Introduction:
Digital technologies present new possibilities for the self-management of cardiovascular disease (CVD). Yet little is known about digital literacy training (DLT) needs among older adults to support their successful uptake of technology. We aimed to synthesize evidence about the impacts of training on health technology use among older adults with CVD and to explore their learning experiences.
Methods:
A systematic review was conducted according to PRISMA guidelines and supplemented by focus group input from older adults with CVD. Multiple databases were searched for articles reporting DLT with adults age 60+ years with CVD published between inception and March 31, 2025. Focus group responses to the question “What have been your experiences learning how to use digital technologies?” were analyzed and triangulated with review findings.
Results:
The review included 56 studies with DLT as part of digital health interventions and 32 patients with CVD (mean age = 73 years) participated in focus groups. The majority of studies reported positive technology-related outcomes (e.g., technology confidence, acceptance, and eHealth literacy), although study designs did not allow for the determination of the role of DLT separate from the overall intervention. Two studies were exceptions, demonstrating positive impacts of training on technology- and health-related outcomes. In ten studies, DLT was evaluated, and patient feedback largely affirmed that training was needed. Analyses across studies found differing DLT characteristics (e.g., print materials, ad hoc support) unrelated to technology uptake. Focus group patients showed variable training needs, with 18 (56%) “high technology” and 13 (41%) “low technology” users. Participants' technology training experiences ranged from extensive and lifelong technology engagement to hesitant engagement, suggesting greater training support needs.
Conclusions:
Together, these findings highlight the role of DLT in encouraging older adults with CVD to use health technologies and suggests the importance of understanding support needs.
