Abstract
<sec> <title>BACKGROUND</title> <p>Digital health environments have rapidly evolved from static information sources into complex ecosystems involving social platforms, mobile applications, telehealth, electronic health records, and AI-enabled technologies. These changes have expanded the competencies required to engage with digital health information and highlighted limitations in existing conceptualisations of eHealth literacy.</p> </sec> <sec> <title>OBJECTIVE</title> <p>This study aimed to develop an updated, consensus-based definition of eHealth literacy that reflects current and emerging digital health environments.</p> </sec> <sec> <title>METHODS</title> <p>A multi-phase eDelphi process and consensus were conducted with an international panel of multidisciplinary experts and end-users. Participants completed iterative survey rounds to rate, prioritise, and provide feedback on proposed items until stability was achieved. Consensus was defined as ≥75% agreement. It was followed by consensus meetings to determine final items.</p> </sec> <sec> <title>RESULTS</title> <p>Twenty-eight multidisciplinary experts from ten countries participated across three eDelphi rounds. Subsequent consensus meetings resulted in the following final components across three domains: Knowledge; Skill; and Context, and six subdomains: Health Knowledge; Knowledge of Digital Ecosystem; Critical Thinking Skill; Technical Skill; Cognitive Skill; and Health Application Skill. These items informed an updated definition describing eHealth literacy as a multidimensional construct comprising interrelated domains of knowledge, skills, and contextual factors that enable individuals to engage with digital health tools, technologies, and AI-enabled services in ways that support informed judgement, communication, and health-related action</p> </sec> <sec> <title>CONCLUSIONS</title> <p>This study provides the first expert consensus on a refined conceptualisation of eHealth literacy aligned with modern eHealth systems. It provides a foundation for future measurement development, intervention design, research, and policy.</p> </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> <p>RR2-83624</p> </sec>