Digital health literacy is the key ability for residents in the digital age to obtain, understand and use health information, which is crucial for leveraging the value of digital technologies in health promotion and education and for improving the health status of county residents.

To explore the contemporary status and determinants of digital health literacy among urban-rural residents in D County, Guizhou Province, conduct a comparative analysis between urban and rural areas, and to offer insights for enhancing digital health literacy among county residents.

In July 2024, a sampling method combining multi-stage stratified sampling and probability proportional scale sampling (PPS) was adopted in County D, Guizhou Province. A questionnaire survey was conducted among permanent residents, the general information questionnaires were used to collect basic demographic data of county residents, the Electronic Health Literacy Scale (eHEALS) was adopted to measure their digital health literacy levels. Binary Logistic regression approach was employed to examine the determinants of digital health literacy across urban and rural populations in County D.

A total of 6 021 questionnaires were distributed and collected, with 5 928 valid questionnaires, with an effective recovery rate of 98.46%. The total score of the Digital Health Literacy Scale of residents in County D was (30.11±7.89). The total score was (30.24±7.89) among urban residents and (29.96±7.88) among rural residents, with no statistically significant difference between the two groups (t=1.423, P>0.05). The rate of overall rate of adequate digital health literacy among residents of county D was 59.35% (3 518/5 928). Specifically, the adequacy rate was 54.08% (1 848/3 147) among urban residents and 60.05% (1 670/2 781) among rural residents, with no statistically significant difference between the two groups (χ²=1.079, P>0.05). Binary Logistic regression analysis showed that payment method of medical expenses, the level of education, per capita monthly household income, self-assessed health status, attitude toward online health information attitude were the common influencing factors on whether urban and rural residents were qualified in digital health literacy (P<0.05). Age and occupation were the unique influencing factors of whether urban residents were qualified in digital health literacy (P<0.05).

In recent years, the digital health literacy level of county residents has improved, however, substantial room for further improvement remains. NO significant urban-rural differences in digital health literacy was observed in County D among urban and rural areas. It is recomment decl to strengthen the individual's awareness of health responsibility, and establish a integrated improvement mechanism from the individual, family, community and social levels to improve the digital health literacy level of county residents and improve the health status and quality of life of county residents.

数字健康素养是数字时代居民获取、理解和利用健康信息的关键能力，对发挥数字技术在健康促进和健康教育中的价值、提升县域居民健康水平至关重要。

了解贵州省D县城镇及农村居民数字健康素养现状及影响因素，并进行城乡对比分析，为提升县域居民的数字健康素养提供参考。

于2024年7月，采用多阶段分层抽样法和概率比例规模抽样法（PPS）相结合的方法在贵州省D县抽取常住居民进行问卷调查。采用一般资料调查表收集县域居民的基本资料，采用数字健康素养量表（eHEALS）测量县域居民的数字健康素养水平，采用二元Logistic回归分析探讨城镇居民和农村居民数字健康素养的影响因素。

共发放和回收问卷6 021份，获得有效问卷5 928份，问卷有效回收率为98.46%。县域居民的eHEALS平均得分为（30.11±7.89）分，城镇居民和农村居民的eHEALS平均得分分别为（30.24±7.89）分和（29.96±7.88）分，二者比较，差异无统计学意义（t=1.423，P>0.05）。县域居民的数字健康素养合格率为59.35%（3 518/5 928），城镇居民和农村居民的数字健康素养合格率分别为54.08%（1 848/3 147）和60.05%（1 670/2 781），二者比较，差异无统计学意义（χ²=1.079，P>0.05）。二元Logistic回归分析结果显示，医疗费用支付方式、受教育程度、家庭人均月收入、自评健康状况、对网络健康信息态度是城镇和农村居民数字健康素养是否合格的共同影响因素（P<0.05）；年龄、职业是城镇居民数字健康素养水平是否合格的影响因素（P<0.05）。

近年来县域居民数字健康素养水平有所提升，但整体数字健康素养水平依然有较大提升空间，未发现D县居民数字健康素养水平在城乡之间存在明显差异。建议强化个体的健康责任意识，从个人、家庭、社区和社会层面建立综合提升机制，提升县域居民数字健康素养水平，进而提高县域居民的健康水平和生活质量。