Health literacy inequities in chronic kidney disease: A digital health education programme
Abstract
Chronic kidney disease requires ongoing patient engagement in complex self-management, yet limited health literacy remains a key barrier to effective disease management. Digital health education programmes can help address these gaps by providing accessible and structured learning resources. This study examined whether a digital health education programme could improve chronic kidney disease-specific health literacy and disease-related knowledge among adults living with chronic kidney disease. A quasi-experimental study with experimental and comparison groups was conducted in two regional teaching hospitals in northern Taiwan. Participants in the experimental group received a 12-week digital health education programme in addition to the usual care, while those in the comparison group received usual care only. Assessments were conducted at baseline, post-intervention (3 months), and follow-up (6 months). Outcomes included chronic kidney disease-specific health literacy (functional, communicative, and critical domains) and chronic kidney disease-related knowledge, and programme usability was evaluated using the System Usability Scale. In addition, brief semi-structured interviews were conducted with a subset of participants in the experimental group after the intervention. Of the 100 people living with chronic kidney disease enrolled in the study, 83 completed all three assessments. Analysis of covariance tests revealed that after controlling for pre-test, age, and education level, participants in the experimental group demonstrated greater improvements in functional, communicative, and critical health literacy compared with usual care. Gains in chronic kidney disease-related knowledge were also sustained at follow-up. Digitally delivered health education programmes may help reduce literacy-related inequities in chronic disease management and support informed participation among adults living with chronic kidney disease.