eHealth literacy and digital health interventions: Key ingredients for supporting the mental health of displaced youth living in the urban slums of kampala, Uganda

Abstract

During and after displacement, many displaced youth face increased vulnerability to poor mental health and can encounter inaccurate or confusing health information. Digital tools create new opportunities to reach more of these youth with mental health interventions. Yet maximizing these tools' effectiveness among displaced youth requires understanding their eHealth literacy (eHEALS; i.e., the ability to find, understand, and appraise health information from electronic sources and apply this knowledge to a health problem). Thus, we conducted a community-based cross-sectional survey of 445 displaced youth (16–24 years) living in the slums of Kampala, Uganda to measure their eHEALS and its association with psychosocial wellbeing. Exploratory and confirmatory factor analysis identified a unidimensional measure of eHEALS. Structural equation modeling results indicated that eHEALS was not directly associated with depressive symptoms (β = .08, p = 0.15), but was significantly positively associated with resilience (β = .32, p < 0.001). Resilience was, in turn, significantly negatively associated with depressive symptoms (β = −.21, p < 0.001). The Sobel test for indirect effects confirmed that eHEALS indirectly negatively affected depressive symptoms through resilience (i.e., β_{indirect effect} = −.07, p = 0.004). Our findings highlight the need for interventionists to develop contextualized eHealth interventions that facilitate displaced youth's ability to access, understand, and use health information to the best of their ability and optimally benefit from services.