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Wolfe K, Crompton CJ, Hoffman P, MacPherson SE. Collaborative learning of new information in older age: a systematic review. ROYAL SOCIETY OPEN SCIENCE 2023; 10:211595. [PMID: 37800148 PMCID: PMC10548100 DOI: 10.1098/rsos.211595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 09/07/2023] [Indexed: 10/07/2023]
Abstract
Ageing is accompanied by a multitude of changes in cognitive abilities, which in turn affect learning. Learning collaboratively may benefit older adults by negating some of these age-related changes. However, studies on collaborative learning in older age differ in their methodology and findings. This systematic review provides an overview of the current research on collaborative learning in older age, exploring what factors influence collaborative learning in this age group. The titles and abstracts of imported 6629 works were screened, as well as four works added manually, which resulted in 29 studies. These studies were conducted across five countries (Canada, United States, United Kingdom, Switzerland and Belgium) between 1993 and 2023. Most studies were quantitative with a non-randomized (n = 16) design. Of the 29 studies, almost all studied collaboration in pairs (n = 28). The results suggest that the benefits of collaborating in older age may depend on the type of learning material, that familiarity between partners does not affect learning, and that age differences appear to decrease or disappear when older adults are provided with adequate time or trials. In addition, this systematic review identifies several gaps in the literature that future research should investigate further. This study was preregistered prior to its commencement on 21 January 2022. The accepted Stage 1 manuscript, unchanged from the point of in-principle acceptance, may be viewed at https://osf.io/tj4w7/. The data and materials of this study can be found at https://osf.io/8xvqf/.
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Affiliation(s)
- Kelly Wolfe
- Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Catherine J. Crompton
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Paul Hoffman
- Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Sarah E. MacPherson
- Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
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Vazquez CE, Xie B, Shiroma K, Charness N. Individualistic Versus Collaborative Learning in an eHealth Literacy Intervention for Older Adults: Quasi-Experimental Study. JMIR Aging 2023; 6:e41809. [PMID: 36757773 PMCID: PMC9951071 DOI: 10.2196/41809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/23/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Older adults tend to have insufficient health literacy, which includes eHealth literacy-the ability to access, assess, and use digital health information. Interventions using methods such as collaborative learning (CL) and individualistic learning (IL) may be effective in addressing older adults' low eHealth literacy, but little is known about the short- and long-term effects of CL versus IL on older adults' eHealth literacy. OBJECTIVE The objective of this study was to use a 3 × 2 × 3 mixed factorial design to examine older adults' learning with CL versus IL for eHealth literacy. METHODS Older adults (N=466; mean age 70.5, SD 7.2; range 60-96 years) from diverse racial and ethnic groups were randomly assigned to either the CL or IL group (233/466, 50% in each). The intervention consisted of 4 weeks of training in 2-hour sessions held twice a week. Using ANOVA and multiple regression, we focused on the main effects of learning condition and interaction between learning condition and previous computer experience. Learning method (CL or IL) and previous computer experience (experienced, new, or mixed) were between-subject variables, and time of measurement (pretest measurement, posttest measurement, and 6-month follow-up) was the within-subject variable. Primary outcome variables were eHealth literacy efficacy, computer and web knowledge, basic computer and web operation skills, information-seeking skills, and website evaluation skills. Control variables were age, sex, education, health status, race and ethnicity, income, primary language, and previous health literacy. RESULTS eHealth literacy efficacy, computer and web knowledge, basic computer and web operation skills, information-seeking skills, and website evaluation skills improved significantly (P<.001 in all cases) from before to after the intervention. From postintervention measurement to 6-month follow-up, there was a significant interaction between learning condition and previous computer experience based on 1 outcome measure, computer and web operation skills (F2,55=3.69; P=.03). To maintain computer and web operation skills 6 months after the intervention, it was more effective for people with little to no previous computer experience to learn individually, whereas for people with more previous computer experience, it was more effective to learn collaboratively. From postintervention measurement to 6-month follow-up, statistically significant decreases were found in 3 of the 5 outcome measures: eHealth literacy efficacy, computer and web knowledge, and basic computer and web operation skills (P<.001 for all 3 cases). CONCLUSIONS Older adults' eHealth literacy can be improved through effective intervention, and the IL or CL condition may have little effect on short-term outcomes. However, to maintain long-term benefits, it may be best to learn collaboratively with others who have similar previous computer experience. eHealth literacy is multidimensional, with some components retained better over time. Findings suggest a need for resources to provide continuous training or periodic boosting to maintain intervention gains.
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Affiliation(s)
| | - Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Kristina Shiroma
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Neil Charness
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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Guo Y, Wen T, Yue S, Zhao X, Huang K. The influence of health information attention and app usage frequency of older adults on persuasive strategies in mHealth education apps. Digit Health 2023; 9:20552076231167003. [PMID: 37021126 PMCID: PMC10068977 DOI: 10.1177/20552076231167003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 03/15/2023] [Indexed: 04/03/2023] Open
Abstract
With the development of mobile communication technology, persuasive technology is widely used in mobile health. Using personalized persuasive strategies in mobile health education (MHE) apps can effectively improve users’ health literacy and health behaviors. The transtheoretical model explains the process of user behavior change. Different usage frequency of the app reflects changes in user behavior. However, few studies have examined how the perceived importance of persuasive strategies among older adults changes with increasing use frequency. In this study, we analyzed the sensitivity of 111 older adults in China to persuasive strategies in MHE apps. Thirteen persuasive strategies were selected for this study. A repeated measure analysis of variance (RM-ANOVA) was used to demonstrate the influence of gender, health information attention and frequency of use on the sensitivity of perceived persuasive strategies among older adults. The results revealed older adults with a high usage frequency of health apps were more receptive to persuasive strategies, especially in social comparison strategy. This result may help developers consider factors such as the frequency of use by older users when designing personalized persuasive strategies for MHE apps.
