.105275. Epub ahead of print. PMID: 39307173 Dec 21;22(12):e19767. doi: 10.2196/19767. PMID: 33106226; PMCID: PMC7781799.
[4]World Health Organisation: Regional digital health action plan for the WHO European Region 2023-2030 Available from:
https://iris.who.int/bitstream/handle/10665/362959/72rs02e-DigitalHealth-220768.pdf?sequence=1

7. INDIAN INSIGHTS
❏ India, with a population of 1.4 billion [5]
has 920 million people living across villages. There are still issues with
these villages' access to healthcare.
❏ A total of 1172.34 million Indians have telephone connections [6]
.
❏ With an aim to create an ecosystem for providing better healthcare services in the country, the National Digital
Health Mission (NDHM) was announced on 15th August 2020, which was later rebranded as Ayushman Bharat
Digital Mission (ABDM) which is consistent with the aims and objectives of the National Health Policy (NHP)
2017 and the National Digital Health Blueprint.[7]
❏ Vision statement of NDHB is "To create a national digital health ecosystem that supports universal health
coverage in an efficient, accessible, inclusive, affordable, timely and safe manner, through provision of a
wide range of data, standards-based digital systems, and ensuring the security, confidentiality and privacy of
health-related personal information."
[5] Worldometer - Population, total - India. Available from: https://www.worldometers.info/world-population/india-population/#google_vignette
[6] TRAI - Press Release No.46/2023, highlights of telecom subscription data as on 31st March, 2023 Available from:
https://trai.gov.in/sites/default/files/PR_No.46of2023_0.pdf
[7] Press Information Bureau, Government of India. Available from: https://pib.gov.in/PressReleseDetail.aspx?PRID=1646049&reg=3&lang=1

8. ❏ After doing review of literature, it was observed that there is a significant lack of studies in Delhi
which relates to determination of the level of access to the internet, broadband services and
knowledge of mobile health apps, various other aspects pertaining to Digital Health Literacy.
❏ There is lack of significant study in Delhi which associates availability of electronic devices, hours
of internet use, language barriers and privacy concerns related to use of health resources to digital
health literacy among the study participants.
❏ Since, patients attending Outpatient Departments are somehow exposed to knowledge about digital
health resources, current study was planned to determine their level of digital health literacy, so as
to, plan further interventions needed to increase access to healthcare resources.
RATIONALE OF STUDY

9. RESEARCH QUESTION
What is the level of Digital Health Literacy among the patients attending Outpatient
Department at a Tertiary Health Care hospital in Delhi ?

10. AIM
This study aims to assess the level of Digital Health Literacy among
patients attending Out Patient Department of a Tertiary Care Center of
Delhi.

11. PRIMARY OBJECTIVE:
To determine the status of digital health literacy among patients attending Out-patient
department in Tertiary care hospital of Delhi.
SECONDARY OBJECTIVES:
1. To assess factors associated with digital health literacy among these patients.
2. To study knowledge and practices regarding health resources and mobile health applications
under Government of India (Example: E- sanjeevani, ABHA and others).
OBJECTIVES

12. Title of research Author of
research
Place of
study
Year Sample size Study
population
Methodology/Tools
used
Result of study
1. eHEALS: The
eHealth Literacy
Scale
Cameron D
Norman,
Harvey A
Skinner
Toronto,
Canada
2006 664 participants (370
boys; 294 girls)
Adolescents
aged 13-21 yrs
1. This cross sectional study
recruited 664 adolescent
aged 13-21 year from 14
secondary school in a large
Canadian city.
2. The questionnaire
eHEALS was administered
using a pencil and paper
survey.
3. Participants completed
the eHEALS prior to the
intervention being
delivered, immediately after
the intervention and at 3-
and 6- month follow up.
1.Baseline levels of eHealth
literacy were higher among
males (t 726 = 2.236, P =
.026); however, no
statistically significant
differences were detected in
scores at post-intervention
and 3 and 6 month follow-up
administrations of the
eHEALS.
2.Age did not predict
eHealth literacy scores at
any time point.
REVIEW OF LITERATURE
International Studies

13. 2.Online Health
Information-Seeking
Behaviour and its
Associated Factors
Among Patients in
the Outpatient
Department of
Dompe E-hospital,
Sri Lanka
S. R. M.
Senarathne
and M. K. D.
L. Meegoda
Sri Lanka 2022 102 patients Adult patients
aged 18 years
and above
1.A Descriptive
cross-sectional study
design was used,
2. The final
questionnaire consisted
of 25 items, covering
demographic
information health
status, regular pattern of
internet use, online
health information
seeking behaviour, and
eHealth literacy.
1. 58% Respondents were online
health information-seekers. 98.3%
of them acquire online health
information through smartphone.
2. The response rate was 93%. More
than half were female(62%) and
educated up to General Certificate
of Education(62.7%). The highest
number of respondents was between
26-35 years(33.3%).
3. There was a significant
association between age and
Online Health Information
Seeking Behaviour (p<0.05).
Title of research Author of
research
Place of
study
Year Sample size Study
population
Methodology tools used Result of study

14. Title of research Author of
research
Place of
study
Year Sample size Study
population
Methodology/Tools
used
Result of study
3.The relationship
between e-health
literacy and
information
technology
acceptance, and the
willingness to share
personal and health
information among
pregnant women
Sajedeh
Rahdar,
Mahdieh
Montazeri,
Moghadame
Mirzaee, Leila
Ahmadian
Iran 2019 250 Pregnant
women aged
between 20-50
years
Cross sectional survey
with Four-part
questionnaire
containing 66
questions used:
A) 11 questions of
demographic details
B) 8 questions of
eHEALS
C) 41 questions of IT
Acceptance
D) 6 questions to
measure willingness
of people to share
personal and health
information
1.The mean age of the participants
was 29 years.The mean score of
electronic health (e-health)
literacy of pregnant women was
27.43 ± 5.82, the mean score of
their IT acceptance was 145.49 ±
25.72, and the mean score of their
willingness to share personal and
health information was 19.16 ±
5.47.
2.In this study, the health literacy
score of people in the age group of
31–40 years was 0.38 units higher
than the score of those in the age
group of 41–50 years.

