A study led by researchers at New York University’s School of Global Public Health found that 68.6 percent of US adults who received a medical test result in the previous year viewed it before hearing from a health care provider. The analysis, published in JAMA Network Open, examined how patients’ decisions to open results and their ability to understand them varied according to factors such as age, income, digital health literacy, chronic illness, geography, and experiences communicating with medical professionals.

The findings emerge from the digital-access requirements of the 21st Century Cures Act, a US law designed in part to make electronic health information more readily available to patients. Under the policy, hospitals and clinics generally release test results to patient portals as soon as they become available, rather than holding them until a clinician has reviewed the information with the patient. The change was intended to give people greater control over their health data, but it also altered the order in which information and explanation arrive. A patient may now read a radiology report or see an abnormal laboratory value before a professional has provided context.

“The Cures Act has restructured the traditional pathway between the release of a test result to a patient-clinician discussion,” said Jemar Bather, assistant professor of biostatistics at NYU School of Global Public Health and lead author of the study. “We wanted to understand whether a patient’s probability of accessing test results—and understanding of them—varies based on sociodemographic characteristics, health status, patient-centered communication, and digital health literacy.”

The researchers analyzed responses from 4,982 adults who participated in the 2024 Health Information National Trends Survey, a nationally representative survey collected by the National Institutes of Health. All of the respondents had access to electronic medical records and reported receiving a test result during the preceding year. When weighted to reflect the US population, the sample represented nearly 175 million adults. Because the study used survey data collected at one point in time, it can identify patterns and associations but cannot prove that any single characteristic directly caused a patient to view or understand a result.

People who opened their results before hearing from a provider were more likely to be older and female, to have higher incomes, and to live with multiple chronic health conditions. They also tended to report stronger digital health literacy and more frequent use of social media for health-related information. Digital health literacy refers to the ability to find, access, evaluate, and use health information through digital tools. It includes more than knowing how to log into a portal: patients must also recognize medical terminology, judge the reliability of explanations, understand uncertainty, and decide when professional advice is needed.

Among those who viewed their results immediately, comprehension was uneven. Only 6.6 percent said they understood the results poorly, but 26.8 percent reported understanding them fairly well, 31.7 percent understood them well, and 34.9 percent understood them very well. These categories reflect patients’ self-assessments rather than an objective test of medical knowledge. Even so, the distribution indicates that a sizable minority may be reading important clinical information without feeling fully confident about what it means, whether a result is serious, or what action should follow.

The least confident patients were more likely to live in the Midwest or South and to report having experienced discrimination in medical care. By contrast, higher digital health literacy was associated with better understanding. Patient-centered communication showed a similar relationship. Respondents who felt that clinicians explained information in ways they could understand and involved them in decisions were more likely to report comprehending their test results. The pattern suggests that portal design cannot be separated from the broader relationship between patients and health professionals: an understandable result is not merely a technical product, but part of an ongoing communication process.

The researchers say health systems have largely focused on delivering data, while devoting less attention to how that data is translated into useful meaning. A numerical value may appear alongside a reference range without explaining why it was ordered, how much variation is normal, or whether the result should be interpreted alongside symptoms, medications, previous measurements, or other tests. An imaging report may contain precise clinical language that is familiar to specialists but confusing or alarming to the person being examined. Tools that summarize results in plain language, explain technical terms, show trends over time, and allow patients to submit follow-up questions could help bridge the gap. Artificial intelligence may eventually support some of these functions, although any automated explanation would need safeguards, clinical oversight, and clear warnings that it is not a diagnosis.

“Health systems give you your data, but that does not mean that they put a lot of effort into making the information easy to understand on your own,” said study author José Pagán, professor and chair of NYU’s Department of Public Health Policy and Management. “Health systems and online patient portal developers should look for innovative ways to improve how they communicate—for instance, using AI to summarize test results in plain language and provide easy means for follow-up questions.” The authors emphasize that expanded access remains valuable, but access without interpretation can leave some patients behind. As immediate release becomes standard practice, the next challenge may be ensuring that every patient receives not only a result, but also the context and support needed to understand it.

