Associations of Health and Digital Health Literacy with Health-Related Quality of Life: A Cross-Sectional Study in Greece and Cyprus

Background and Objective: Health literacy and digital health literacy reflect on an individual's ability to access, understand, and use health information and digital tools. Both have been associated with self-efficacy and improved health outcomes. The main aim of this study is to investigate the relationship between health literacy and digital health literacy with health-related quality of life. In addition, the study aims to identify the factors contributing to health and digital health literacy.Materials and Methods: A cross-sectional online survey was conducted between December ۲۰۲۴ and January ۲۰۲۵. The questionnaire included socio-demographic data, the HLS-EU-Q۱۶, the electronic Health Literacy Scale (eHEALS), while the SF-۱۲ was applied to assess physical and mental health-related quality of life. Descriptive statistics and inferential analysis were applied, including multiple linear and logistic regressions.Results: The sample included ۵۵۷ adults, aged ۱۸ years or above (mean age: ۳۱.۴ years; ۷۶.۵% female). Most participants had an adequate level of health literacy (۶۴.۸%), while the average digital health literacy score was ۲۷.۹۲ (sd=۷.۱۵). A significant positive correlation between health literacy and digital health literacy was found (r = ۰.۴۸۷, p<۰.۰۰۱). Health literacy was positively associated with educational level and income. Digital health literacy was also associated with higher educational attainment. Health literacy, but not digital health literacy, was significantly associated with better physical and mental health-related quality of life (b = ۰.۶۴ and b = ۰.۸۴, respectively; p<۰.۰۰۱).Conclusions: Among adults in Greece and Cyprus, health literacy was generally adequate and positively associated with higher education and income. Digital health literacy correlated with health literacy and education but was not independently related to health-related quality of life. Higher health literacy consistently predicted better physical and mental health-related quality of life, underscoring health literacy as a key, modifiable correlate. These findings support prioritizing health literacy building strategies to advance equity and self-management.

کلیدواژه ها:

Health Literacy ، Digital health literacy ، Health-Related Quality of Life ، Public health