Assessment of health literacy (Traditional vs eHealth) among Filipino LGBTQIA+ individuals living in the United States

Filipino LGBTQIA+ individuals in the United States experience layered health inequities related to culture, language, sexual orientation, and digital access. Health literacy, both traditional and electronic, is a key determinant of health behaviors and outcomes, yet little is known about literacy patterns in this population. This quality improvement project evaluated changes in traditional, eHealth, LGBTQIA-specific, and cultural health literacy following a targeted educational intervention. Forty-four Filipino LGBTQIA+ adults completed pre- and post-test assessments using the S-TOFHLA, eHEALS, and investigator-developed LGBTQIA-specific and cultural literacy measures. Post-intervention gains were observed across all literacy domains. Increases in S-TOFHLA and eHEALS scores were positive but not statistically significant, likely due to ceiling effects linked to high baseline scores among participants with graduate degrees and healthcare employment. In contrast, LGBTQIA-specific and cultural literacy demonstrated statistically significant improvements, indicating strong responsiveness to culturally tailored content. Participants with lower or mid-range baseline literacy, non-healthcare backgrounds, and associate-level education benefited the most. Findings support community-centered and identity-affirming educational strategies to reduce health disparities in marginalized populations. Future work should include recruitment of individuals with lower baseline literacy, follow-up assessments to determine retention, and evaluation of scalability for clinical and community use.