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Abstract
Background: Tele-physiotherapy expanded rapidly during and after COVID-19 pandemic, but its sustainable integration depends on a future workforce that is both digitally literate and willing to adopt it. Evidence on the digital health literacy (DHL) and adoption readiness of physiotherapy students in low-income settings like Bahawalpur and even in Pakistan remains scarce.
Objective: To assess DHL and readiness to adopt tele-physiotherapy and to identify predictors of its adoption, among Doctor of Physical Therapy (DPT) students in Bahawalpur, Pakistan.
Methods: In this cross-sectional survey, 200 penultimate- and final-year DPT students from five institutions completed 8-item eHealth Literacy Scale (eHEALS) and a Unified Theory of Acceptance and Use of Technology (UTAUT)-based instrument measuring performance expectancy (PE), effort expectancy (EE), social influence (SI) and facilitating conditions (FC), with adoption intention (AI) as the outcome. Data were analyzed with independent-samples t-tests, one-way ANOVA, Pearson correlation and multiple linear regression; effect sizes were reported alongside p-values using SPSS version 26.0 keeping level of significance at α <0.05.
Results: Students reported moderate-to-high DHL (mean 28.9/40, SD 5.4) and positive adoption intention (3.89/5, SD 0.70). DHL correlated with AI (r = 0.26) and with all UTAUT constructs (r = 0.23–0.48; all p < 0.01). In the regression model (adjusted R² = 0.40), PE (β = 0.30), EE (β = 0.31) and FC (β = 0.20) independently predicted AI (all p ≤ 0.003), whereas DHL and SI did not. Adoption intention did not differ significantly by gender (p = 0.058; d = 0.37), prior telehealth experience (p = 0.71) or institution type (p = 0.44), but differed across academic semesters (p = 0.001; η² = 0.08).
Conclusions: DPT students in this setting were digitally capable and broadly willing to adopt tele-physiotherapy. Their intention was driven by perceived usefulness, ease of use and access to supporting resources rather than by digital health literacy per se. Embedding competency-based telehealth training within the DPT curriculum and ensuring institutional digital infrastructure may convert this latent readiness into competent practice.