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Affiliation(s)
- Yongyan Guo
- School of Art Design and Media,
East
China University of Science and Technology of Art Design and
Media, Shanghai, China
- Yongyan Guo, East China University of
Science and Technology School of Art Design and Media, 130 Meilong Road, Xuhui
District, Shanghai 200037, China.
| | - Tingting Wen
- School of Art Design and Media,
East
China University of Science and Technology of Art Design and
Media, Shanghai, China
| | - Siyu Yue
- School of Art Design and Media,
East
China University of Science and Technology of Art Design and
Media, Shanghai, China
| | - Xiaoran Zhao
- School of Art Design and Media,
East
China University of Science and Technology of Art Design and
Media, Shanghai, China
| | - Keke Huang
- School of Art Design and Media,
East
China University of Science and Technology of Art Design and
Media, Shanghai, China
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Ghorbanian Zolbin M, Huvila I, Nikou S. Health literacy, health literacy interventions and decision-making: a systematic literature review. JOURNAL OF DOCUMENTATION 2022. [DOI: 10.1108/jd-01-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to assess the relationship between elderly people's health literacy skills and those people's decision to make use of digital health service platforms. Despite the substantial influence of digitisation on the delivery of healthcare services, understanding how health intervention strategies might help empower elderly people's health literacy skills is critical.Design/methodology/approachThis paper analyses the existing trends in research on the convergence of health literacy, health intervention programmes and digital health service platforms by reviewing 34 studies published between 2000 and 2020.FindingsThe findings of the review indicate three primary themes (health literacy skills, health management competency and attitude/confidence), which provide a summary of the current literature, and in all three the results show that health intervention programmes help to enhance health literacy skills of elderly people. Based on the review results and by organising the fragmented status quo of health intervention research, the authors develop a comprehensive research model and identify future research directions for research in this domain.Practical implicationsThe findings will be useful to health professionals in two ways: (1) the findings provide practical information about the growing need to implement health literacy intervention programmes to satisfy elderly people's appetite for accessing health services due to cognitive and physiological impairments, and (2) the finding help them to understand that with digital health platforms, elderly people have quicker access to health services, improving the quality of care provided to them.Originality/valueThis paper presents a comprehensive research model for analysing the impact of health literacy skills on older people's ability and intention to access digital health information sources, considering various health intervention approaches.
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De Main AS, Xie B, Shiroma K, Yeh T, Davis N, Han X. Assessing the Effects of eHealth Tutorials on Older Adults' eHealth Literacy. J Appl Gerontol 2022; 41:1675-1685. [PMID: 35466732 DOI: 10.1177/07334648221088281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
eHealth literacy is the ability to access, assess, and use digital health information. This study compared the effects of a multimedia tutorial versus a paper-based control in improving older adults' eHealth literacy from pre- to posttest. A total of 99 community-dwelling older adults (63-90 years old; mean = 73.09) participated from July 2019 to February 2020. Overall, knowledge about computer/Internet terms, eHealth literacy efficacy, knowledge about the quality of health information websites, and procedural skills in computer/Internet use improved significantly from pre- to posttest. No interaction effect was found between time and group. Participants in both groups had an overwhelmingly positive attitude toward training. Their attitudes toward training approached a statistically significant difference between the two conditions: F (1, 89) = 3.75, p = .056, partial η2 = .040, with the multimedia condition showing more positive attitudes. These findings have implications for designing effective eHealth literacy interventions for older adults.
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Affiliation(s)
- Atami S De Main
- 12330The University of Texas at Austin School of Nursing, Austin, TX, USA
| | - Bo Xie
- 12330The University of Texas at Austin School of Nursing, Austin, TX, USA.,12330The University of Texas at Austin School of Information, Austin, TX, USA
| | - Kristina Shiroma
- 12330The University of Texas at Austin School of Information, Austin, TX, USA
| | - Tom Yeh
- Department of Computer Science, 1877The University of Colorado Boulder, Boulder, CO, USA
| | - Nathan Davis
- 12330The University of Texas at Austin School of Information, Austin, TX, USA
| | - Xu Han
- Department of Computer Science, 1877The University of Colorado Boulder, Boulder, CO, USA
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Chavarria EA, Christy SM, Feng H, Miao H, Abdulla R, Gutierrez L, Lopez D, Sanchez J, Gwede CK, Meade CD. Online health information seeking and eHealth literacy among Spanish language- dominant Latinos receiving care in a community clinic (Preprint). JMIR Form Res 2022; 6:e37687. [PMID: 35238785 PMCID: PMC9614617 DOI: 10.2196/37687] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/12/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background eHealth literacy is the ability to seek, obtain, and decipher online health information (OHI) for health and disease management. Rapid developments in eHealth (eg, health care services and online information) place increased demands on patients to have high eHealth literacy levels. Yet, greater emphasis on eHealth may disproportionately affect groups with limited eHealth literacy. Cultural background, language, and eHealth literacy are influential considerations affecting health care and information access, health care use, and successful eHealth resource use, and they may influence OHI seeking for behavioral change toward cancer prevention. Objective This study aimed to characterize the extent of OHI seeking and eHealth literacy among Spanish-dominant (SD) Latino adults aged 50 to 75 years. Further, we aimed to examine potential associations between sociodemographic characteristics, Preventive Health Model (PHM) constructs, OHI-seeking behaviors, and eHealth literacy, separately. Methods Participants (N=76) self-identified as Latino, were enrolled in a colorectal cancer (CRC) screening intervention, were aged 50 to 75 years, were at average risk for CRC, were not up to date with CRC screening, and preferred receiving health information in Spanish. We describe participants’ sociodemographic characteristics, PHM constructs, OHI-seeking behaviors, and eHealth literacy—among those seeking OHI—assessed at enrollment. Descriptive analyses were first performed for all variables. Next, primary