15. 4.Adolescents’
self-efficacy and
digital health
literacy: A
cross-sectional
mixed methods
study
Melody Taba
et al
Australia 2022 21 participants
living in
Australia
Adolescents
aged 12-17
years
1. A Cross-sectional mixed
methods study was
conducted.
2. Participants completed
an online demographic
survey for age, gender etc.
3. They subsequently
completed an online
eHEALS measure.
4. They subsequently
completed an health
information search task.
5. And semi structured
interviews regarding
understanding, belief and
attitudes towards online
health information were
also taken.
1. Mean eHEALS score 3.7
out of 5 (SD=0.5)
2. Mean age came out to be
14.2 years (SD=1.6 years).
3. 62% believed that
internet is useful in health
decisions, and 71% believed
it was important for them
to access health
information on internet.
4. Total time spent searching
in the practical search task
ranged from 3 to 18 minutes
(mean=7.9 min,SD=3.8
min).
Title of research Author of
research
Place of
study
Year Sample size Study
population
Methodology tools used Result of study

16. Title of research Author of
research
Place of
study
Year Sample size Study
populatio
n
Methodology/Tools
used
Result of study
5.E-health literacy
and associated
factors among
chronic patients in
a low-income
country:a
cross-sectional
survey
Kirubel Biruk
Shiferaw,
Binyam
Chakilu
Tilahun
,Berhanu
Fikadie
Endehabtu ,
Monika
Knudsen
Gullslett and
Shegaw
Anagaw
Mengiste
Ethiopia 2020 423 subjects Chronic
patients in
a low
income
country
1.)An institutional based
cross-sectional study
was conducted.
2.) Stratified sampling
technique was used to
select 423 study
participants among
chronic patients
3.)The eHealth literacy
scale (eHEALS) was
used for data collection
1)The mean eHealth literacy
score was 24.6 with a standard
deviation of 6.4.
2)The multivariable logistic
regression model indicated that
participants holding diploma and
above are more likely to possess
high eHealth literacy skill.
3)Having higher monthly income
> 5500ETB AOR: 4.44, 95% CI
(1.32, 14.86), being daily internet
user AOR: 2.96, 95% CI (1.08,
6.76) were the predictors positively
associated with higher eHealth
literacy level.

17. 6.eHealth
literacy among
undergraduate
nursing students
Ahmad
Tubaishat and
Laila habiballah
Jordan 2016 541 participants 541 nursing
students
(mean age
=21.9)
1) Study
design is
descriptive
cross sectional
survey
2) 541 students
from two
universities(
one private
and other
public) are
selected and
questionnaire
:eHeals was
given to them
for their
evaluation
1.Overall response rate of 60%.
The mean age of the participants
in this study was 21.9 (SD=3.48),
the majority of the participants
were female (69.8%, n=376) .
2.The overall mean score for
eHealth literacy was 3.62 (SD=
0.58), range 1-5.
3.The results of the test revealed
a statistically significant
difference (t(539)=7.941,
p<0.001), where the students in
the private university had a
higher mean score (M=3.89,
SD=0.67) than those in the
public one (M=3.39, SD=0.47
Title of
research
Author of
research
Place of study Year Sample size Study
population
Methodology
tools used
Result of study

18. Title of
research
Author of
research
Place of
study
Year Sample
size
Study
population
Methodology tools used Result of study
7.Assessing
electronic health
literacy in the
state of Kuwait,
survey of
Internet users
from an Arab
state
Dari Alhuwail and
Yousef
Abdulsalam
Kuwait 2019 386
participa
nts
18 years and
above
1. Cross sectional
anonymous web based
survey used to conduct
study.
2. eHEALS score is
measured using 8 Likert
type scales
3. Participants also
surveyed about frequency
of using social media
platforms for seeking
health information.
1. In total, 615 people attempted the
survey, and 386 fully completed
it (completion rate of 62.7%,
386/615). Of the respondents, 63%
(243/386) were females, and 37%
(143/386) were males.
Furthermore, 63% of participants
(244/386) accessed the internet
for 3 hours or more per day.
2. The eHealth literacy score, which
was calculated as the composite of the
8 items, had a mean of 28.63, median
of 29, and SD of 5.6.
Females had a statistically
significant higher eHEALS score
than men. (p<0.05)
3. The model was statistically
significant, explaining 28% of the
variance in eHEALS observations
(F11,374=12.29, P<.001).

19. 8.Correlation
Between eHealth
Literacy and
Health Literacy
Using the eHealth
Literacy Scale and
Real-Life
Experiences in the
Health Sector as a
Proxy Measure of
Functional Health
Literacy
Pietro Del
Giudice et al
Italy 2018 868 respondents, of
which 259 had
working or
studying
experience in the
health field
Adults living in
Northeast italy
1. A Web-based
cross sectional
survey was
conducted among
adults living in
Northeast Italy using
an Italian version of
the eHEALS
(IT-eHEALS).
sample is divided
into two groups,one
characterized by
studying or working
experience in the
health sector and by
lack thereof.
1. Mean (SD) eHEALS total
score was 28.2 (6.2) for the
whole sample, with
statistically significant
differences between the two
groups, with the higher
health literate group
scoring significantly better
(31.9 (5.9) vs 26.7 (5.6),
respectively), with a
standardized mean difference
(Cohen d) of 0.9
2. No differences related to
gender are found
Title of research Author of
research
Place of
study
Year Sample size Study
population
Methodology tools
used
Result of study

20. Title of research Author of
research
Place of
study
Year Sample size Study
population
Methodology/Tools
used
Result of study
9. The effect of
mobile health
applications on the
health literacy of
individual
Abdurrahman
yunus
sariyildiz et al
Samsun,
Turkey
2022 431 participants 18-40 yrs
of adults
1. questionnaire form
consisting of a socio-
demographic part
consisting 15
questions 2. health
literacy index with 25
statements used
3.cross sectional
study
1)In the study 54.3% of the
participants were women,67.4%
were individuals between
(18-25).76.9% of the participants
are single and 78.5% of
participants were at undergraduate
level
2) women have higher literacy
than male & level of access to
information of individuals aged
26-40 is higher than 18-25 aged
group

21. Title of research Author of
research
Place of study Year Sample size Study
population
Methodology/
tools used
Result of study
1.Digital health
literacy among
the ageing
population: A
comparative cross
sectional study
between rural and
urban Telangana,
India
Patel S et al Telangana,
India
2023 318 subject
(159 rural and
159 urban)
Rural and urban
population of
Telangana of
age (45-59)
years
1) Cross sectional
study
2) An
interviewer-
administered
questionnaire
with
socio-demograph
ic data
3)Tool to
evaluate digital
health literacy;
(eHealth Literacy
Scale -
eHEALS).
1)Overall, 20.4% of the
study participants had
good DHL with a similar
proportion between rural
and urban areas.
(rural-20.1% and
urban-20.8%, p value-
0.889)
2)In univariate analysis
,45-59 years of age, males,
computer usage in the past
month,higher educational
qualifications and
ownership of mobile
phones were significantly
associated with higher
DHL.
REVIEW OF LITERATURE
Indian Studies

22. Title of
research
Author of
research
Place of
study
Year Sample size Study
population
Methodology tools used Result of study
2.Exploring
Telehealth
Readiness in a
Resource
Limited Setting:
Digital and
Health Literacy
among Older
People in Rural
India
(DAHLIA)
Tshepo
Mokuedi et al
Mysore,
Suttur
2022 150 subjects Patients over
65 years who
resided in rural
settings
1) This was a
mixed-method
cross-sectional focus group
and survey-based study
2) eHEALS was used for
assessment of digital
literacy
3) Association between
demographic characteristics
and digital literacy was
analysed using non
parametric tests: Fisher's
exact test, Mann Whitney
test, Krushkal Wallis test,
Spearman's correlation
1. The median score for
eHealth literacy was 24.0,
and eHealth literacy was
significantly associated with
gender and education.
Males exhibited
significantly higher
mean ranks for health
literacy (79.72) compared
to females (68.42, p =
0.016).
2. Those with secondary
education or higher had
significantly higher mean
ranks for health literacy
(90.64) compared to those
with primary education or
less (68.15, U = 1732.50,
p < 0.001).

