Literacia digital em saúde e fatores associados em pessoas afetadas pela hanseníase: estudo transversal analítico

Abstract

The aim of the study was to analyze the level of digital health literacy in people affected by leprosy, identify associated factors, and develop a screening protocol applicable in Primary Health Care. This was an observational, cross-sectional, analytical study with a quantitative approach, conducted at the Dona Libânia Dermatology Reference Center, Ceará. The population consisted of people affected by leprosy, aged 18 years or older, receiving follow-up care at the service. The sample size was calculated for a finite population of 216 individuals, considering a 95% confidence level, an expected proportion of 50%, a 5% margin of error, and an additional 10% to account for losses or refusals, resulting in a minimum sample of 155 participants. Sampling was by convenience, with direct selection from the service’s appointment schedules, including patients undergoing multidrug therapy, those being monitored for leprosy reactions, and others under follow-up related to the disease. Sociodemographic, clinical, and functional variables were collected, along with the application of the eHealth Literacy Scale and the Mobile Device Proficiency Questionnaire. Analyses included descriptive statistics, bivariate nonparametric tests, effect size calculation, multiple linear regression, and binary logistic regression with ROC curve analysis. A total of 155 individuals participated in the study, of whom 87% reported owning a smartphone. The mean age was approximately 52 years, with a predominance of males. Incomplete elementary education was the most common educational category, and family income was concentrated between 1 and 2 minimum wages. Regarding the clinical profile, 48.4% of participants had one or more associated comorbidities, and 38.7% used assistive adaptations. Low digital health literacy was observed in 55.5% of the sample, while 48.4% demonstrated high digital proficiency, indicating a discrepancy between operational competence and digital literacy. The literacy scale showed excellent internal consistency (α = 0.97). In bivariate analyses, education level had a large effect on digital literacy (eta² = 0.209), while the presence of comorbidity showed a moderate effect (r = 0.207). In multivariate analysis, age was the main independent predictor of lower digital health literacy (standardized β = −0.315). The linear model showed moderate explanatory capacity, with an adjusted R² of 0.3299, and the logistic model demonstrated excellent discriminatory capacity, with an AUC = 0.849. Based on the findings, the Digital Health Literacy Screening Protocol for Primary Health Care (ProLID-APS) was developed, consisting of five questions, a score ranging from 0 to 10 points, and classification into three risk levels. The study revealed high vulnerability in digital health literacy among people affected by leprosy, highlighting the influence of age and education. The psychometric robustness of the instrument and the good performance of the predictive model supported the development of ProLID-APS, a brief, light-hard technology applicable to Primary Care, with the potential to early identify individuals at risk and support targeted educational interventions.