univariate logistic analyses explored possible associations with OHI seeking. Finally, using data from those seeking OHI, exploratory univariate analyses sought possible associations with eHealth literacy. Results A majority (51/76, 67%) of the participants were female, 62% (47/76) reported not having graduated high school, and 41% (31/76) reported being unemployed or having an annual income of less than US $10,000. Additionally, 75% (57/76) of the participants reported not having health insurance. In total, 71% (54/76) of the participants reported not having sought OHI for themselves or others. Univariate logistic regression suggested that higher educational attainment was significantly associated with an increased likelihood of having sought OHI (odds ratio 17.4, 95% CI 2.0-150.7; P=.009). Among those seeking OHI (22/76, 29%), 27% (6/22) were at risk of having low eHealth literacy based on an eHealth Literacy Scale score of less than 26. Among OHI seekers (22/76, 29%), an examination of associations found that higher eHealth literacy was associated with greater self-efficacy for screening with the fecal immunochemical test (β=1.20, 95% CI 0.14-2.26; P=.02). Conclusions Most SD Latino participants had not sought OHI for themselves or others (eg, family or friends), thus potentially limiting access to beneficial online resources. Preliminary findings convey that higher eHealth literacy occurs among those with higher self-efficacy for CRC screening. Findings inform areas of focus for future larger-scale investigations, including further exploration of reasons for not seeking OHI among SD Latino adults and an in-depth look at eHealth literacy and cancer screening behaviors. Trial Registration ClinicalTrials.gov NCT03078361; https://clinicaltrials.gov/ct2/show/NCT03078361
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Affiliation(s)
- Enmanuel A Chavarria
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
- Cancer Prevention and Control Research Program, Winship Cancer Institute, Emory University, Atlanta, GA, United States
| | - Shannon M Christy
- Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
| | - Han Feng
- School of Medicine, Tulane University, New Orleans, LA, United States
| | - Hongyu Miao
- College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Rania Abdulla
- Non-Therapeutic Research Office, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
| | | | - Diana Lopez
- Suncoast Community Health Centers, Brandon, FL, United States
| | - Julian Sanchez
- Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
| | - Clement K Gwede
- Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
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A Comprehensive Analysis of E-Health Literacy Research Focuses and Trends. Healthcare (Basel) 2021; 10:healthcare10010066. [PMID: 35052230 PMCID: PMC8775877 DOI: 10.3390/healthcare10010066] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 12/04/2022] Open
Abstract
Objective: To sort out the research focuses in the field of e-health literacy, analyze its research topics and development trends, and provide a reference for relevant research in this field in the future. Methods: The literature search yielded a total of 431 articles retrieved from the core dataset of Web of Science using the keywords “ehealth literacy”, “E-health literacy” and “electronic health literacy”. A bibliometric analysis was performed by using CiteSpace to explore the development history, hot themes, and trends of future research in the field of e-health literacy. Results: The thematic evolution path in e-health literacy was divided into three stages. The research focuses were inspected from four aspects: evaluation, correlation with health-promotion behaviors, influencing factors, and intervention measures for improvement. Conclusion: E-health literacy research faces challenges such as the development of the connotation of the term, the objectivity of evaluation methods, and the long-term impact of interventions. Future research themes in e-health literacy will include the standardization of evaluation instruments and the individualization of therapeutic strategies.
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Oh SS, Kim KA, Kim M, Oh J, Chu SH, Choi J. Measurement of Digital Literacy Among Older Adults: Systematic Review. J Med Internet Res 2021; 23:e26145. [PMID: 33533727 PMCID: PMC7889415 DOI: 10.2196/26145] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/04/2021] [Accepted: 01/16/2021] [Indexed: 12/15/2022] Open
Abstract
Background Numerous instruments are designed to measure digital literacy among the general population. However, few studies have assessed the use and appropriateness of these measurements for older populations. Objective This systematic review aims to identify and critically appraise studies assessing digital literacy among older adults and to evaluate how digital literacy instruments used in existing studies address the elements of age-appropriate digital literacy using the European Commission’s Digital Competence (DigComp) Framework. Methods Electronic databases were searched for studies using validated instruments to assess digital literacy among older adults. The quality of all included studies was evaluated using the Crowe Critical Appraisal Tool (CCAT). Instruments were assessed according to their ability to incorporate the competence areas of digital literacy as defined by the DigComp Framework: (1) information and data literacy, (2) communication and collaboration, (3) digital content creation, (4) safety, and (5) problem-solving ability, or attitudes toward information and communication technology use. Results Searches yielded 1561 studies, of which 27 studies (17 cross-sectional, 2 before and after, 2 randomized controlled trials, 1 longitudinal, and 1 mixed methods) were included in the final analysis. Studies were conducted in the United States (18/27), Germany (3/27), China (1/27), Italy (1/27), Sweden (1/27), Canada (1/27), Iran (1/27), and Bangladesh (1/27). Studies mostly defined older adults as aged ≥50 years (10/27) or ≥60 years (8/27). Overall, the eHealth Literacy Scale (eHEALS) was the most frequently used instrument measuring digital literacy among older adults (16/27, 59%). Scores on the CCAT ranged from 34 (34/40, 85%) to 40 (40/40, 100%). Most instruments measured 1 or 2 of the DigComp Framework’s elements, but the Mobile Device Proficiency Questionnaire (MDPQ) measured all 5 elements, including “digital content creation” and “safety.” Conclusions The current digital literacy assessment instruments targeting older adults have both strengths and weaknesses, relative to their study design, administration method, and ease of use. Certain instrument modalities like the MDPQ are more generalizable and inclusive and thus, favorable for measuring the digital literacy of older adults. More studies focusing on the suitability of such instruments for older populations are warranted, especially for areas like “digital content creation” and “safety” that currently lack assessment. Evidence-based discussions regarding the implications of digitalization for the treatment of older adults and how health care professionals may benefit from this phenomenon are encouraged.
