Using Technology Adoption Theory and a Lifespan Approach to Develop a Theoretical Framework for eHealth Literacy: Extending UTAUT.

Advancements in health information technology (HealthIT) and the electronic exchanges of health information have "revolutionized" health systems in the US. However, adopting technological developments into the healthcare system has the potential to benefit populations with more resources, further exacerbating health status disparities. Efficacious utilization of HealthIT requires eHealth literacy. Although eHealth literacy is comprised of six factors, new research indicates that the components related to technology literacy may be more impactful in eHealth literacy among certain populations (e.g., older populations who shoulder a greater illness-management burden). Recognizing the importance of technology literacy in eHealth literacy across the lifespan, we investigate generational differences in New Communication Technology (NCT) use and eHealth literacy, especially considering how NCT adoption theory might systematically inform scholars' understanding of eHealth literacy. Participants included 525 adults primarily in the Midwestern United States. We found significant differences between generational groups across all variables. We found that UTAUT determinants such as performance expectancy and effort expectancy explained 38% of the variance in eHealth literacy, controlling for age, sex, level of education, and prior online health information seeking. Finally, we engaged with early critiques of UTAUT, finding that when applying UTAUT in voluntary (vs. mandatory) contexts, scholars should reconsider variables previously dismissed, such as attitude. In doing this, we extend UTAUT in three ways: new contexts (voluntary NCT adoption), endogenous theoretical mechanisms (eHealth literacy), and exogenous variables (attitude; lifespan). These findings underscore a need for a targeted approach to improve eHealth literacy and health self-management across generations.