Kontakt 2025, 27(2):150-157 | DOI: 10.32725/kont.2025.017

Socioeconomic impacts on e-learning accessibility and health literacy in underserved communities: A meta-synthesisSocial Sciences in Health - Review article

Mirko Prosen *, Sabina Ličen
University of Primorska, Faculty of Health Sciences, Izola, Slovenia

Introduction: Socioeconomic disparities continue to hinder full access to e-learning and digital health resources, making both educational and health equity elusive. This study addresses the research question: How do socioeconomic factors influence the accessibility and effectiveness of e-learning and consequently health literacy in underserved communities? Methods: A systematic meta-synthesis of qualitative studies was conducted following the process by Noblit and Hare. Studies focusing on health inequalities without a connection to educational access or e-learning were excluded to maintain coherence with the research aim.

Results: The interpretation of the findings resulted in five themes: (1) digital divide, (2) technological and language barriers, (3) inadequate infrastructure, (4) economic constraints, (5) cultural and contextual adaptations.

Conclusion: The digital divide, along with technological proficiency and language barriers, exacerbates educational disparities by limiting access to technology and supportive resources, particularly for non-English speaking populations. The findings underscore the need for a more holistic examination of accessibility beyond educational outcomes, incorporating health literacy dimensions as well.

Keywords: Digital equity; Educational technology; Inclusivity; Multilingual education; Social justice
Grants and funding:

The study was conducted as part of the project "Development of a Digital Education Standard in Higher Education for Ensuring Equity and Accessibility in Digital Education" (J5-4572), co-financed by the Slovenian Research and Innovation Agency.

Conflicts of interest:

No ethical statement has been made for this literature review. The authors have no conflict of interest to declare.