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Affiliation(s)
- Sarah Soyeon Oh
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Kyoung-A Kim
- Department of Nursing, Yeoju Institute of Technology, Yeoju, Gyeonggi-do, Republic of Korea
| | - Minsu Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Jaeuk Oh
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Sang Hui Chu
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - JiYeon Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
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Theory-based E-health literacy interventions in older adults: a systematic review. ACTA ACUST UNITED AC 2020; 78:72. [PMID: 32793345 PMCID: PMC7418312 DOI: 10.1186/s13690-020-00455-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/30/2020] [Indexed: 11/16/2022]
Abstract
Background e-health literacy can facilitate the uptake of benefits of health for older adults. In this review, we aimed to tabulate the types and outcomes of the theory-based e-health interventions that had been applied to improve the e-health literacy of older adults. Methods In this systematic review, theory-based e-health literacy interventions that published up to April 2020 were retrieved from several online electronic databases, including Medline via PubMed, Cochrane Library, ProQuest, and EMBASE. The published papers were included in this study, if the study had been conducted on older adults, a theory-based intervention aimed at promoting e-health literacy, and had been written in English language in the timeframe of 2008–2020. Results A total of 1658 records were identified initially, of which, 12 articles met the inclusion criteria. The systematic review identified the using of variety of intrapersonal, interpersonal, and societal level conceptual models in enhancing of e-health literacy in older adults, and the concept of self-efficacy was applied in the most of interventions as the main conceptual theoretical framework. Conclusions Despite the paucity of conceptual models, which are specifically designed for e-health literacy interventions, based on our findings, we recommend self-efficacy as a powerful concept that can play an important role in improving e-health literacy in older adults.
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Mullins LB, Skemp L, Reed D, Emerson M. Internet Programming to Reduce Loneliness and Social Isolation in Aging. Res Gerontol Nurs 2020; 13:233-242. [PMID: 32286668 DOI: 10.3928/19404921-20200320-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 11/05/2019] [Indexed: 11/20/2022]
Abstract
Loneliness and social isolation in older adults carry mortality risks similar to cigarette smoking. The study aim was to use a Culturally Informed Healthy Aging (CIHA) assessment process in Housing and Urban Development (HUD) communities of older adults (N = 262). Through the CIHA assessment process, older adults identified pertinent health problems and the study team developed a health intervention, an Internet Information Station (IIS). The IIS pilot study included computer lesson participation (n = 261), written feedback (n = 42), and the revised University of California, Los Angeles (R-UCLA) Loneliness Scale (n = 11). Increased confidence with technology and connectedness were reported, and a significant difference in "There is no one I can turn to" was observed (IIS compared to non-IIS). The IIS remains an active site for interaction 1-year post intervention. These pilot results supplement the research on older adult engagement in problem identification, intervention design, and outcomes measurement. TARGET Older adults living in HUD communities. INTERVENTION DESCRIPTION Through CIHA assessment, health problems were identified, and the IIS was developed and implemented. MECHANISMS OF ACTION Lessons were developed (e.g., computer basics, connecting with technology, open forum) and evaluated. Pre and post lesson, the R-UCLA Loneliness Scale measured social isolation and loneliness. OUTCOMES Older adults were engaged in problem identification, program development, and implementation. Feelings of connectedness improved; however, program evaluation with the R-UCLA scale was difficult to obtain. [Research in Gerontological Nursing, 13(5), 233-242.].
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Levin-Zamir D, Bertschi I. Media Health Literacy, eHealth Literacy, and the Role of the Social Environment in Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081643. [PMID: 30081465 PMCID: PMC6121358 DOI: 10.3390/ijerph15081643] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 07/28/2018] [Accepted: 07/30/2018] [Indexed: 12/24/2022]
Abstract
Health literacy describes skills and competencies that enable people to gain access to, understand and apply health information to positively influence their own health and the health of those in their social environments. In an increasingly media saturated and digitized world, these skill sets are necessary for accessing and navigating sources of health information and tools, such as television, the Internet, and mobile apps. The concepts of Media Health Literacy (MHL) and eHealth Literacy (eHL) describe the specific competencies such tasks require. This article introduces the two concepts, and then reviews findings on the associations of MHL and eHL with several contextual variables in the social environment such as socio-demographics, social support, and system complexity, as a structural variable. As eHL and MHL are crucial for empowering people to actively engage in their own health, there is a growing body of literature reporting on the potential and the effectiveness of intervention initiatives to positively influence these competencies. From an ethical standpoint, equity is emphasized, stressing the importance of accessible media environments for all—including those at risk of exclusion from (digital) media sources. Alignment of micro and macro contextual spheres will ultimately facilitate both non-digital and digital media to effectively support and promote public health.
