Identifying facilitators of and barriers to digital health literacy in pediatric rheumatic disease: A scoping review
7 affiliations
- 1Faculty of Nursing, University of Regina (Saskatoon Campus), Saskatoon, Canada
- 2Health Sciences Graduate Program, College of Medicine, University of Saskatchewan, Saskatoon, Canada
- 3Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Canada
- 4Research Institute, The Hospital for Sick Children, Toronto, Canada
- 5Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- 6School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Canada
- 7Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada
Abstract
Digital health (DH) technologies have the potential to benefit pediatric patients with rheumatic diseases and their caregivers. Digital health literacy (DHL) refers to the knowledge and skills necessary to use technology and the internet to manage and communicate about health. The aim of this scoping review is to identify facilitators of and barriers to DHL and map them to the Capability, Opportunity, and Motivation Model of Behavior (COM-B Model) for children and adolescents with rheumatic diseases and their primary caregivers. We searched MEDLINE, CINAHL, Embase, Web of Science, and ProQuest for English full-text primary research studies. Facilitators of and barriers to DHL identified were codified and mapped to the COM-B Model. This review adhered to the JBI scoping review framework and conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Scoping Review guidelines. Of the 5789 unique records, 44 met inclusion criteria. All the included studies did not explicitly address the concept and impact of DHL. However, the studies identified promoting and detracting factors that matched the definition of DHL. Thus, these were coded as facilitators of and barriers to DHL. The COM-B Model domain of psychological capability emerged as a major determinant of DHL. The COM-B Model domain of psychological capability emerged as a prominent source of facilitators of and barriers to DHL. The design, function, language, and presentation of DH crafted to meet the developmental and educational needs of the user were essential to improving DHL. Likewise, providers fostering quality communication and answering medical and technical questions arising from DH use fostered DHL in the domain of physical opportunity. Addressing DHL requires consideration across clinical, administrative, design, and research contexts. Recognizing low DHL and enacting educational interventions are essential to empowering digital health users. Trial Registration Open Science Framework (https://osf.io/g4jbh/). Author summary: Digital health is the use of digital information and communication technologies to manage health care. The skills, know-how, and ability to get benefit from using digital health is called digital health literacy (DHL). Having lower levels of DHL means a person may not get the full benefit from digital health. We did a scoping review to identify factors that make DHL better and worse in young people with childhood rheumatic disease and their caregivers. A scoping review looks at what is already known about this in medical studies and groups the findings together into one study. Once we found the factors that make DHL better and worse, we matched them to the COM-B Model of Behavior. Using the COM-B Model helps us understand how these factors make people act. We found that how well people understand the digital health was a major reason their DHL got better or worse. We also found that people need certain things in digital health to make their DHL better. These include the app being easy to use and understand. Doctors and nurses help by telling their patients about digital health. They can also help by training their patients to use digital health and answering any questions they have.
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BibTeX
@article{eling2026identifying,
title = {{Identifying facilitators of and barriers to digital health literacy in pediatric rheumatic disease: A scoping review}},
author = {Craig Eling and Alan M. Rosenberg and Jennifer N. Stinson and Maryam Mehtar and Jasmin Bhawra and Roona Sinha and Donna Goodridge},
journal = {PLOS Digital Health},
year = {2026},
month = oct,
doi = {10.1371/journal.pdig.0001777},
url = {https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001777},
note = {CC BY},
}
RIS
TY - JOUR
TI - Identifying facilitators of and barriers to digital health literacy in pediatric rheumatic disease: A scoping review
AU - Craig Eling
AU - Alan M. Rosenberg
AU - Jennifer N. Stinson
AU - Maryam Mehtar
AU - Jasmin Bhawra
AU - Roona Sinha
AU - Donna Goodridge
PY - 2026
DA - 2026/10/01
JO - PLOS Digital Health
DO - 10.1371/journal.pdig.0001777
UR - https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001777
AB - Digital health (DH) technologies have the potential to benefit pediatric patients with rheumatic diseases and their caregivers. Digital health literacy (DHL) refers to the knowledge and skills necessary to use technology and the internet to manage and communicate about health. The aim of this scoping review is to identify facilitators of and barriers to DHL and map them to the Capability, Opportunity, and Motivation Model of Behavior (COM-B Model) for children and adolescents with rheumatic diseases and their primary caregivers. We searched MEDLINE, CINAHL, Embase, Web of Science, and ProQuest for English full-text primary research studies. Facilitators of and barriers to DHL identified were codified and mapped to the COM-B Model. This review adhered to the JBI scoping review framework and conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Scoping Review guidelines. Of the 5789 unique records, 44 met inclusion criteria. All the included studies did not explicitly address the concept and impact of DHL. However, the studies identified promoting and detracting factors that matched the definition of DHL. Thus, these were coded as facilitators of and barriers to DHL. The COM-B Model domain of psychological capability emerged as a major determinant of DHL. The COM-B Model domain of psychological capability emerged as a prominent source of facilitators of and barriers to DHL. The design, function, language, and presentation of DH crafted to meet the developmental and educational needs of the user were essential to improving DHL. Likewise, providers fostering quality communication and answering medical and technical questions arising from DH use fostered DHL in the domain of physical opportunity. Addressing DHL requires consideration across clinical, administrative, design, and research contexts. Recognizing low DHL and enacting educational interventions are essential to empowering digital health users. Trial Registration Open Science Framework (https://osf.io/g4jbh/). Author summary: Digital health is the use of digital information and communication technologies to manage health care. The skills, know-how, and ability to get benefit from using digital health is called digital health literacy (DHL). Having lower levels of DHL means a person may not get the full benefit from digital health. We did a scoping review to identify factors that make DHL better and worse in young people with childhood rheumatic disease and their caregivers. A scoping review looks at what is already known about this in medical studies and groups the findings together into one study. Once we found the factors that make DHL better and worse, we matched them to the COM-B Model of Behavior. Using the COM-B Model helps us understand how these factors make people act. We found that how well people understand the digital health was a major reason their DHL got better or worse. We also found that people need certain things in digital health to make their DHL better. These include the app being easy to use and understand. Doctors and nurses help by telling their patients about digital health. They can also help by training their patients to use digital health and answering any questions they have.
SN - 2767-3170
ER -