Health and digital health literacy and self-rated health in migrants residing in Portugal.

Abstract

Health and digital health literacy are key determinants of health, particularly among migrants who often face challenges accessing health information and navigating healthcare systems. However, diversity of health literacy aspects within this group, particularly digital health literacy, remains underexplored. This study aims to identify different profiles of health and digital health literacy, in migrant communities in Portugal, and their associations with sociodemographic and migration factors, as well as self-rated health. A national cross-sectional study was conducted with 998 migrants residing in Portugal. Data were collected through a paper-based questionnaire comprising sociodemographic, migration-related, and health variables, along with items from the Health Literacy Questionnaire (HLQ) and the eHealth Literacy Questionnaire (eHLQ). Items representing HLQ dimensions were selected based on clarity and representativeness, while eHLQ items were informed by informed by prior workshops and interviews with migrants. Hierarchical cluster analysis was applied. Clusters were characterized based on health and digital literacy scores and their sociodemographic, migration and health characteristics. Thirteen distinct health literacy profiles were identified, reflecting varying combinations of health literacy strengths and needs, and differences in age, education, income, and country of origin. A majority (72%) reported at least one literacy challenge, particularly in healthcare system navigation and healthcare professional support. Confidence in digital access and use was mostly reported. Generally, a higher percentage of good self-rated health was observed in clusters with none or minor health literacy challenges. This study highlights the importance of recognizing diversity within migrant groups and addressing digital health literacy. It identifies varying strengths and needs, supporting targeted interventions where digital health literacy can serve as a valuable resource. Interventions in this specific community should incorporate both their needs and strengths, using digital health literacy to strengthen relationships with healthcare providers and improve healthcare access and use.