23. Title of
research
Author of
research
Place of
study
Year Sample size Study
population
Methodology tools used Result of study
3.Electronic
Health Literacy
and Demand for
Digital Health
Technology
among the
Elderly in
Rajasthan
Kumar A,
Praveena
Tandon,
Gaurav
Meratwal
Rajasthan,
India
2023 357(306
responded)
306 elderly
people (aged
60yrs and
older) of
tertiary care
hospital in
Ajmer,
Rajasthan
1. Hospital based cross
sectional study was
conducted in tertiary care
institute in Ajmer
2. Data were collected using
pretested semi-structured,
interviewer administered
questionnaire.
3. Literacy in eHealth was
evaluated using eHEALS.
1. Mean age of participants
was 69.47
2. Approximately one-fifth
of elderly had a smart
device.
3. The mean eHEALS score
was 14.08 and median was
11. It ranged from 8 to 40.
4. eHealth literacy was
significantly associated
with residence, education,
income and smartphone
ownership.

24. Title of
research
Author of
research
Place of
study
Year Sample size Study population Methodology tools used Result of study
4.Role of
ehealth literacy,
learning styles,
and patterns of
web based
e-content access
for seeking
health
information
among dental
University
students in
Vadodara, India
Ramya Iyer
R., Rajesh
Sethuram
Vadodara,
India
2022 380 students Undergraduates,
interns and
postgraduate dental
students (age range=
18-29 years) of KM
Shah Dental College
and Hospital,
Vadodara
1.An institutional based
cross sectional self
administered questionnaire
(in English) was used.
2.The data recording
performa included I.general
information ; II. eHEALS
scale items (10 items); III.
VARK Questionnaire; IV. a
set of items (6 items) for
assessment of the pattern of
use and preferences of
web-based e-content for
receiving health
information.
3.Printed questionnaires
were distributed to all
students(UGs, interns, PGs).
1. Mean (SD) ehealth
literacy score was 30.27
(3.41).
2. Response rate was 75%.
Out of total respondents, 79%
were females and 21% were
males.
3. Mean age of respondents
was 21.89 ± 2.299 years.
4. 65.6% people searched for
information related to healthy
lifestyles.
5. 70.9% chose textual
content for gathering
information as opposed to
picture and slide content
(58.6%), video content
(48.4%), and audio (11.2%).

25. METHODOLOGY
TYPE OF STUDY:
Cross sectional study
STUDY SETTING:
Vardhman Mahavir
Medical College
(VMMC) & Safdarjung
Hospital (SJH), Delhi
SAMPLING
TECHNIQUE :
Probability
proportional to size
STUDY DURATION:
6 weeks from 29th
September 2024 to
16th November 2024
STUDY POPULATION:
Adult Patients attending
the Outpatient care in
different departments of
SJH, New Delhi
METHODOLOGY

26. Methodology
INCLUSION CRITERIA:
Patients aged 18 years or more attending Outpatient Department for the first time at
a Tertiary Care Centre of New Delhi
EXCLUSION CRITERIA:
1) Patients less than 18 years of age.
2) Patients visiting outpatient department for follow up.
METHODOLOGY

27. From the previous multicentric study conducted by Sunil Patel et al [8]
,the prevalence of adequate digital health literacy
among the study population was 20.4%.
The formula used for sample size calculation is -
For 95% confidence, Z=1.96, Z²= 3.86.
P = 20.4%
Q = (100-20.4) = 79.6 %
L = 20% of P = 4.08%
Putting all these values into the formula, we get Sample size = 376.53.
Non Response Rate= 10% of 376.53 = 37.65
Final Sample size = 376.53 + 37.63 = 414.18 ~ 415
[8] Digital Health Literacy among the ageing population: A comparative cross sectional study between rural and urban Telengana, India; Sunil et al ;
Medical Journal Armed Forces India; Published on 7 sept 2023.
SAMPLE SIZE CALCULATION

28. Patients were included from each
OPD
Informed Consent was
taken from selected people
before interview.
New Person was
selected.
Physical Interview
via the questionnaire
Yes
DATA
COLLECTION
Till target sample size
was reached
List of the number of new patients
attending each OPD was taken from
the MRD.
PPS was
applied
No If person refuses or was
unable to participate.

29. SAMPLING TECHNIQUE (CONTINUED)
❏ Probability proportional to size sampling was applied for various outpatient departments to select
a specified number of participants from each department as shown in the table on the next slide.
❏ An average of patients attending Outpatient department during the 1st 6 months (January - June) of
the same calendar year was taken for each department and the proportions were then decided based
on the sample size.
❏ Average daily patients attending outpatient department for the first time =2480
❏ Sample size of our study = 415
❏ According to probability proportional to size , the proportion of patients to be taken from each
department = (415/2480)x100 = 16.73%.

30. Distribution of participants taken from different OPDs based on PPS (N=415)
Sr. No. Department No. of
participants
taken
1 Medicine 70
2 Orthopedics 47
3 Skin 42
4 Ent 30
5 Arthroscopy
joint disorder
29
6 PMR 26
7 General surgery 26
8 Eye 18
9 Dental clinic 17
10 ANC 15
Sr.
No.
Department No. of
participants
taken
11 Obstetrics and
gynecology
14
12 Cardiology opd 12
13 Urology 9
14 General psychiatric
opd
6
15 Neurology clinic 6
16 Neurosurgery 5
17 Pulmonary critical
case & sleep medicine
5
18 CRU ayurveda 4
19 Family planning 3
20 Integrative medicine 3
Sr.
No.
Department No. of
participant
s taken
21 SSB heart command 3
22 Nephrology 3
23 Plastic & maxillofacial
surgery
2
24 Sports medicine 2
25 Endo & diabetic 2
26 CTVS 2
27 Gastro opd 2
28 Infertility 1
29 Immunization splu 1
30 Hematology clinic 1
Sr. No. Department No. of
participants
taken
31 Radiation
oncology
1
32 Burns OPD 1
33 Oncology 1
34 Maternal
wellness
1
35 Cancer surgery 1
36 NCD screening
clinic
1
37 STD 1
38 Occupational
and
environmental
health
1
39 Pain clinic 1

