Designing Solutions for Cultural Barriers in Digital Health Literacy Among Older Adults in Austria

Aim and Research Question(s)

The aim of this study was to identify cultural barriers that hinder older migrants in Austria from accessing digital health information. Based on the findings, a culturally sensitive, multilingual website prototype was developed, tested, and improved. The central research questions were:

1. How do experiences and attitudes toward digital health literacy differ among older adults with diverse cultural backgrounds in Austria, and how do these insights inform the design of a website mockup?
2. What cultural barriers need to be addressed in the design of a website mockup to promote digital health literacy among older adults with migration backgrounds in Austria?
3. What design and content elements should be incorporated into the website mockup to address the specific needs of older adults from diverse cultural backgrounds?
4. How do different stakeholders contribute to improving digital health literacy for older adults with diverse cultural backgrounds in Austria, and how can their input be integrated into the website mockup design and evaluation?

Background

The digitalization of healthcare requires Digital Health Literacy (DHL) as a key competency (Norman & Skinner, 2006). Older migrants face specific challenges such as language barriers, limited digital experience, and low trust in digital systems. Targeted support is needed to improve their access and participation (Walter & Röding, 2019, as cited in Enste & Wielga, 2021).

Methods

The study followed a user-centered design approach. Seven semi-structured interviews were conducted with older adults (65+) with a migration background (≥5 years in Austria, German ≥ B1), transcribed, and thematically analyzed in MAXQDA (deductive and inductive). Based on the results, a culturally sensitive digital prototype was developed in Figma and tested with the same participants using 15 Likert-scale items and 3 open-ended questions to assess acceptance, clarity, and design.

Results and Discussion

The interviews show that older migrants use digital devices but are largely unfamiliar with digital health services. Barriers include language, limited awareness, and technical uncertainty. Participants called for simple language, native-language content, and clear navigation. The prototype received mostly positive feedback. Strong reliance on family members highlights the need for culturally sensitive, accessible solutions tailored to disadvantaged groups.

Conclusion

Digital health services are only effective when they are tailored to the needs of their users. For older adults with a migration background, this means they must be linguistically accessible, culturally appropriate, and grounded in everyday life. Technical functionality alone is not enough; trust and use within social contexts are essential. Participatory development processes have proven to be a suitable approach. The findings offer concrete starting points for practice and further research.

References

1. Enste, P., & Wielga, J. (2021). Die Bedeutung der digitalen Gesundheitskompetenz bei der Gesundheitsversorgung Geflüchteter (Forschung Aktuell Nr. 12/2021). Institut Arbeit und Technik (IAT), Westfälische Hochschule. https://hdl.handle.net/10419/248878
2. Norman, C. D., & Skinner, H. A. (2006). Ehealth Literacy: Essential Skills for Consumer Health in a Networked World. Journal of Medical Internet Research, 8(2), e9. https://doi.org/10.2196/jmir.8.2.e9