Subject of Research: Patient access to and comprehension of immediately released medical test results

Article Title: Patient Viewing and Comprehension of Immediately Released Test Results

News Publication Date: 18-Aug-2026

Web References: https://doi.org/10.1001/jamanetworkopen.2026.30698

References: Bather J, Pagán JA, Goodman M, et al. “Patient Viewing and Comprehension of Immediately Released Test Results.” JAMA Network Open. Published 18 August 2026. DOI: 10.1001/jamanetworkopen.2026.30698

Keywords: patient portals, electronic health records, medical test results, digital health literacy, patient-centered communication, health care access, health information technology, 21st Century Cures Act, medical communication, health equity

The study, which was recently published in the prestigious journal Nature Aging, highlights a stark and troubling dichotomy in how different age groups consume potentially life-altering information. Lead author Ben Lyons, an associate professor at the University of Utah, notes that while the overall volume of traffic to low-credibility health sites is objectively low, the exposure is not distributed equally across the population. Instead, the data illuminates a dark concentration of misinformation consumption among older adults, particularly those who align themselves with right-leaning political ideologies. This specific demographic intersection appears to create a unique behavioral feedback loop where health-related vulnerabilities and partisan news consumption habits converge, leading to a disproportionately high engagement with medical claims that lack scientific validation. The finding is particularly pressing given that this older cohort is simultaneously the most likely to face significant health challenges and the most frequent users of the formal healthcare system.

To achieve this level of granular insight, the research team employed a rigorous methodology that moved beyond self-reported surveys to analyze approximately nine million individual page views and five hundred thousand YouTube video sessions. This trace-data approach allowed the scientists to bypass the social desirability bias often found in questionnaires, providing a raw and honest look at what people actually do when they are alone behind their screens. From a total of 1,055 unique domains identified as providing health-related information, the researchers found that only seventy-eight of them met the criteria for being low-credibility sources. This small fraction demonstrates that while the internet is vast, the actual infrastructure of medical misinformation is relatively compact. However, the study’s most striking finding was that only thirteen percent of the participants visited even a single one of these sites during the entire month, proving that the vast majority of the public is either uninterested in or actively avoiding questionable medical advice.

The power of the data lies in its ability to pinpoint exactly where the “heavy users” of misinformation are located within the societal fabric. Among that thirteen percent who engaged with low-credibility content, a tiny fraction of outliers—the top ten percent of the sample—accounted for more than three-quarters of all the visits recorded during the study. This hyper-concentration suggests that misinformation is not a broad contagion affecting everyone equally but is instead a niche phenomenon that deeply affects a small, isolated group of individuals. For these users, dubious health information is not a random encounter but a recurring destination, suggesting that their digital journeys are guided by pre-existing beliefs or specific browsing habits that lead them into a closed loop of misinformation. This behavioral pattern suggests that interventions designed to curb misinformation may need to be far more targeted than the current broad-spectrum digital literacy campaigns suggest.

A fascinating aspect of the research is the comparison between how people consume political misinformation versus health misinformation. Lyons and his colleagues noted that the “age effect” observed in health misinformation, while significant, is notably smaller than the age effect seen in the realm of partisan political content. The researchers hypothesize that politics offers a sense of team identity and emotional catharsis that health information generally lacks. While sharing a politically charged fake news story can serve as a social signal or an attack on an ideological opponent, there is much less social utility or entertainment value in sharing a dubious claim about a medical procedure. This lack of “tribal” motivation means that while older adults are still the primary consumers of health misinformation, they do not engage with it with the same fervor or frequency as they do with the high-stakes theater of modern American politics.

The researchers were also surprised to find that traditional “gateways” to misinformation, such as Google searches or Facebook referral links, were not the primary drivers for these low-credibility salud-related visits. Instead of being led astray by algorithms or social media feeds, the individuals most frequently visiting these sites appeared to be doing so through direct navigation or through links found on other low-credibility domains. This suggests an insular digital environment where users who already reside in “alternative” information ecosystems simply move from one dubious source to another without ever returning to the mainstream information stream. This direct-entry behavior makes it significantly harder for platform moderators or public health officials to intervene, as the users are often operating within a self-contained bubble that bypasses the traditional filters of the broader internet.

Beyond mere demographics, the study delved into the psychological precursors of misinformation exposure by examining the results of mid-study questionnaires. They found a strong correlation between pre-existing conspiratorial worldviews and the likelihood of seeking out low-credibility medical content. Individuals who already harbored deep-seated suspicions about institutional authorities or who believed in various “hidden truths” were significantly more likely to find their way to these fringe health sites. This suggests that the problem of misinformation is not merely a lack of information but a specific cognitive orientation that views fringe sources as more “authentic” or “truthful” than legitimate scientific institutions. Consequently, simply providing more “correct” information may not be an effective remedy for a population that is psychologically predisposed to distrust mainstream medical consensus.