31. Health Resources: In the context of eHEALS, the term "Health resources" generally refers to digital or
online sources of health information and tools. As per National Digital Health Blueprint, this includes:
a)Single, secure health id to all citizens
b)Personal health record
c)Single(national) health portal
d)Apps (e.g Arogya setu, ABHA, Ayushman app etc.)
e)Specialised services for remote areas/ Disadvantaged groups
f)NDHM call centres
g)Digital referrals and consultations
h)Online appointments
I)e Prescription services
j)Digital child health
k)National “opt-out”(for privacy)
l)Digital pharmacy and pharmacy supply chain[9]
OPERATIONAL DEFINITION
[9] National digital health blueprint, Ministry of health and Family Welfare Government of India. Available from Microsoft Word - NDHB Report dated 30.10.19

32. Questionnaire: A predesigned, semi-structured ,interviewer administered questionnaire was
used for data collection. The questionnaire has following parts -
1. Socio-Demographic Profile(e.g. age, gender, education, family income, etc.)
2. eHEALS score , a validated scale, was used to access digital health literacy. The eHEALS
is an 8-item scale. Each item is measured on a Likert scale of 1-5.
3. Knowledge and practices regarding factors associated with digital literacy and mobile
health applications under Government.

33. ETHICAL CONSIDERATION
❏ Approval was sought from the institutional ethics committee.
❏ Full free voluntary informed consent was taken from all participants after explaining the
purpose of the study.
❏ Data collected during the study was kept strictly confidential.
❏ The privacy of the study participants and confidentiality of information were maintained and
this was also explained to the subjects prior to inclusion.
❏ Data collected during the study was used for academic purposes only and no personal
information of the study subjects was divulged to anyone

34. STATISTICAL METHOD
❏ Data collected was entered in Microsoft Excel and cleaned for errors and missing
values.
❏ Data analysis was done using licensed SPSS software version 21.0.
❏ Data was presented in the form of tables and appropriate diagrams.
❏ Qualitative data was summarised as proportions while quantitative data was presented
as mean and appropriate measures of dispersion.
❏ Appropriate tests of significance were used wherever applicable and a p-value < 0.05
was taken as significant

35. RESULTS

36. 11.32%
18.55%
15.90%
1.49%
9.15%
MAXIMUM AGE: 79 MINIMUM AGE:18 RANGE OF AGE :61
MEAN AGE: 34.85 MEDIAN AGE:32.00 MODE OF AGE : 22
STANDARD DEVIATION: 13.12
FIGURE 1: DISTRIBUTION OF PARTICIPANTS ACCORDING TO AGE (N=415 )
(11.32%)
(13.49%)
(7.22%)
(9.15%)
(10.84%)
(13.49%)
(15.90%)
(18.55%)
(11.32%)
No.of
participants

37. SEX FREQUENCY (n) PERCENTAGE (%)
MALE 227 54.69%
FEMALE 187 45.06%
OTHERS(TRANSGENDER) 1 0.24%
TOTAL 415 100%
TABLE-1 : DISTRIBUTION OF PARTICIPANTS ACCORDING TO SEX (N=415)

38. TABLE-2 : DISTRIBUTION OF PARTICIPANTS ACCORDING TO RELIGION (N=415)
RELIGION OF PARTICIPANTS FREQUENCY (n) PERCENTAGE (%)
HINDU 349 84.09%
MUSLIM 59 14.22%
OTHERS(SIKH,CHRISTIAN) 7 1.69%
TOTAL 415 100%

39. FIGURE 2: DISTRIBUTION OF PARTICIPANTS ACCORDING TO EDUCATION LEVEL
(N=415 )
30(7%) 27(6.5%)
59(14%)
101(24%)
76(18%)
107(26%)
15(4%)
Education level
No.of
participants

40. 25(6%)
66(15.9%)
49(11.4%)
22(5.3%) 15(3.6%)
35(8.5%)
18(4.3%)
106(25.5%)
75(18.1%)
4(1%)
FIGURE NO 3: DISTRIBUTION OF PARTICIPANTS ACCORDING TO OCCUPATION (N=415)
Occupation
No.of
participants

41. TABLE-3 : DISTRIBUTION OF PEOPLE ACCORDING TO SOCIO-ECONOMIC CLASS ACCORDING
TO B.G PRASAD’S SES SCALE UPDATED FOR YEAR 2024 (N=415)
SOCIO-ECONOMIC CLASS BASED ON
MONTHLY PER CAPITA INCOME IN
RUPEES
FREQUENCY (n) PERCENTAGE (%)
I (UPPER CLASS) (9,098 AND ABOVE) 136 32.77%
II (UPPER MIDDLE CLASS) (4,549-9,097) 154 37.1%
III (MIDDLE CLASS) (2,729-4,548) 74 17.83%
IV (LOWER MIDDLE CLASS) (1,364-2,728) 36 8.67%
V (LOWER CLASS) (<1,364) 15 3.61%
TOTAL 415 100%

42. TABLE-4 : DISTRIBUTION OF PARTICIPANTS ACCORDING TO TIME OF ONSET OF PRESENTING
COMPLAINT (N=415)
TIME OF ONSET OF
PRESENTING COMPLAINT
FREQUENCY (n) PERCENTAGE (%)
<3 MONTHS 242 58.31%
≥3 MONTHS 173 41.69%
TOTAL 415 100%

43. Questions
Likert Scale
Strongly
Disagree Disagree Undecided Agree
Strongly
Agree Mean S.D.
1)Know what health resources are available on the
Internet
47
(11.3%)
118
(28.4%)
21
(5.1%)
194
(46.7%)
35
(8.4%) 3.13 1.237
2) Know where to find helpful health resources on the
Internet
52
(12.5%)
153
(36.9%)
48
(11.6%)
147
(35.4%)
15
(3.6%) 2.81 1.155
3) Know how to find helpful health resources on the
Internet
52
(12.5%)
163
(39.3%)
47
(11.3%)
141
(34%)
12
(2.9%) 2.75 1.137
4) Know how to use the Internet to answer their questions
about health
48
(11.6%)
143
(34.5%)
42
(10.1%)
168
(40.5%)
14
(3.4%) 2.90 1.157
TABLE-5a : DISTRIBUTION OF PARTICIPANTS ACCORDING TO E-HEALS SCORE (N= 415)

44. Questions
Likert Scale
Strongly
Disagree Disagree Undecided Agree
Strongly
Agree
Mean S.D.
5) Know how to use the health information found on the
Internet to help them
49
(11.8%)
145
(34.9%)
57
(13.7%)
155
(37.3%)
9
(2.2%) 2.83 1.121
6) Have the skills needed to evaluate the health resources
found on the Internet
55
(13.3%)
153
(36.9%)
66
(15.9%)
132
(31.8%)
9
(2.2%) 2.73 1.110
7) Can tell high quality health resources from low quality
health resources on the Internet
60
(14.5%)
160
(38.6%)
73
(17.6%)
110
(26.5%)
12
(2.9%) 2.65 1.106
8) Feel confident in using information from the Internet to
make health decisions
52
(12.5%)
181
(43.6%)
70
(16.9%)
101
(24.3%)
11
(2.7%) 2.61 1.066
TABLE-5b : DISTRIBUTION OF PARTICIPANTS ACCORDING TO E-HEALS SCORE (N= 415) contd..

