The relationship between attitudes towards telemedicine in the digital health ecosystem and health literacy

Objective: This study examined the relationship between health literacy levels and individuals' attitudes towards telemedicine services, as well as the effect of sociodemographic data on this relationship. Materials and Methods: This cross-sectional and descriptive study was conducted between April and June 2025 with 1,312 teachers meeting the inclusion criteria, working in all public schools affiliated with the Ministry of National Education in the central district of Çorum province. Data were collected through face-to-face interviews. Participants were administered the Turkish Health Literacy Scale-32 (TSOY-32), the Attitude Scale Towards the Use of Telemedicine Services, and a Sociodemographic Data Form prepared by the researchers through a review of relevant literature. Statistical analyses and calculations were performed using Statistical Package for the Social Sciences (SPSS) version 30. Results: According to the overall classification of the Turkish Health Literacy Scale (TSOY-32), 28.6% of participants had inadequate, 43.6% had problematic–limited, 17.0% had sufficient, and 10.7% had excellent health literacy levels. When health literacy levels were compared with sociodemographic variables, only income level was found to have a statistically significant positive correlation (p<0.05). The mean score of participants on the Attitude Scale Towards the Use of Telemedicine Services (USHKYTÖ) was 61.24±13.2, with a median value of 63, indicating a moderate-to-good level. Scores of married individuals, those with a master's degree, and those whose income exceeded expenses were found to be significantly higher (p<0.05). Participants whose first source of health-related information was the internet had significantly higher USHKYTÖ scores compared to those whose first source was a healthcare professional or healthcare institution (p<0.001). No statistically significant relationship was found between the total score of TSOY-32 and the total score of USHKYTÖ (p>0.05). Conclusion: In conclusion, individuals' attitudes towards telemedicine services are influenced not only by their level of knowledge but also by socioeconomic conditions, experiences, and access to healthcare services. Factors such as the increasing average age of the population, the growing number of bedridden individuals and those with chronic diseases, and the rising importance of labor loss due to industrialization highlight the increasing importance of telemedicine applications in healthcare. In light of this information, raising public awareness, improving access to telemedicine services, and developing relevant policies in this direction are important both for the sustainability of healthcare systems and for societal and individual benefits. Keywords: Health literacy, Telemedicine, Digital health ecosystem