The implications for public health are profound, especially as the global population continues to age and rely more heavily on digital tools for wellness management. Since older adults carry the heaviest health burdens and are tasked with making the most frequent and complex medical decisions, their exposure to misinformation carries higher stakes. A single piece of bad advice regarding terminal illness, medication management, or preventive care could have devastating real-world consequences. The study suggests that for this vulnerable group, the internet is not a wide-open sea of data but a narrow corridor that often leads back to the same unreliable sources. This concentration of risk in a specific age group demands a reimagining of how digital health literacy programs are designed, moving away from general youth-focused initiatives toward senior-centric models that address the specific psychological and political filters through which they view the world.

Collaborating with the University of Utah School of Medicine and the Huntsman Cancer Institute provided the research team with a unique clinical perspective on how these browsing habits might influence actual patient outcomes. By bridging the gap between communication science and clinical epidemiology, the researchers were able to frame internet usage as a genuine social determinant of health. The findings suggest that a person’s digital “neighborhood” might be just as important to their physical well-being as their physical zip code. If a significant portion of a person’s digital life is spent in an environment that validates false health claims, their ability to adhere to evidence-based medical treatments may be severely compromised. This interdisciplinary approach highlights the necessity of treating digital misinformation as a public health crisis rather than just a technological or social media problem.

Despite the complexities revealed, Ben Lyons maintains a cautiously optimistic stance, emphasizing that the “good news” of the study is the overall low level of engagement with these sites. The fact that eighty-seven percent of the study participants avoided low-credibility sites entirely during a month-long period indicates that the mainstream information environment is still functioning for the vast majority of people. This baseline of digital resilience provides a foundation upon which more specialized interventions can be built. Rather than trying to “fix” the whole internet, the data suggests that resources would be better spent focusing on the high-frequency outliers who are truly at risk. Understanding that most people are naturally skeptical or disinterested in fringe medical claims allows researchers and policy makers to move past the hysteria of a “post-truth” world and toward more surgical, data-driven solutions.

Ultimately, this research underscores the idea that our online lives are a reflection of our offline identities, including our age, our politics, and our preexisting biases. The internet does not necessarily change who we are; rather, it provides a vast mirror for our existing tendencies and a laboratory for our specific curiosities. As the team from the University of Utah prepares to incorporate these findings into more extensive longitudinal works, the message for the public remains clear: the digital world is a place of both incredible utility and hidden traps. Staying informed requires more than just access to a search engine; it requires a conscious awareness of how our own backgrounds and beliefs might be steering us toward or away from the truth. The journey toward a healthier digital society will likely involve not just better algorithms, but a deeper understanding of the human heart and the aging mind as they navigate the complexities of the twenty-first century.

As the scientific community continues to digest these results, the conversation is shifting toward the development of specialized tools to assist older adults in navigating the medical landscape online. Innovations such as browser extensions that flag low-credibility health claims or digital literacy workshops held in community centers could offer a lifeline to those currently trapped in misinformation bubbles. Moreover, the study serves as a call to action for medical professionals to engage more directly with their patients about where they receive their online health information. By treating a patient’s internet history with the same level of concern as their medical history, doctors can help identify those who are being misled before a digital falsehood turns into a physical tragedy. The path forward is complex, but with data as clear as that provided by Lyons and his team, the roadmap for protecting our most vulnerable citizens is finally beginning to take shape.

Subject of Research: 1,055 U.S. adults (web-browsing habits and health information seeking)
Article Title: Exposure to low-credibility online health content is limited and is concentrated among older adults
News Publication Date: February 4, 2026
Web References: https://www.nature.com/articles/s43587-025-01059-x
References: Lyons, B., King, A., Kaphingst, K., & Barter, R. (2026). Exposure to low-credibility health websites is limited and is concentrated among older adults. Nature Aging. DOI: 10.1038/s43587-025-01059-x
Keywords: Communications, Information science, Internet, Misinformation, Health, Older Adults, University of Utah, Nature Aging

The study primarily investigates the construct of digital health literacy, which encapsulates a person’s ability to seek, understand, and utilize health-related information via digital means. This skill is not merely a technical requirement; rather, it forms a cornerstone of effective learning, particularly in fields that are evolving rapidly, such as nursing. In this context, digital health literacy is posited as a vital determinant influencing online learning engagement.