45. TABLE-6 : DISTRIBUTION OF PARTICIPANTS ACCORDING TO TOTAL E-HEALS SCORE(N=415)
eHEALS SCORE
(According to mean=22.4)
FREQUENCY(n) PERCENTAGE(%)
<22.4 204 49.2%
≥22.4 211 50.8%
TOTAL 415 100%
MAXIMUM SCORE:40 MEAN: 22.4 + 7.84
MINIMUM SCORE:8 MEDIAN:23
MODE:16

46. FIGURE 4:FREQUENCY DISTRIBUTION OF Total e-HEALS SCORE(N=415)

47. FIGURE 5:DISTRIBUTION OF PARTICIPANTS ACCORDING TO KNOWLEDGE AND PRACTICE OF
HEALTH RESOURCES (N=415)
The values are not mutually exclusive

48. HAVE YOU EVER STRUGGLED
TO UNDERSTAND ONLINE
HEALTH INFORMATION DUE TO
A LANGUAGE BARRIER
FREQUENCY (n) PERCENTAGE (%)
YES 91 21.92%
NO 324 78.07%
TOTAL 415 100%
TABLE-7 : DISTRIBUTION OF PARTICIPANTS BASED ON EXPERIENCING LANGUAGE BARRIER
WHILE USING INTERNET FOR ONLINE HEALTH RESOURCES (N=415)

49. FIGURE 6:DISTRIBUTION OF PARTICIPANTS ACCORDING TO KNOWLEDGE AND PRACTICE OF
HEALTH RELATED APPS(N=415)
The values are not mutually exclusive

50. Table-8 : DISTRIBUTION OF PARTICIPANTS BASED ON EXPERIENCING LANGUAGE BARRIER
WHILE USING HEALTH RELATED APP (N=415)
HAVE YOU EVER STRUGGLED
TO UNDERSTAND HEALTH
INFORMATION ON HEALTH
APPS DUE TO A LANGUAGE
BARRIER?
FREQUENCY (n) PERCENTAGE (%)
YES 45 10.84%
NO 370 89.15%
TOTAL 415 100%

51. ❏ MAXIMUM
HOURS OF
INTERNET USE :
16 HOURS
❏ MEAN HOURS OF
INTERNET USE:
3.235
FIGURE 7:DISTRIBUTION OF HOURS OF INTERNET USE PER DAY (N=415)
190(45.78%)
161(38.80%)
48(11.56%)
10(2.40%)
4(0.96%) 2(0.48%)

52. TABLE-9 : DISTRIBUTION OF PARTICIPANTS BASED ON EXPERIENCING PRIVACY CONCERNS
THAT MAKE THEM HESITANT TO USE DIGITAL HEALTH APPS (N=415)
HAVE YOU EVER EXPERIENCE
HESITANCY IN USING DIGITAL
HEALTH APPS DUE TO PRIVACY
CONCERN
FREQUENCY (n) PERCENTAGE (%)
YES 74 17.83%
NO 341 82.16%
TOTAL 415 100%

53. ASSOCIATIONS

54. TABLE-10 : ASSOCIATION BETWEEN AGE AND DIGITAL HEALTH LITERACY (N=415)
AGE ( Median
Age =32 years)
LOW DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL
χ2 P VALUE
<32 YEARS 59(30.25%) 136(69.75%) 195(46.9%) 52.575 0.000 (<0.05)
≥32 YEARS 145(65.90%) 75(34.09%) 220(53.1%)
TOTAL 204(49.15%) 211(50.85%) 415(100%)
Since the p-value=0.000,which is less than 0.05,therefore there is statistically significant association between age and Digital Health
Literacy.

55. ● Correlation Coefficient=
-0.43
● Correlation is significant at
the 0.01 level of significance
● Spearman’s Rho Correlation
FIGURE 8:Scatter plot showing correlation of Age with eHEALS Score (N=415)

56. SEX LOW DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL FISHER’S
EXACT TEST
P VALUE
FEMALES 103(55.08%) 84(44.92%) 187(45.06%) 5.949 0.026(<0.05)
MALES 100(44.05%) 127(55.95%) 227(54.69%)
TRANSGENDER 1(100%) 0(0%) 1(0.24%)
TOTAL 204(49.2%) 211(50.8%) 415(100%)
TABLE-11 : ASSOCIATION BETWEEN SEX AND DIGITAL HEALTH LITERACY (N=415)
Since the p-value=0.026,which is less than 0.05,therefore there is statistically significant association between sex and Digital Health
Literacy.

57. TABLE-12 : ASSOCIATION BETWEEN RELIGION AND DIGITAL HEALTH LITERACY (N=415)
RELIGION LOW DIGITAL
HEALTH LITERACY
HIGH DIGITAL
HEALTH LITERACY
TOTAL P VALUE
HINDU 166(47.6%) 183(52.4%) 349(84.09%)
0.329
MUSLIM 34(57.6%) 25(42.4%) 59(14.21%)
OTHERS
(SIKH ,CHRISTIAN)
4(57.1%) 3(42.9%) 7(1.69%)
TOTAL 204(49.2%) 211(50.8%) 415(100%)
*This value is calculated by Fisher’s exact test.
Since the p-value=0.329, which is more than 0.05,therefore there is no statistically significant association between religion and Digital
Health Literacy was found.

58. TABLE-13 : ASSOCIATION BETWEEN EDUCATIONAL STATUS AND DIGITAL HEALTH LITERACY
(N=415)
EDUCATIONAL
STATUS
LOW DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL
χ2 P VALUE
BELOW HIGH
SCHOOL
95(81.9%) 21(18.1%) 116(27.95%) 69.052 0.000 (<0.05)
HIGH SCHOOL
AND ABOVE
109(36.5%) 190(63.5%) 299(72.05%)
TOTAL 204(49.2%) 211(50.85%) 415(100%)
Since the p-value=0.000,which is less than 0.05,therefore there is statistically significant association between Educational status and
Digital Health Literacy.

