Evaluating digital health literacy and associated factors among primary care professionals in the Brazilian Federal District

Healthcare is undergoing a quiet revolution. Across the globe, doctors and nurses are increasingly relying on digital tools to manage patient records, find the latest medical guidelines, and communicate with families. This shift promises faster, more personalized care, but it only works if the people using the technology feel confident and capable. A new concept called digital health literacy has emerged to describe this specific skill set. It is not just about knowing how to turn on a computer or connect to the internet; it is about knowing how to find reliable health information online, understanding what that information means, and having the confidence to use it to make safe decisions for patients. Without this skill, the very tools meant to improve care could lead to confusion or errors, leaving the promise of digital transformation unfulfilled.

In the Federal District of Brazil, a team of researchers decided to investigate how well primary care professionals were navigating this new digital landscape. They focused on the front-line workers who coordinate daily care in community health centers: doctors, nurses, and community health workers who visit families in their homes. The study took place across eight different health units, where the researchers spoke directly with 123 professionals. Instead of sending out online surveys that might miss those less comfortable with technology, the team visited the units in person, meeting staff before their shifts began to ensure everyone had a fair chance to participate. They asked detailed questions about how these workers used the internet, what devices they owned, and how confident they felt when searching for health information online. They also measured their digital health literacy using a standard scale that asks people to rate their own knowledge and skills in finding and evaluating health information on the web.

The results painted a picture of a workforce that is fully connected but still cautious. Every single participant had access to the internet, and almost everyone used a smartphone as their primary tool to get online. They were comfortable with the basics: finding information, using email, and communicating with colleagues. On average, the professionals scored very high on their general ability to navigate digital health resources, with most rating themselves as highly capable. However, a closer look at their answers revealed a distinct gap. While they felt very sure about their ability to find information, their confidence dropped significantly when it came to judging whether that information was high-quality or safe to use for making clinical decisions. They knew how to search, but they were less certain about how to trust what they found.

The study also uncovered who was most likely to feel confident in these digital skills. The researchers found that a person's level of formal education was a strong predictor of their digital literacy; those with higher degrees tended to score higher. There was also a clear difference based on job role. Doctors and nurses reported higher levels of digital confidence compared to community health workers and nursing technicians. Surprisingly, the researchers found that neither a person's age nor how many years they had worked in healthcare made a difference in their digital skills. This suggests that simply working with technology for a long time does not automatically build the critical thinking needed to evaluate health information.

The authors suggest that this hesitation to trust digital information is not necessarily a failure of skill, but rather a form of professional caution. Unlike the general public, who might overestimate their understanding of complex topics, these healthcare workers seem to be actively guarding against misinformation. They recognize that just because information is available online does not mean it is correct. This "epistemic buffer," as the researchers call it, shows that they are aware of the noise and unreliability that can exist in the digital ecosystem. However, this caution becomes a problem if it stops them from using valid digital tools effectively, especially for community health workers who act as the main bridge between the health system and vulnerable families. If these frontline workers lack the confidence to critically appraise digital content, they may struggle to filter out bad information for the people they serve.

Ultimately, the study indicates that while Brazil's primary care workforce is well-equipped with technology, the system needs to do more to build the critical thinking skills required to use it safely. The researchers argue that digital health literacy should not be viewed as an individual trait that workers must develop on their own, but as a core part of the organization's responsibility. To truly protect patients and ensure safety, health systems must move beyond simply providing internet access. They need to create environments that support continuous training in critical evaluation, ensuring that every professional, regardless of their job title or education level, feels empowered to navigate the digital world with both skill and confidence.