Artificial Intelligence and Digital Health Literacies Among Older Adults: A Mixed-method Pilot Intervention Study

NCT07881510 | Not Yet Recruiting

• 2 other identifiers: DERC Ref: 001455RCA: 2026-00857
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this pilot study is to determine the feasibility and to learn if a training program called E2NGAGE-Literacy (Empowering Elders in Navigating Generative AI for Greater E-health Literacy) can potentially help older adults in Singapore use generative AI (GenAI) chatbots safely and confidently to find and evaluate health information. The main questions it aims to answer are:

• Is the conduct of E2NGAGE-Literacy program to improve older adults' AI literacy and digital health literacy feasible?
• Do older adults find the E2NGAGE-Literacy program acceptable?
• What are the potential changes in AI literacy, digital health literacy and actual use of AI-chatbot apps and web-based apps between older adults who receive E2NGAGE-Literacy program and those who do not receive the program?
• What do participants think about E2NGAGE-Literacy, and how can it be improved? Researchers will compare two groups:
• E2NGAGE-Literacy group: Participants will join a 6-week program with face-to-face group lessons on using GenAI for health information, supported by online videos, quizzes and short homework tasks.
• Waitlist control group: Participants will continue with their usual activities at the senior centres and receive the same program after the study period. Participants in the E2NGAGE-Literacy group will:
• Join weekly 1.5-hour face-to-face sessions for 6 weeks during the study period
• Watch short videos and complete online quizzes and practice tasks between sessions during the study period
• Be invited to a focus group discussion after the program to share their experiences
• Complete a questionnaire at the start of the study and again at 7 and 12 weeks later
• Be invited to share AI-chatbot transcripts for analysis Participants in the waitlist group will:
• Complete a questionnaire at the start of the study and again at 7 and 12 weeks later
• Join weekly 1.5-hour face-to-face sessions for 6 weeks after the study period (after week 8)
• Watch short videos and complete online quizzes and practice tasks between sessions after the study period (after week 12)
• Be invited to share AI-chatbot transcripts for analysis

Conditions

AI Chatbot; Aged 60 Years or Older; Digital Health Literacy

Keywords

digital health literacy; Artificial intelligence literacy; older adults

Outcome Measures

Primary Outcomes (2)

• Artificial intelligence literacy

  Competency in artificial intelligence (AI) literacy will be measured using the 12-item Artificial Intelligence Literacy Scale (AILS) on a 7-point Likert scale. The AILS includes four domains: awareness (ability to identify and understand AI technology), usage (ability to apply and use AI technology to accomplish tasks proficiently), evaluation (ability to analyse, select and critically evaluate AI applications and their output) and ethics (ability to be aware of the responsibilities and risks associated with the use of AI technology). Internal consistency for the tool is α=0.88, with domains ranging from α=0.73 to 0.78.

  Baseline, week 7 (post-test) and week 12 (post-test)

• Digital health literacy

  Competency in digital health literacy will be measured using the 24-item Digital Health Literacy Instrument 2.0 (DHLI 2.0). The DHLI 2.0 includes eight domains: operational skills, navigation skills, information searching, evaluating reliability, determining relevance, generating content, using security measures, and protecting privacy. Internal consistency for the tool is α=0.94.

  Baseline, week 7 (post-test) and week 12 (post-test)

Secondary Outcomes (6)

• Actual use of AI chatbot apps and web-based apps

  Baseline, week 7 (post-test) and week 12 (post-test)

• Health information orientation

  Baseline, week 7 (post-test) and week 12 (post-test)

• Motivated learning behaviour

  Baseline, week 7 (post-test) and week 12 (post-test)

• Perceived usefulness of GenAI chatbots

  Baseline, week 7 (post-test) and week 12 (post-test)

• Perceived ease of use of GenAI chatbots

  Baseline, week 7 (post-test) and week 12 (post-test)

Other Outcomes (4)

• Participant recruitment

  Baseline

• Retention rate

  End of the study (week 12)

• Intervention attendance

  6-week intervention

Study Arms (2)

E2NGAGE-Literacy Intervention

EXPERIMENTAL

Participants in this arm will take part in the E2NGAGE-Literacy program during the study period.

Behavioral: AI and digital health literacy program (E2NGAGE-Literacy)

Waitlist Control

NO INTERVENTION

Participants in this arm will continue with the usual activities provided at their active ageing centres during the study period. They will not receive the E2NGAGE-Literacy program during the study period, and will receive the same program after completing the post-intervention questionnaire.

Interventions

AI and digital health literacy program (E2NGAGE-Literacy) BEHAVIORAL

A 6-week program delivered through weekly 1.5-hour face-to-face group lessons, supported by online videos, quizzes and homework on using generative AI chatbots for health information. The programme will be delivered in English and Chinese. Additional support may be provided if needed.

E2NGAGE-Literacy Intervention

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• aged 60 years and above
• has a smartphone
• has limited knowledge and exposure to GenAI and internet usage for health information
• has no cognitive impairment (e.g., screened using the Mini-Cog Test; a score below 3 will be considered a positive screen for possible cognitive impairment or higher risk of dementia)
• willing to participate and be audio-recorded for qualitative interview

You may not qualify if:

• diagnosed with dementia or cognitive impairment
• have severe visual or hearing impairments that make it challenging to participate in the intervention group sessions

Sponsors & Collaborators

• National University of Singapore: lead
• Buddhist Compassion Relief Tzu-Chi Foundation (Singapore): collaborator

Related Publications (5)

• Yang K, Hu Y, Qi H. Digital Health Literacy: Bibliometric Analysis. J Med Internet Res. 2022 Jul 6;24(7):e35816. doi: 10.2196/35816.

  PMID: 35793141 BACKGROUND

• Milanti A, Norman C, Chan DNS, So WKW, Skinner H. eHealth Literacy 3.0: Updating the Norman and Skinner 2006 Model. J Med Internet Res. 2025 Mar 11;27:e70112. doi: 10.2196/70112.

  PMID: 40068166 BACKGROUND

• van der Vaart R, Drossaert C. Development of the Digital Health Literacy Instrument: Measuring a Broad Spectrum of Health 1.0 and Health 2.0 Skills. J Med Internet Res. 2017 Jan 24;19(1):e27. doi: 10.2196/jmir.6709.

  PMID: 28119275 BACKGROUND

• Eskinazi N, Zwilling M, Marques A, Tesler R. The Role of AI in Improving Digital Wellness Among Older Adults: Comparative Bibliometric Analysis. JMIR AI. 2026 Jan 14;5:e71248. doi: 10.2196/71248.

  PMID: 41540814 BACKGROUND

• Dong Q, Liu T, Liu R, Yang H, Liu C. Effectiveness of Digital Health Literacy Interventions in Older Adults: Single-Arm Meta-Analysis. J Med Internet Res. 2023 Jun 28;25:e48166. doi: 10.2196/48166.

  PMID: 37379077 BACKGROUND

Central Study Contacts

Betsy Seah, PhD, BSc (Nursing)(Hons), RN

CONTACT

6566013213; nurseah@nus.edu.sg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Betsy Seah, PhD, BSc (Nursing)(Hons), RN, National University of Singapore, Alice Lee Centre for Nursing Studies

Model Details: Waitlist control: no intervention during the study period. They will receive the E2NGAGE-Literacy program after the post-intervention survey.

Study Record Dates

• First Submitted: October 12, 2026
• First Posted: October 19, 2026
• Study Start: October 1, 2026
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): July 1, 2027
• Last Updated: October 19, 2026

Record last verified: 2026-10

Data Sharing

• IPD Sharing: Will not share