Information Literacy, Digital Trust, and Health Decision-Making in Rural Populations: Evaluating Privacy-Aware Engagement with Mobile Health Applications
Information literacy; rural health; health decision-making; mobile health (mHealth); digital health literacy; patient trust; data privacy; privacy governance; health informatics; digital divide; health behavior; technology adoption; structural equation modeling.
AuthorsAbstractBackground:Rural populations increasingly rely on mobile health (mHealth) applications to access healthcare information, monitor chronic conditions, and support self-care in settings where medical infrastructure is often limited. However, this growing dependence occurs alongside persistent deficits in information literacy and limited capacity to critically evaluate digital health content. As a result, individuals in rural contexts are particularly vulnerable to misinformation, suboptimal health decisions, and insufficient awareness of data privacy risks embedded in digital health ecosystems. Objective:This study examines the interrelationship between information literacy, health decision-making, and perceived effectiveness of data privacy protections in mHealth applications. It seeks to understand how rural users interpret, trust, and act upon digital health information while engaging with platforms that collect and process sensitive personal data. Methods:A mixed-methods research design was employed, integrating a structured survey of rural mHealth users, systematic privacy audits of widely used health applications, and behavioral modeling techniques. The survey assessed information literacy levels, trust in digital health systems, and healthrelated decision-making behaviors. App audits evaluated privacy practices including permission structures, encryption protocols, and third-party data sharing. Quantitative data were analyzed using regression and structural equation modeling to identify relationships between literacy, privacy perception, and adoption behavior. Results:Findings indicate that higher information literacy is positively associated with improved health decision-making and greater critical awareness of privacy risks. However, trust in mHealth applications often mediates this relationship, with users demonstrating continued reliance on apps despite recognizing potential privacy vulnerabilities. Significant discrepancies were also observed between perceived and actual privacy protections across applications, particularly in wellness-oriented platforms. Conclusion:The study highlights a complex interplay between information literacy, digital trust, and privacy governance in shaping rural health behaviors. Strengthening digital health literacy and improving transparency in mHealth privacy practices are essential for supporting equitable health decision-making and reducing vulnerability in underserved populations. 2. Introduction Digital health has moved from being a supplementary component of healthcare delivery to a central infrastructure through which people access information, monitor symptoms, communicate with providers, and make everyday health decisions. The World Health Organization’s Global Strategy on Digital Health 2020–2025 frames digital technologies as essential to strengthening health systems, improving equity, and expanding access, particularly where conventional services remain geographically or •••••••••••••••••••••••••••••••• ejprd.org- Published by Riset Publishing Services LLC.
EJPRD
Copyright © 2026 by Riset Publishing Services LLC