59. OCCUPATION LOW
DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL FISHER’S
EXACT TEST
P VALUE
EMPLOYED 95(44.39%) 118(55.59%) 213(51.32%)
8.918 0.012
UNEMPLOYED 15(78.1%) 4(21.1%) 19(4.57%)
NOT IN LABOUR
FORCE
94(51.4%) 89(48.6%) 183(44.09%)
TOTAL 204(49.15%) 211(50.85%) 415(100%)
TABLE-14 : ASSOCIATION BETWEEN OCCUPATION AND DIGITAL HEALTH LITERACY (N=415)
Since the p-value=0.012, which is less than 0.05, therefore there is statistically significant association between occupation and
Digital Health Literacy.

60. TABLE-15 : ASSOCIATION OF DIGITAL HEALTH LITERACY WITH SOCIAL CLASS (N=415)
SOCIAL CLASS LOW DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL
χ2 P VALUE
UPPER 119 (41%) 171 (59%) 290(69.87%) 25.787 0.00 (<0.05)
MIDDLE 52 (70.3%) 22 (29.7%) 74(17.83%)
LOWER 33 (64.7%) 18 (35.3%) 51(12.22%)
TOTAL 204 (49.1%) 211 (50.9%) 415(100%)
Since the p-value=0.00, which is less than 0.05, therefore there is statistically significant association between Social Class and Digital
Health Literacy.

61. DURATION OF
PRESENTING
COMPLAINTS
LOW DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL
χ2 P VALUE
<3 MONTHS 112 (46.3%) 130 (53.7%) 242(58.31%) 1.921 0.166
≥3 MONTHS 92 (53.2%) 81 (46.8%) 173(41.69%)
TOTAL 204(49.2%) 211(50.8%) 415(100%)
Since, the p-value = 0.166, which is more than 0.05, therefore there is no statistically significant association between duration of
presenting complaint and digital health literacy.
TABLE-16 : ASSOCIATION BETWEEN DURATION OF PRESENTING COMPLAINT AND DIGITAL
HEALTH LITERACY (N=415)

62. PARTICIPANTS
HAVING
ELECTRONIC
DEVICE
LOW DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL P VALUE
YES 183(46.7%) 209(53.3%) 392(94.45%) 0.000 (<0.05)*
NO 21(91.3%) 2(8.7%) 23(5.55%)
TOTAL 204(49.1%) 211(50.8%) 415(100%)
TABLE-17 : ASSOCIATION BETWEEN PARTICIPANTS HAVING ELECTRONIC DEVICE AND
DIGITAL HEALTH LITERACY (N=415)
*This value is calculated by Fisher’s exact test.
Since, the p-value=0.000,which is less than 0.05,therefore there is statistically significant association between having electronic device
and Digital Health Literacy.

63. INTERNET
USAGE
(MEDIAN=3
HOURS)
LOW DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL
χ2 P VALUE
HIGH USAGE
(≥3 HOURS)
67(29.77%) 158(70.22%) 225(54.21%)
73.844 0.000(<0.05)
LOW USAGE
(<3 HOURS)
137(72.10%) 53(27.89%) 190(45.79%)
TOTAL 204(49.15%) 211(50.85%) 415(100%)
TABLE-18 : ASSOCIATION BETWEEN HOURS OF INTERNET USAGE AND DIGITAL HEALTH
LITERACY (N=415)
Since the p-value=0.000,which is less than 0.05,therefore there is statistically significant association between “ hours of internet
usage” and Digital Health Literacy.

64. Have you ever had difficulty in
understanding health related
information on the internet
because it was in different
language?
Low DHL High DHL TOTAL
χ2 P VALUE
YES 60 (65.9%) 31 (34.1%) 91(21.92%)
13.127 0.000 (<0.05)
NO 144 (44.4%) 180 (55.6%) 324(78.08%)
TOTAL 204(49.1%) 211(50.9%) 415
TABLE-19 : ASSOCIATION OF LANGUAGE BARRIER WITH DIGITAL HEALTH LITERACY(N=415)
Since the p-value=0.000,which is less than 0.05,therefore there is statistically significant association between Language Barrier and
Digital Health Literacy.

65. Have you experienced
any privacy concerns
that make you hesitant
to use digital health
apps?
LOW DIGITAL
HEALTH
LITERACY
HIGH DIGITAL
HEALTH
LITERACY
TOTAL
χ2 P VALUE
YES 34(45.9%) 40(54.1%) 74(17.83%)
0.371 0.542
NO 170(49.9%) 171(50.1%) 341(82.17%)
TOTAL 204 211 415
TABLE-20 : ASSOCIATION OF PRIVACY CONCERNS WITH DIGITAL HEALTH LITERACY (N=415)
Since the p-value=0.542,which is more than 0.05,therefore no statistically significant association between “privacy concerns ” and Digital
health literacy was found.

66. 1. In this study, mean eHEALS score was 22.4. Approximately 50.8% of participants scored above and equal to this mean, indicating
a high level of Digital health literacy among patients attending the OPD at a tertiary care hospital in New Delhi.
2. Younger patients (less than 32 years) had higher Digital health literacy (69.75%) while older adults (more than 32 years) had lower
digital health literacy rate (34.09%)
3. Females represented (44.91%) of the high digital health literacy whereas males represented (55.95%) indicating males had higher
Digital health literacy scores.
4. Literate participants showed higher Digital health literacy especially those with higher education level with (54.80%) scoring high
on eHEALS.
5. Participants who are employed had higher Digital health literacy (55.6%) compared to those who are unemployed(21.1%) and not
in labour force (48.6%) .
6. Significant association was found between social class and Digital health literacy. Upper Socioeconomic status (59%) had highest
Digital health literacy followed by lower Socioeconomic class (35.3%) and then middle class (29.7%) with lowest Digital health
literacy among social classes.
CONCLUSION

67. 7. In our study, possession of electronic devices and higher hours of internet usage corresponded to higher digital health literacy and
vice versa.
8. A statistically significant association between language barrier and digital health literacy was found. 21.9% of our study
participants had faced language barrier while accessing health related information on the internet.
9. No significant association of Digital health literacy with respect to religion, type of illness and privacy concern was observed.
10. The most availed digital health resources were ordering medicines online (30.12%) and booking appointments online (28.6%).
11. Least availed digital health resource grievance redressal NDHM call center (2.65%) and child health apps (4.33%).
12. The most popular health related apps among study participants were Aarogya Setu, ABHA, and Ayushman apps.

68. LIMITATIONS
LACK OF LONGITUDINAL DATA
- Cross sectional study provides the snapshot of digital health literacy level at one time .
- Longitudinal study might reveal the evolution of digital health literacy with time , age or exposure, especially with
the ongoing implementation of digital health initiatives in India
-The cross sectional study only tells us about the status of digital health literacy at a point but doesn’t tells us about the
cause of low or high digital health literacy. To determine the cause, we require temporal association which can not be
assessed using a cross sectional study.
SINGLE CENTER STUDY
- It has limited diversity of the participant pool in terms of socio-economic, cultural , religious and linguistic barriers .