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Affiliation(s)
- Diane Levin-Zamir
- Department of Health Education and Promotion, Clalit Health Services, Tel Aviv 62098, Israel.
- School of Public Health, University of Haifa, Haifa 31905, Israel.
| | - Isabella Bertschi
- Department of Psychology, University of Zurich, Zürich 8050, Switzerland.
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Mitsuhashi T. Effects of two-week e-learning on eHealth literacy: a randomized controlled trial of Japanese Internet users. PeerJ 2018; 6:e5251. [PMID: 30013857 PMCID: PMC6047505 DOI: 10.7717/peerj.5251] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 06/27/2018] [Indexed: 11/20/2022] Open
Abstract
Background The Internet is widely used as a source of information by people searching for medical or healthcare information. However, information found on the Internet has several drawbacks, and the ability to consume accurate health information on the Internet (eHealth literacy) is increasingly important. This study’s goal was to clarify the extent to which eHealth literacy is improved after e-learning in a randomized controlled trial. Methods Data were collected on 301 Japanese adults through an online survey. Participants were assigned to the intervention (e-learning about eHealth literacy) group or the control group in a 1:1 ratio. The intervention group included 148 participants, and 153 participants were in the control group. The participants provided information at baseline on demographic characteristics, self-rated health, and frequency of Internet searching. The eHealth Literacy Scale (eHEALS), which was the main measure of eHealth literacy, and data on secondary outcomes (the Healthy Eating Literacy Scale and skill for evaluating retrieved search results) were obtained at baseline and at follow-up. The score difference was calculated by subtracting the score at baseline from the score at follow-up. Linear regression analysis and multinomial regression analysis were performed using the differences in score as the dependent variables and the intervention as the explanatory variable. Intention-to-treat analysis was employed. Results The results from participants who responded to all of the questions both times were analyzed (134 in the intervention group and 148 in the control group). eHEALS increased 1.57 points due to the intervention effect (Δ score change = 1.57; 95% CI [0.09–3.05]; p = 0.037). Skills for evaluating retrieved search results improved more in the intervention group than in the control group (relative risk ratio = 2.47; 95% Confidence Interval: 1.33, 4.59; p = 0.004). There were no large differences at baseline between the intervention and control groups in the eHEALS, Healthy Eating Literacy scale, or skill for evaluating retrieved search results. However, at follow-up, the intervention group had improved more than the control group on both the eHEALS and skill for evaluating retrieved search results. Discussion eHealth literacy improved after the e-learning, as evidenced by the change to the eHEALS scores and increased skill for evaluating retrieved search results. There was no significant effect of e-learning, which did not include content on healthy eating, on the Healthy Eating Literacy Scale scores. This indicates that scores did not increase much due to effects other than e-learning, as is sometimes seen with the Hawthorne effect. Although it was statistically significant, the effect size was small. Therefore, future research is necessary to verify the clinical implications. In sum, this study suggests that e-learning is an effective way to improve eHealth literacy.
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Affiliation(s)
- Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
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Zakaria N, AlFakhry O, Matbuli A, Alzahrani A, Arab NSS, Madani A, Alshehri N, Albarrak AI. Development of Saudi e-health literacy scale for chronic diseases in Saudi Arabia: using integrated health literacy dimensions. Int J Qual Health Care 2018; 30:321-328. [PMID: 29584913 PMCID: PMC7108630 DOI: 10.1093/intqhc/mzy033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 01/08/2018] [Accepted: 02/14/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Health literacy has become a global issue, and it is important that patients and individuals are able to use information technology to access health information and educational services. The research objective is to develop a Saudi e-health literacy scale (SeHL) for measuring e-health literacy among Saudis suffering from non-communicable diseases (NCD). METHODS Overall, 14 relevant papers in related interdisciplinary fields were reviewed to select the most useful literacy dimensions. From these articles, we extracted the most common dimensions used to measure e-health literacy across the disciplines. Multiple workshops with multidisciplinary team members reviewed and evaluated items for SeHL. RESULTS Four key aspects of e-health literacy-use of technology/media, information-seeking, usefulness and confidence-were identified and integrated as e-health literacy dimensions. These will be used to measure e-health literacy among Saudi patients with NCDs. A translation from Arabic to English was performed in order to ensure that translation process was accurate. A SeHL scale was developed to measure e-health literacy among Saudi patients. By understanding e-health literacy levels, we will be able to create a patient-education system to be used by patients in Saudi Arabia. CONCLUSIONS As information technology is increasingly used by people of all ages all over the world, e-health literacy has been identified as a key factor in determining health outcomes. To date, no comprehensive scale exists to assess e-health literacy levels among speakers of Arabic, particularly among people with NCD such as diabetes, cardiovascular diseases and hypertension.
