Digital Health Literacy and Its Role in Awareness of and Access to Sexual Health Products and Services Among Displaced Youth in Uganda’s Informal Urban Settlements: Community-Based Cross-Sectional Study
Bibliographic record
Abstract
BACKGROUND: Digital health interventions can enhance sexual health equity among marginalized and underserved populations, including displaced youth. However, there is limited understanding of displaced youth's digital health literacy (DHL) and its association with knowledge of and access to sexual health products and services. OBJECTIVE: This study aims to identify patterns of DHL among displaced youth and assess how these patterns are associated with awareness of and access to sexual health products and services, while considering gender differences. METHODS: We conducted a cross-sectional tablet-assisted survey in Kampala, Uganda. We used peer-driven sampling to recruit displaced youth aged 16-24 years living in 5 informal urban settlements. We identified DHL patterns using latent profile analysis. Gender-disaggregated multivariate probit models were constructed to estimate the relationship between DHL and awareness of and access to sexual health products and services (eg, sexual and reproductive health [SRH] information, external condoms, condom use training, sexually transmitted infection testing, and HIV testing). RESULTS: Among the participants (N=445), our latent profile analysis identified 4-DHL classes named: low (class 1, 51/444, 11.5%), moderate (class 2, 99/444, 22.2%), high (class 3, 138/444, 31%), and very high (class 4, 157/444, 35.3%). Our adjusted multivariate probit model indicated that, compared to class 1, class 4 participants were more likely to know where to access condom use training (marginal effect [ME]=0.23; P<.001), external condoms (ME=0.19; P<.001), and HIV testing (ME=0.23; P<.001). We also noted gender-based differences. Men with very high DHL, compared with those with low DHL, were more likely to know where to access SRH information (ME=0.46; P<.001) and condom use training (ME=0.40; P<.050), while women with very high DHL were more likely than those with low DHL to report knowing how to access condom use training (ME=0.12, SE=0.06; P<.050), external condoms (ME=0.34; P<.001), and HIV testing (ME=0.22, SE=0.10; P<.050). Regarding access to sexual health products and services in the last 3 months, class 4 respondents reported higher access to condom use training (ME=0.13, SE=0.04; P<.001), external condoms (ME=0.14; P<.050), and HIV testing (ME=0.24; P<.050) than class 1 respondents. Gender differences showed that among men, those with very high DHL were more likely to access condom use training (ME=0.28; P<.010) than those with low DHL. In contrast, among women, those with very high DHL were less likely to access SRH information (ME=-0.20; P<.001). CONCLUSIONS: Our findings reveal a generally high level of DHL but suboptimal awareness of and access to SRH services among urban displaced youth in Kampala. Improving SRH among urban displaced populations will require gender-responsive and culturally grounded digital sexual health interventions to increase awareness of and access to sexual health products and services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".