Universal Journal of Public Health 13(1): 152-159, 2025 http://www.hrpub.org DOI: 10.13189/ujph.2025.130115 Assessing e-Health Literacy and Digital Competence among Peruvian Primary Health Care Patients Anahis Xiomara Palomino 1 , Shiry Imelda Palomino 1 , Juan Morales 2,* 1 Faculty of Health Sciences, School of Nursing, University of Sciences and Humanities (UCH), Peru 2 E-Health Research Center, University of Sciences and Humanities (UCH), Peru Received September 23, 2024; Revised November 19, 2024; Accepted December 11, 2024 Cite This Paper in the Following Citation Styles (a): [1] Anahis Xiomara Palomino, Shiry Imelda Palomino, Juan Morales , "Assessing e-Health Literacy and Digital Competence among Peruvian Primary Health Care Patients," Universal Journal of Public Health, Vol. 13, No. 1, pp. 152 - 159, 2025. DOI: 10.13189/ujph.2025.130115. (b): Anahis Xiomara Palomino, Shiry Imelda Palomino, Juan Morales (2025). Assessing e-Health Literacy and Digital Competence among Peruvian Primary Health Care Patients. Universal Journal of Public Health, 13(1), 152 - 159. DOI: 10.13189/ujph.2025.130115. Copyright©2025 by authors, all rights reserved. Authors agree that this article remains permanently open access under the terms of the Creative Commons Attribution License 4.0 International License Abstract The aim of the study was to assess the level of e-Health literacy among users of primary health care. Materials and methods: Quantitative approach study, cross- sectional descriptive design. The population consisted of users of primary health care located in the northern area of the city of Lima, Peru. The e-Health Literacy Scale (eHEALS) was used. Results: The study involved 400 subjects of both sexes, with a median age of 35 years (Q1=28, Q3=47, IQR=19, Min=18, Max=78). The median eHEALS scale score obtained by the respondents was 18 (Q1=14, Q3=22, IQR=8, Min=8, Max=40). A mere 18.2% (n=73) of health users demonstrated a high level of e- Health literacy. The e-Health literacy was significantly associated with educational level (p<0.001, 1-β=1, ω=0.41), frequency of internet access (p<0.001, 1-β=1, ω=0.51), and autonomy in the use of digital technology (p<0.001, 1-β=1, ω=0.40). The e-Health literacy was most strongly associated with possession of a university education (OR=12.662, IC95%: 0.962-523.566), frequency of Internet access [(OR=2.520, IC95%: 1.190-5.490), (OR=5.992, IC95%: 2.848-13.157)], and digital technology skills (OR=2.847, IC95%: 1.218-7.109). Conclusions: Low e-Health literacy is widespread among primary care users. However, the frequency of Internet access and the digital competence of individuals are the key factors in increasing the level of e-Health literacy among patients. Keywords e-Health Literacy, Health Services, Primary Health Care, Peru 1. Introduction Information and communication technologies (ICT) contribute to improving the quality, efficiency and effectiveness of the healthcare system [1]. Connectivity has profound and diverse repercussions; the Internet has the potential to improve the well-being of people throughout their lives [2]. Currently, the number of Internet users worldwide is 5.78 billion, equivalent to two-thirds of the world's population; the average global Internet penetration rate is 64.6%, the highest in Northern Europe 97.3%, and the lowest in East Africa 23.3%; South America has a rate of 80.6% [3]. In the United States, two decades ago, in primary care facilities located in urban areas, the proportion of patients using the Internet to search for health information was 53% [4]. Patients who used the Internet to obtain medical information were mainly those with higher educational levels and higher incomes [5]. Nowadays, there is a high level of adoption of the Internet for various healthcare purposes [6]. The COVID-19 pandemic increased the use of digital tools in healthcare [7], and the use of telemedicine has expanded enormously [8]. Access to digital devices and the internet is key as it is related to e-Health literacy, which is the ability to search, find, understand and evaluate health information from electronic sources and apply the knowledge gained to