ArticlemHealth2025
Mitigating the digital divide: exploring moderation and mediation effects on eHealth performance in a comparative study of Europe and Southeast Asia.
Article in mHealth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The digital divide significantly influences healthcare accessibility and outcomes, particularly regarding eHealth technologies. Disparities in eHealth adoption between Europe and Southeast Asia underscore the impact of E-government development on eHealth performance. This study focuses on digital literacy as a mediating factor and religious beliefs as a moderating variable, recognizing that these elements can shape the effectiveness of eHealth initiatives. Methods: A quantitative analysis was conducted using secondary data from 31 geographically diverse countries, representing both developed and emerging economies, spanning the years 2019 to 2022. This period was chosen due to the coronavirus disease 2019 (COVID-19) pandemic, which exacerbated the digital divide in eHealth adoption and accessibility. The analysis examined the relationships between E-government development, digital literacy, religious beliefs, and eHealth performance. Results: The findings indicate that E-government development positively influences eHealth performance, with digital literacy playing a significant mediating role in this relationship. Additionally, religious beliefs, particularly Atheism, were found to moderate the relationship between E-government development and eHealth performance. Regions with lower levels of religiosity demonstrated a greater receptiveness to eHealth technologies, suggesting that cultural factors significantly affect technology adoption. Conclusions: The results underscore the necessity of integrating digital literacy initiatives alongside E-government development to enhance eHealth performance effectively. Policymakers should consider the cultural and religious landscape when designing eHealth strategies to ensure equitable access to healthcare resources. By addressing both technological and cultural barriers, it is possible to improve healthcare accessibility and outcomes for diverse populations, ultimately bridging the digital divide in healthcare.
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