Engagement, defined as the degree of attention, interest, and motivation participants devote to their learning experience, is significantly shaped by the tools and platforms used for education. As digital natives, today’s students are often expected to navigate various online settings to access learning materials, collaborate with peers, and interact with instructors. However, the effectiveness of these interactions is inherently linked to their level of digital health literacy. The more adept students are in leveraging digital resources, the more likely they are to engage deeply with their educational experiences.

Liu et al.’s research suggests a nuanced relationship between digital health literacy and online learning engagement, revealing that academic self-efficacy plays a crucial mediating role in this dynamic. Academic self-efficacy refers to a student’s belief in their competency to execute tasks related to their studies. This self-belief is critical, especially in an online environment where students often operate independently. Students who perceive themselves as capable of utilizing digital tools effectively are more inclined to engage with learning materials, participate in discussions, and seek help when needed.

Moreover, the findings indicate that future work self-salience—how prominently students consider future career implications—further mediates this relationship. In a field like nursing, where students are constantly reminded of their future responsibilities, the connection between education and career aspirations can be immensely motivating. The study illustrates that when nursing students recognize how their academic efforts online relate to their future professional roles, their engagement levels spike, creating a positive feedback loop that enhances learning outcomes.

Interestingly, the research outlines that students possessing a high degree of digital health literacy not only benefit from their perceived self-efficacy but are also better equipped to envision their future careers. This foresight allows them to contextualize their learning within a larger framework, motivating them to not only complete their coursework but to engage in broader discussions and real-time applications of their studies.

In delving deeper into the methodology, Liu and colleagues employed a mixed-methods approach, combining quantitative surveys with qualitative interviews. This dual approach enriched the data, providing a well-rounded perspective on how digital health literacy impacts student engagement. The surveys quantitatively mapped students’ digital skills, engagement levels, self-efficacy beliefs, and future aspirations, while interviews offered contextual insights into personal experiences, thus enhancing the validity of their findings.

The implications of these findings are profound, particularly for educational institutions aiming to bolster online learning environments. By understanding the significance of digital health literacy, academic programs—especially in health and nursing—can tailor their curricula and support systems to cultivate these skills. Interactive workshops, tutorials on effective digital tool usage, and integrating real-world applications can significantly enhance students’ competencies and confidence.

Furthermore, the incorporation of strategies to bolster academic self-efficacy within course designs can create a culture of empowerment. Such strategies could involve fostering mentorship programs where students can discuss their aspirations and delineate paths toward achieving them. Structural support systems that highlight the relevance of coursework to future careers can increase students’ motivation and engagement, ultimately leading to improved educational outcomes.

As the landscape of education continues to evolve, fostering an environment that promotes digital health literacy, self-efficacy, and future work considerations can better prepare nursing students for the realities of their profession. Educators need to recognize the importance of these interconnections, as they represent not only academic success but also the potential to enhance the quality of healthcare delivery in the future.

The study by Liu, Cheng, and Tao takes a forward-thinking approach, providing a roadmap for future research in the area of digital education. As institutions grapple with ongoing changes in educational technologies and methodologies, understanding these relationships will be crucial in designing programs that are both effective and adaptable. Ensuring students are equipped with the necessary skills to thrive in digital environments will ultimately lead to a more competent and resilient workforce, particularly in sectors critical to public health.

As we traverse this evolving educational paradigm, Liu et al.’s research stands as a significant contribution, highlighting the multifaceted relationship between digital health literacy and academic engagement. It calls on educators, policymakers, and students alike to invest in Digital Literacy as a pillar of modern education, recognizing its foundational role in shaping the healthcare professionals of tomorrow.

Ultimately, the findings of this study not only illuminate the critical pathways through which digital health literacy enhances online learning engagement but also provoke deeper inquiry into how we can equip future generations for success in an increasingly digital world. Emphasizing the fusion of education, technology, and professional preparation, this research serves as a catalyst for ongoing dialogue and innovation in educational practices.

Subject of Research: The impact of digital health literacy on online learning engagement among undergraduate nursing students

Article Title: The impact of digital health literacy on online learning engagement among undergraduate nursing students: the chain mediating roles of academic self-efficacy and future work self-salience

Article References: Liu, Y., Cheng, Zy., Tao, J. et al. The impact of digital health literacy on online learning engagement among undergraduate nursing students: the chain mediating roles of academic self-efficacy and future work self-salience. BMC Nurs (2025). https://doi.org/10.1186/s12912-025-04235-x

Image Credits: AI Generated

DOI: 10.1186/s12912-025-04235-x

Keywords: digital health literacy, online learning, nursing students, academic self-efficacy, education, future work self-salience