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Affiliation(s)
- Nasriah Zakaria
- Research Chair of Health Informatics and Promotion, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
- Medical Informatics and e-Learning Unit, Medical Education Department, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Ohoud AlFakhry
- Ministry of National Guard-Health Affairs, Khasham Alan, Riyadh 14415, Saudi Arabia
| | - Abeer Matbuli
- College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
| | - Asma Alzahrani
- Prince Sultan Military Medical City, AlSulimaniah, Riyadh 11159, Saudi Arabia
| | - Noha Samir Sadiq Arab
- King Faisal Specialist and Research Center, Zahrawi St, Al Maather, Riyadh 11211, Saudi Arabia
| | - Alaa Madani
- College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
| | - Noura Alshehri
- College of Pharmacy, King Said University, Riyadh 12372, Saudi Arabia
| | - Ahmed I Albarrak
- Research Chair of Health Informatics and Promotion, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
- Medical Informatics and e-Learning Unit, Medical Education Department, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
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Griebel L, Enwald H, Gilstad H, Pohl AL, Moreland J, Sedlmayr M. eHealth literacy research-Quo vadis? Inform Health Soc Care 2017; 43:427-442. [PMID: 29045164 DOI: 10.1080/17538157.2017.1364247] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The concept of electronic health (eHealth) literacy evolved from the social and information sciences and describes competencies necessary to use electronic health services. As it is a rather new topic, and as there is no current overview of the state of the art in research, it is not possible to identify research gaps. Therefore, the objective of this viewpoint article is to increase knowledge on the current state of the art of research in eHealth literacy and to identify gaps in scientific research which should be focused on by the research community in the future. The article provides a current viewpoint of the concept of eHealth literacy and related research. Gaps can be found in terms of a missing "gold standard" regarding both the definition and the measurement of eHealth literacy. Furthermore, there is a need for identifying the implications on eHealth developers, which evolve from the measurement of eHealth literacy in eHealth users. Finally, a stronger inclusion of health professionals, both in the evolving concept and in the measurement of eHealth literacy, is needed in the future.
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Affiliation(s)
- Lena Griebel
- a Chair of Medical Informatics , Friedrich-Alexander University Erlangen-Nürnberg , Erlangen, Germany
| | - Heidi Enwald
- b Information Studies , University of Oulu , Oulu, Finland.,c Information Studies , Åbo Akademi University , Turku, Finland
| | - Heidi Gilstad
- d Health Informatics Research Group, Faculty of Medicine , NTNU The Norwegian University of Science and Technology , Trondheim, Norway
| | - Anna-Lena Pohl
- e Institute for eHealth and Management in HealthCare , Flensburg University of Applied Sciences , Flensburg, Germany
| | - Julia Moreland
- f Social Sciences , University of the Highlands and Islands, Moray College UHI , Elgin, Scotland
| | - Martin Sedlmayr
- a Chair of Medical Informatics , Friedrich-Alexander University Erlangen-Nürnberg , Erlangen, Germany
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15
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Aponte J, Nokes KM. Validating an electronic health literacy scale in an older hispanic population. J Clin Nurs 2017; 26:2703-2711. [DOI: 10.1111/jocn.13763] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Judith Aponte
- Hunter College; Hunter-Bellevue School of Nursing; New York NY USA
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Richtering SS, Hyun K, Neubeck L, Coorey G, Chalmers J, Usherwood T, Peiris D, Chow CK, Redfern J. eHealth Literacy: Predictors in a Population With Moderate-to-High Cardiovascular Risk. JMIR Hum Factors 2017; 4:e4. [PMID: 28130203 PMCID: PMC5303199 DOI: 10.2196/humanfactors.6217] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/30/2016] [Accepted: 12/18/2016] [Indexed: 11/20/2022] Open
Abstract
Background Electronic health (eHealth) literacy is a growing area of research parallel to the ongoing development of eHealth interventions. There is, however, little and conflicting information regarding the factors that influence eHealth literacy, notably in chronic disease. We are similarly ill-informed about the relationship between eHealth and health literacy, 2 related yet distinct health-related literacies. Objective The aim of our study was to investigate the demographic, socioeconomic, technology use, and health literacy predictors of eHealth literacy in a population with moderate-to-high cardiovascular risk. Methods Demographic and socioeconomic data were collected from 453 participants of the CONNECT (Consumer Navigation of Electronic Cardiovascular Tools) study, which included age, gender, education, income, cardiovascular-related polypharmacy, private health care, main electronic device use, and time spent on the Internet. Participants also completed an eHealth Literacy Scale (eHEALS) and a Health Literacy Questionnaire (HLQ). Univariate analyses were performed to compare patient demographic and socioeconomic characteristics between the low (eHEALS<26) and high (eHEALS≥26) eHealth literacy groups. To then determine the predictors of low eHealth literacy, multiple-adjusted generalized estimating equation logistic regression model was used. This technique was also used to examine the correlation between eHealth literacy and health literacy for 4 predefined literacy themes: navigating resources, skills to use resources, usefulness for oneself, and critical evaluation. Results The univariate analysis showed that patients with lower eHealth literacy were older (68 years vs 66 years, P=.01), had lower level of education (P=.007), and spent less time on the Internet (P<.001). However, multiple-adjusted generalized estimating equation logistic regression model demonstrated that only the time spent on the Internet (P=.01) was associated with the level of eHealth literacy. Regarding the comparison between the eHEALS items and HLQ scales, a positive linear relationship was found for the themes “usefulness for oneself” (P=.049) and “critical evaluation” (P=.01). Conclusions This study shows the importance of evaluating patients’ familiarity with the Internet as reflected, in part, by the time spent on the Internet. It also shows the importance of specifically assessing eHealth literacy in conjunction with a health literacy assessment in order to assess patients’ navigational knowledge and skills using the Internet, specific to the use of eHealth applications.