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WHO/HPR/HEP/98.1
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Literacy Assessment and Accurate Assessment of Online Health Information: Cross-Sectional Questionnaire Study. J Med Internet
Res. 2020
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REFERENCES

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72. ANNEXURE V: QUESTIONNAIRE/प्र नावली
DATE/तारीख:____________ FORM NO./फॉमर्ज नं.:________
PART A:SOCIO-DEMOGRAPHIC DATA/खण्ड क ;सामािजक-जनसांिख्यकीय डेटा
Name/नाम-_____________________ Age/उम्र-________
1.Have you come to the hospital for the first time?- (Yes/No)/ क्या आप इस अस्पताल में पहली बार आये हैं?(हाँ/ नहीं)
2.Do you have any electronic devices (mobile phone, laptop, iPad, or computer) at home/workplace? (Yes/No)/ क्या आपक
े पास
घर/कायर्जस्थल पर कोई इलेक्ट्रॉ नक संपक
र्ज उपकरण (मोबाइल फोन, लैपटॉप, आईपैड, या क
ं प्यूटर) है? (हाँ/ नहीं)
3. Do you have any mode of internet access at home (mobile data/Wi-Fi)? (Yes/No)/ क्या आपक
े पास घर पर इंटरनेट सु वधा (मोबाइल
डेटा/Wi-Fi) है? (हाँ/ नहीं)
4. Age / उम्र: _____
5. Sex / लंग:
a. Male / पुरुष
b. Female / म हला
c. Others / अन्य

73. 6. Religion / धमर्ज:
a. Hindu / हन्दू
b. Muslim / मुिस्लम
c. Christian / ईसाई
d. Others / अन्य
7. Educational status / शैक्ष णक िस्थ त:
a. Profession/honours / पेशेवर/मानद
b. Graduate / स्नातक
c. Intermediate or diploma / इंटरमी डएट या
डप्लोमा
d. High school certificate / हाई स्क
ू ल
प्रमाणपत्र
e. Middle school certificate / म डल स्क
ू ल
प्रमाणपत्र
f. Primary school certificate / प्राइमरी स्क
ू ल
प्रमाणपत्र
g. Illiterate / नरक्षर
8. Occupation / व्यवसाय: ___________
9. Family income / प रवार की आय: ___________
10. Number of family members / प रवार क
े सदस्यों की संख्या: __________

74. PART B [eHealth Literacy Scale(eHEALS)]/खण्ड ख
I would like to ask you for your opinion and about your experience using the Internet for health information. For each statement, tell me
which response best reflects your opinion and experience right now./ मैं आपसे इंटरनेट का उपयोग करक
े स्वास्थ्य जानकारी प्राप्त करने क
े बारे
में आपक
े अनुभव और राय जानना चाहूंगा/चाहूंगी। प्रत्येक कथन क
े लए, वह प्र त क्रिया चुनें जो अभी आपकी राय और अनुभव को सबसे अच्छा
दशार्जती है
1. I know what health resources are available on the Internet/ मुझे पता है क इंटरनेट पर कौन-कौन से स्वास्थ्य सु वधा उपलब्ध हैं।
a) Strongly Disagree/ पूरी तरह असहमत
b) Disagree/ असहमत
c) Undecided/ अ नि चत
d) Agree/ सहमत
e) Strongly Agree/ पूरी तरह सहमत
2. I know where to find helpful health resources on the Internet/ मुझे पता है क इंटरनेट पर उपयोगी स्वास्थ्य सु वधा कहां मलती है?
a) Strongly Disagree/ पूरी तरह असहमत
b) Disagree/ असहमत
c) Undecided/ अ नि चत
d) Agree/ सहमत
e) Strongly Agree/ पूरी तरह सहमत

75. 3. I know how to find helpful health resources on the Internet/ मुझे पता है क इंटरनेट पर उपयोगी स्वास्थ्य सु वधा क
ै से खोजी जाती है?
a) Strongly Disagree/ पूरी तरह असहमत
b) Disagree/ असहमत
c) Undecided/ अ नि चत
d) Agree/ सहमत
e) Strongly Agree/ पूरी तरह सहमत
4. I know how to use the Internet to answer my questions about health/ मुझे पता है क मैं स्वास्थ्य संबंधी प्र नों क
े उत्तर इंटरनेट से क
ै से पा
सकता / सकती हूँ।
a) Strongly Disagree/ पूरी तरह असहमत
b) Disagree/ असहमत
c) Undecided/ अ नि चत
d) Agree/ सहमत
e) Strongly Agree/ पूरी तरह सहमत
5. I know how to use the health information I find on the Internet to help me/ मुझे पता है क इंटरनेट पर पाई गई स्वास्थ्य जानकारी का
उपयोग मैं अपनी मदद क
े लए क
ै से कर सकता/ सकती हूँ।
a) Strongly Disagree/ पूरी तरह असहमत
b) Disagree/ असहमत
c) Undecided/ अ नि चत
d) Agree/ सहमत
e) Strongly Agree/ पूरी तरह सहमत

76. 6. I have the skills I need to evaluate the health resources I find on the Internet/ मैं इंटरनेट पर मले स्स्वास्थ्य सु वधा को समझने की क्षमता
रखता/रखती हूं।
a) Strongly Disagree/ पूरी तरह असहमत
b) Disagree/ असहमत
c) Undecided/ अ नि चत
d) Agree/ सहमत
e) Strongly Agree/ पूरी तरह सहमत
7. I can tell high quality health resources from low quality health resources on the Internet/ मैं अच्छे स्वास्थ्य सु वधा को सामान्य स्वास्थ्य
सु वधा से फक
र्ज कर सकता/ सकती हूँ।
a) Strongly Disagree/ पूरी तरह असहमत
b) Disagree/ असहमत
c) Undecided/ अ नि चत
d) Agree/ सहमत
e) Strongly Agree/ पूरी तरह सहमत
8. I feel confident in using information from the Internet to make health decisions/ मैं स्वास्थ्य नणर्जय लेने क
े लए इंटरनेट से मली
जानकारी का उपयोग करने में आत्म व वास महसूस करता /करती हूँ।
a) Strongly Disagree/ पूरी तरह असहमत
b) Disagree/ असहमत
c) Undecided/ अ नि चत
d) Agree/ सहमत
e) Strongly Agree/ पूरी तरह सहमत