Received: February 3, 2025; Revised: March 17, 2025; Accepted: April 16, 2025; Prepublished online: April 22, 2025; Published: June 23, 2025  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Prosen M, Ličen S. Socioeconomic impacts on e-learning accessibility and health literacy in underserved communities: A meta-synthesis. Kontakt. 2025;27(2):150-157. doi: 10.32725/kont.2025.017.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. . Arcia A, Stonbraker S, Warner ERA (2019). Continuing Education Module - Information Needs and Information-Seeking Processes of Low-Income Pregnant Women in Relation to Digital Maternity Education Resources. J Perinat Educ 28(3): 151‒162. DOI: 10.1891/1058-1243.28.3.151. Go to original source... Go to PubMed...
    2. . Azubuike OB, Adegboye O, Quadri H (2021). Who gets to learn in a pandemic? Exploring the digital divide in remote learning during the COVID-19 pandemic in Nigeria. Int J Educ Res Open 2: 100022. DOI: 10.1016/j.ijedro.2020.100022. Go to original source... Go to PubMed...
    3. . Azzopardi-Muscat N, Sørensen K (2019). Towards an equitable digital public health era: promoting equity through a health literacy perspective. Eur J Public Health 29(Supplement_3): 13‒17. DOI: 10.1093/eurpub/ckz166. Go to original source... Go to PubMed...
    4. . Bantham A, Taverno Ross SE, Sebastião E, Hall G (2021). Overcoming barriers to physical activity in underserved populations. Prog Cardiovasc Dis 64: 64‒71. DOI: 10.1016/j.pcad.2020.11.002. Go to original source... Go to PubMed...
    5. . Berete F, Gisle L, Demarest S, Charafeddine R, Bruyère O, Van den Broucke S , Van der Heyden J (2024). Does health literacy mediate the relationship between socioeconomic status and health related outcomes in the Belgian adult population?. BMC Public Health 24(1): 1182. DOI: 10.1186/s12889-024-18676-7. Go to original source... Go to PubMed...
    6. . Buliva N (2020). Technological Tribal Territories: How Culture Influences Learning Beyond Content in Educational Technologies: A Narrative Review of Literature. In: Hokanson B, Clinton G, Tawfik AA, Grincewicz A, Schmidt M (Eds). Educational Technology Beyond Content: A New Focus for Learning. Cham: Springer International Publishing, pp. 119‒126. DOI: 10.1007/978-3-030-37254-5_10. Go to original source...
    7. . Careemdeen JD (2023). The Impact of Socio-Economic Factors in the Virtual Learning Environment on Student Learning. Int J Acad Res Bus Soc Sci 802‒812. DOI: 10.6007/IJARBSS/v13-i12/19892. Go to original source...
    8. . Chen S, Niu M , Ngai CSB (2024). What is the next step of ICT development? The changes of ICT use in promoting elderly healthcare access: A systematic literature review. Heliyon 10(3): e25197. DOI: 10.1016/j.heliyon.2024.e25197. Go to original source... Go to PubMed...
    9. . Chen T, Wanberg RC, Gouioa ET, Brown MJS, Chen JCY, Kurt Kraiger JJ (2019). Engaging parents Involvement in K - 12 Online Learning Settings: Are We Meeting the Needs of Underserved Students?. J E-Learn Knowl Soc 15(2). DOI: 10.20368/1971-8829/1563. Go to original source...
    10. . Cheung KKC, Tai KWH (2023). The use of intercoder reliability in qualitative interview data analysis in science education. Res Sci Technol Educ 41(3): 1155‒1175. DOI: 10.1080/02635143.2021.1993179. Go to original source...
    11. . Critical Appraisal Skills Programme (2023). CASP Checklist: CASP Qualitative Studies Checklist. [online] [cit. 2024-01-06]. Available from: https://casp-uk.net/casp-tools-checklists/qualitative-studies-checklist/
    12. . Cuellar NG (2021). Justice Is Equality . . . But Equality of What? (Aristotle). J Trans Nurs 32(2): 93‒93. DOI: 10.1177/1043659620984291. Go to original source... Go to PubMed...
    13. . Edwards J, Kaimal G (2016). Using meta-synthesis to support application of qualitative methods findings in practice: A discussion of meta-ethnography, narrative synthesis, and critical interpretive synthesis. Arts Psychother 51: 30‒35. DOI: 10.1016/j.aip.2016.07.003. Go to original source...
    14. . Kim CJH, Padilla AM (2020). Technology for Educational Purposes Among Low-Income Latino Children Living in a Mobile Park in Silicon Valley: A Case Study Before and During COVID-19. Hisp J Behav Sci 42(4): 497‒514. DOI: 10.1177/0739986320959764. Go to original source...
    15. . Lachal J, Revah-Levy A, Orri M, Moro MR (2017). Metasynthesis: An Original Method to Synthesize Qualitative Literature in Psychiatry. Front Psychiatry 8: 269. DOI: 10.3389/fpsyt.2017.00269. Go to original source... Go to PubMed...
    16. . Lastrucci V, Lorini C, Caini S, Florence Health Literacy Research Group: Bonaccorsi G (2019). Health literacy as a mediator of the relationship between socioeconomic status and health: A cross-sectional study in a population-based sample in Florence. PLoS One 14(12): e0227007. DOI: 10.1371/journal.pone.0227007. Go to original source... Go to PubMed...
    17. . Mahdavi Ardestani SF, Adibi S, Golshan A, Sadeghian P (2023). Factors Influencing the Effectiveness of E-Learning in Healthcare: A Fuzzy ANP Study. Healthcare 11(14): 2035. DOI: 10.3390/healthcare11142035. Go to original source... Go to PubMed...
    18. . Mash RJ, Cairncross J (2023). Piloting of virtual group education for diabetes in Cape Town: An exploratory qualitative study. S Afr Fam Pract 65(1): e1‒e7. DOI: 10.4102/safp.v65i1.5635. Go to original source... Go to PubMed...
    19. . Noblit GW, Hare RD (1988). Meta-Ethnography: Synthesizing Qualitative studies. Newbury Park: Sage Publications, 88 p. Go to original source...
    20. . Notley T, Aziz A (2024). The unjust burden of digital inclusion for low-income migrant parents. Policy Internet 16(2): 428‒442. DOI: 10.1002/poi3.383. Go to original source...
    21. . O'Connor C, Joffe H (2020). Intercoder Reliability in Qualitative Research: Debates and Practical Guidelines. Int J Qual Methods 19: 1-13. DOI: 10.1177/1609406919899220. Go to original source...
    22. . Prosen M, Karnjuš I, Ličen S (2022). Evaluation of E-Learning Experience among Health and Allied Health Professions Students during the COVID-19 Pandemic in Slovenia: An Instrument Development and Validation Study. Int J Environ Res Public Health 19(8): 4777. DOI: 10.3390/ijerph19084777. Go to original source... Go to PubMed...
    23. . Rosenberg NE, Tembo TA, Simon KR, Mollan K, Rutstein SE, Mwapasa V, et al. (2022). Development of a Blended Learning Approach to Delivering HIV-Assisted Contact Tracing in Malawi: Applied Theory and Formative Research. JMIR Form Res 6(4): e32899. DOI: 10.2196/32899. Go to original source... Go to PubMed...
    24. . Thorne S (2022). Qualitative meta-synthesis. Nurse Author Ed 32(1): 15‒18. DOI: 10.1111/nae2.12036. Go to original source...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content