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Affiliation(s)
- Sarah S Richtering
- The George Institute for Global Health, Sydney, Australia.,Hôpitaux Universitaires de Genève, Université de Genève, Geneva, Switzerland
| | - Karice Hyun
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Lis Neubeck
- The George Institute for Global Health, Sydney, Australia.,School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.,Sydney Nursing School, Charles Perkin Centre, University of Sydney, Sydney, Australia
| | - Genevieve Coorey
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - John Chalmers
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Tim Usherwood
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Westmead Hospital, Sydney, Australia
| | - David Peiris
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Clara K Chow
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Westmead Hospital, Sydney, Australia
| | - Julie Redfern
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
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Griebel L, Kolominsky-Rabas P, Schaller S, Siudyka J, Sierpinski R, Papapavlou D, Simeonidou A, Prokosch HU, Sedlmayr M. Acceptance by laypersons and medical professionals of the personalized eHealth platform, eHealthMonitor. Inform Health Soc Care 2016; 42:232-249. [DOI: 10.1080/17538157.2016.1237953] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lena Griebel
- Chair of Medical Informatics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Kolominsky-Rabas
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Sandra Schaller
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Jakub Siudyka
- Kardiosystem Sp. z.o.o., Medicalgorithmics S.A., Warsaw, Poland
| | | | | | | | - Hans-Ulrich Prokosch
- Chair of Medical Informatics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
- University Hospital Erlangen, Erlangen, Germany
| | - Martin Sedlmayr
- Chair of Medical Informatics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
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18
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Whealin JM, Seibert-Hatalsky LA, Howell JW, Tsai J. E-mental health preferences of Veterans with and without probable posttraumatic stress disorder. ACTA ACUST UNITED AC 2016; 52:725-38. [PMID: 26562090 DOI: 10.1682/jrrd.2014.04.0113] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/03/2015] [Indexed: 11/05/2022]
Abstract
Mental health care practices supported by electronic communication, referred to as e-mental health, offer ways to increase access to mental health resources. In recent years, e-mental health interventions using clinical video teleconferencing, Internet-based interventions, social networking sites, and telephones have emerged as viable, cost-effective methods to augment traditional service delivery. Whereas some research evaluates attitudes about e-mental health, few studies have assessed interest in using these approaches in a contemporary sample of U.S. Veterans. This study sought to understand willingness to use e-mental health in a diverse group of Veterans residing in Hawaii. Mailed surveys were completed by 600 Operation Iraqi Freedom/Operation Enduring Freedom Veterans and National Guard members. Results suggest that overall willingness to use e-mental health ranged from 32.2% to 56.7% depending on modality type. Importantly, Veterans who screened positive for posttraumatic stress disorder (PTSD) were significantly less likely to report willingness to use each e-mental health modality than their peers without PTSD, despite their greater desire for mental health services. These results suggest that despite solutions to logistical barriers afforded via e-mental health services, certain barriers to mental health care may persist, especially among Veterans who screen positive for PTSD.
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Affiliation(s)
- Julia M Whealin
- Department of Veterans Affairs (VA) Pacific Islands Health Care System, Honolulu, HI
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19
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Wu D, Li Y. Online health information seeking behaviors among Chinese elderly. LIBRARY & INFORMATION SCIENCE RESEARCH 2016. [DOI: 10.1016/j.lisr.2016.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Abstract
Purpose
The purpose of this paper is to assess the involvement of libraries in health literacy programs and initiatives based on a review of the literature.
Design/methodology/approach
Four databases were searched for papers that described health literacy programs and initiatives within libraries.
Findings
Several themes of health literacy programs in libraries emerged: health literacy for older adults, underserved populations, the general public, healthcare professionals, and medical students, and patients. Collaborations between libraries and community organizations were frequently used.
Practical implications
Librarians may use this review to understand the history of health literacy efforts and libraries to inform future programming. This review will contextualize current research on health literacy and libraries.
Originality/value
Despite the currency and relevance of this topic, there are no literature reviews on health literacy and librarianship.
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21
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Aponte J, Nokes KM. Electronic health literacy of older Hispanics with diabetes. Health Promot Int 2015; 32:482-489. [DOI: 10.1093/heapro/dav112] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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22
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Watkins I, Xie B. eHealth literacy interventions for older adults: a systematic review of the literature. J Med Internet Res 2014; 16:e225. [PMID: 25386719 PMCID: PMC4260003 DOI: 10.2196/jmir.3318] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 07/16/2014] [Accepted: 07/31/2014] [Indexed: 12/03/2022] Open
Abstract
Background eHealth resources offer new opportunities for older adults to access health information online, connect with others with shared health interests, and manage their health. However, older adults often lack sufficient eHealth literacy to maximize their benefit from these resources. Objective This review evaluates the research design, methods, and findings of eHealth literacy interventions for older adults. Methods A systematic review of peer-reviewed research articles from 28 databases in 9 fields was carried out in January 2013. Four rounds of screening of articles in these databases resulted in a final sample of 23 articles. Results Findings indicated a significant gap in the literature for eHealth literacy interventions evaluating health outcomes as the outcome of interest, a lack of theory-based interventions, and few studies applied high-quality research design. Conclusions Our findings emphasize the need for researchers to develop and assess theory-based interventions applying high-quality research design in eHealth literacy interventions targeting the older population.
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Affiliation(s)
- Ivan Watkins
- School of Information, The University of Texas at Austin, Austin, TX, United States.
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23
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PARK HYEJIN, MOON MIKYUNG, BAEG JUNGHOON. Association of eHealth Literacy With Cancer Information Seeking and Prior Experience With Cancer Screening. Comput Inform Nurs 2014; 32:458-63. [DOI: 10.1097/cin.0000000000000077] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Watkins I, Kules B, Yuan X, Xie B. Heuristic Evaluation of Healthy Eating Apps for Older Adults. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2014. [DOI: 10.1080/15398285.2014.902267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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25
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Kim YM. Does Online Searching Cause or Enforce Health Information Disparity? JOURNAL OF INFORMATION & KNOWLEDGE MANAGEMENT 2014. [DOI: 10.1142/s0219649213500329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A growing number of people are seeking health information on the Internet. To meet demands, healthcare providers are increasingly disseminating information online. While online health information has enhanced the dissemination of health information and improved people's health-related knowledge, critics posit that such dissemination has widened knowledge disparities in health information and health benefits as a result. Drawing on existing studies, this study identified the main causes of such disparity, namely education, health literacy, computer self-efficacy (CSE) and usage of health-related social media. The finding showed that education resided at the centre of the disparity and impacted other elements. An interesting finding is although individuals possess high levels of CSE, the efficacy does not highly impact their health benefits, meaning that computer does not directly cause health information disparity but is the tool to promote health-related knowledge disparity.