77. PART C/ खण्ड ग
1. Have you ever had difficulty understanding health-related information on the internet because it was in a different language?/ क्या
आपने कभी इंटरनेट पर उपलब्ध स्वास्थ्य संबं धत जानकारी को समझने में क ठनाई महसूस की है क्यों क वह अलग भाषा में थी?
Yes /हाँ( ) No /नहीं( )
2. How many hours do you use the internet in a day?/ आप इंटरनेट का उपयोग प्र त दन कतने घंटे करते हैं?
______________________
3a. Are you aware that there is a digital health ID for individuals?/ क्या आप जानते हैं क लोगों क
े लए एक डिजटल स्वास्थ्य आई डी होता है?
Yes/ हाँ ( ) No/ नहीं( )
3b. Have you made your digital health ID?/ क्या आपने अपना डिजटल स्वास्थ्य आई डी बनवाया है?
Yes/ हाँ ( ) No/ नहीं( )
4a. Do you know that you can access all your personal health records online through an online platform (ABHA)?/ क्या आप जानते हैं क
आप एक ऑनलाइन प्लेटफ़ॉमर्ज (आयुष्मान भारत ऐप) क
े माध्यम से अपने सभी नजी स्वास्थ्य रकॉ र्जस तक पहुँच सकते हैं?
Yes/ हाँ ( ) No/ नहीं( )
4b. Have you accessed your personal health records?/ क्या आपने कभी अपने नजी ऑनलाइन स्वास्थ्य रकॉ र्जस का उपयोग कया है?
Yes/ हाँ ( ) No/ नहीं( )

78. 5a. Are you aware that you can find authentic health information on government websites?/ क्या आप जानते हैं क आप सरकारी वेबसाइटों
पर प्रामा णक स्वास्थ्य जानकारी प्राप्त कर सकते हैं?
Yes/ हाँ ( ) No/ नहीं( )
5b. Have you ever tried to search for such information on a government website?/ क्या आपने कभी इन सरकारी वेबसाइटों पर जानकारी
खोजने की को शश की है?
Yes/ हाँ ( ) No/ नहीं( )
6a. Are you aware that you can make appointments with doctors over the phone or video call?/ क्या आप जानते हैं क आप फोन या वी डयो
कॉल क
े माध्यम से डॉक्टरों से मलने क
े लए अपॉइंटमेंट ले सकते हैं?
Yes/ हाँ ( ) No/ नहीं( )
6b. Have you ever booked an appointment with a doctor via phone or video call?/ क्या आपने कभी फोन या कॉल क
े माध्यम से डॉक्टर से
मलने क
े लए अपॉइंटमेंट लया है?
Yes/ हाँ ( ) No/ नहीं( )
7a. Are you aware of any helpline number or email address where you can submit your health-related grievances (NDHM call centre)?/
क्या आप कसी हेल्पलाइन नंबर या ईमेल पते क
े बारे में जानते हैं जहाँ आप स्वास्थ्य संबंधी शकायतें दजर्ज कर सकते हैं (एन.डी.एच.एम. कॉल सेंटर)?
Yes/ हाँ ( ) No/ नहीं( )
7b. Have you ever used this helpline to submit a grievance?/ क्या आपने कभी इस हेल्पलाइन नंबर का उपयोग करक
े शकायत दजर्ज की है?
Yes/ हाँ ( ) No/ नहीं( )

79. 8a. Do you know that medicines can be ordered online?/ क्या आप जानते हैं क दवाइयाँ ऑनलाइन मंगवाई जा सकती हैं?
Yes/ हाँ ( ) No/ नहीं( )
8b. Have you ever ordered medicines online?/ क्या आपने कभी ऑनलाइन दवाइयाँ मंगवाई हैं?
Yes/ हाँ ( ) No/ नहीं( )
9a. Do you know about apps related to child health (e.g., Kilkari app, Immunize India)?/ क्या आप बच्चों से संबं धत स्वास्थ्य ऐप क
े बारे में
जानते हैं (उदाहरण क
े लए: कलकारी ऐप, इम्यु नज इं डया ऐप)?
Yes/ हाँ ( ) No/ नहीं( )
9b. Have you ever used these apps (Kilkari app, Immunize India)?/ क्या आपने कभी इन ऐप्स (उदाहरण क
े लए: कलकारी ऐप, इम्यु नज
इं डया ऐप) का उपयोग कया है?
Yes/ हाँ ( ) No/ नहीं( )
10a. Are you aware that you can deactivate or opt out from any digital health services anytime?/ क्या आप जानते हैं क आप कसी भी
ऑनलाइन स्वास्थ्य सेवा का उपयोग करना कभी भी छोड़ सकते हैं?
Yes/ हाँ ( ) No/ नहीं( )
10b. Have you ever used this feature?/ क्या आपने कभी इस सु वधा का उपयोग कया है?
Yes/ हाँ ( ) No/ नहीं( )

80. 11b. Do you know how to use these apps?/ क्या आप जानते हैं क इन ऐप्स का उपयोग क
ै से करें?
Yes/ हाँ( ) No/ नहीं( )
S.no Name of the app/ ऐप का नाम ✓
i Aarogya Setu/ आरोग्य सेतु
ii ABHA/ आयुष्मान भारत स्वास्थ्य खाता
iii e-Aushadhi/ ई-औष ध
iv e-Sanjeevani/ ई-संजीवनी
v Mera Aspataal/ मेरा अस्पताल
vi e-Raktkosh/ ई-रक्तकोष
vii Nikshay/ नक्षय
viii Poshan tracker/ पोषण ट्रैकर
ix Ayushman App/ आयुष्मान ऐप
11a. Are you aware of the Government health app developed by the Government of India/ क्या आप भारत सरकार द्वारा वक सत सरकारी स्वास्थ्य ऐप्स
क
े बारे में जानते हैं?

81. 12. Have you encountered situations where health websites or apps did not offer your preferred language as an option?/ क्या आपने ऐसी
िस्थ तयां अनुभव की हैं जहाँ स्वास्थ्य वेबसाइट या ऐप्स ने आपकी पसंदीदा भाषा में वकल्प नहीं दया?
Yes/ हाँ( ) No/ नहीं( )
11c. Have you ever used these apps/ क्या आपने कभी इन ऐप्स का उपयोग कया है?
S.no Name of the app/ ऐप का नाम ✓
i Aarogya Setu/ आरोग्य सेतु
ii ABHA/ आयुष्मान भारत स्वास्थ्य खाता
iii e-Aushadhi/ ई-औष ध
iv e-Sanjeevani/ ई-संजीवनी
v Mera Aspataal/ मेरा अस्पताल
vi e-Raktkosh/ ई-रक्तकोष
vii Nikshay/ नक्षय
viii Poshan tracker/ पोषण ट्रैकर
ix Ayushman App/ आयुष्मान ऐप

82. 13. Have you experienced any privacy concerns that make you hesitant to use digital health apps?/ क्या आपने कसी गोपनीयता संबंधी चंताओं
का अनुभव कया है जो आपको डिजटल स्वास्थ्य ऐप्स क
े उपयोग में हच कचाहट पैदा करती है?
Yes/ हाँ ( ) No/ नहीं( )