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Affiliation(s)
- Yong-Mi Kim
- School of Library and Information Studies, University of Oklahoma, 4502 E. 41st Street, Tulsa, Oklahoma 74135, USA
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26
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Jones R. Development of a Questionnaire and Cross-Sectional Survey of Patient eHealth Readiness and eHealth Inequalities. MEDICINE 2.0 2013; 2:e9. [PMID: 25075244 PMCID: PMC4084763 DOI: 10.2196/med20.2559] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 05/24/2013] [Accepted: 08/16/2013] [Indexed: 11/13/2022]
Abstract
BACKGROUND Many speak of the digital divide, but variation in the opportunity of patients to use the Internet for health (patient eHealth readiness) is not a binary difference, rather a distribution influenced by personal capability, provision of services, support, and cost. Digital divisions in health have been addressed by various initiatives, but there was no comprehensive validated measure to know if they are effective that could be used in randomized controlled trials (RCTs) covering both non-Internet-users and the range of Internet-users. OBJECTIVE The aim of this study was to develop and validate a self-completed questionnaire and scoring system to assess patient eHealth readiness by examining the spread of scores and eHealth inequalities. The intended use of this questionnaire and scores is in RCTs of interventions aiming to improve patient eHealth readiness and reduce eHealth inequalities. METHODS Based on four factors identified from the literature, a self-completed questionnaire, using a pragmatic combination of factual and attitude questions, was drafted and piloted in three stages. This was followed by a final population-based, cross-sectional household survey of 344 people used to refine the scoring system. RESULTS the patient ehealth readiness questionnaire (perq) includes questions used to calculate four subscores: patients' perception of (1) provision, (2) their personal ability and confidence, (3) their interpersonal support, and (4) relative costs in using the Internet for health. These were combined into an overall PERQ score (0-9) which could be used in intervention studies. Reduction in standard deviation of the scores represents reduction in eHealth inequalities. CONCLUSIONS PERQ appears acceptable for participants in British studies. The scores produced appear valid and will enable assessment of the effectiveness of interventions to improve patient eHealth readiness and reduce eHealth inequalities. Such methods need continued evolution and redevelopment for other environments. Full documentation and data have been published to allow others to develop the tool further.
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Affiliation(s)
- Ray Jones
- University of Plymouth Faculty of Health, Education, and Society Plymouth United Kingdom
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Norman C. eHealth literacy 2.0: problems and opportunities with an evolving concept. J Med Internet Res 2011; 13:e125. [PMID: 22193243 PMCID: PMC3278111 DOI: 10.2196/jmir.2035] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 12/22/2011] [Accepted: 12/22/2011] [Indexed: 01/12/2023] Open
Abstract
As the use of eHealth grows and diversifies globally, the concept of eHealth literacy – a foundational skill set that underpins the use of information and communication technologies (ICT) for health – becomes more important than ever to understand and advance. EHealth literacy draws our collective attention to the knowledge and complex skill set that is often taken for granted when people interact with technology to address information, focusing our attention on learning and usability issues from the clinical through to population health level. Just as the field of eHealth is dynamic and evolving, so too is the context where eHealth literacy is applied and understood. The original Lily Model of eHealth literacy and scale used to assess it were developed at a time when the first generation of web tools gained prominence before the rise of social media. The rapid shifts in the informational landscape created by Web 2.0 tools and environments suggests it might be time to revisit the concept of eHealth Literacy and consider what a second release might look like.
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Xie B. Improving older adults' e-health literacy through computer training using NIH online resources. LIBRARY & INFORMATION SCIENCE RESEARCH 2011; 34:63-71. [PMID: 22639488 DOI: 10.1016/j.lisr.2011.07.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Bo Xie
- 2117G Hornbake Library, South Wing, College of Information Studies, University of Maryland, College Park, MD 20740, U.S.A
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29
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Xie B. Effects of an eHealth literacy intervention for older adults. J Med Internet Res 2011; 13:e90. [PMID: 22052161 PMCID: PMC3222191 DOI: 10.2196/jmir.1880] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 09/14/2011] [Accepted: 09/27/2011] [Indexed: 11/25/2022] Open
Abstract
Background Older adults generally have low health and computer literacies, making it challenging for them to function well in the eHealth era where technology is increasingly being used in health care. Little is known about effective interventions and strategies for improving the eHealth literacy of the older population. Objective The objective of this study was to examine the effects of a theory-driven eHealth literacy intervention for older adults. Methods The experimental design was a 2 × 2 mixed factorial design with learning method (collaborative; individualistic) as the between-participants variable and time of measurement (pre; post) as the within-participants variable. A total of 146 older adults aged 56–91 (mean 69.99, SD 8.12) participated in this study during February to May 2011. The intervention involved 2 weeks of learning about using the National Institutes of Health’s SeniorHealth.gov website to access reliable health information. The intervention took place at public libraries. Participants were randomly assigned to either experimental condition (collaborative: n = 72; individualistic: n = 74). Results Overall, participants’ knowledge, skills, and eHealth literacy efficacy all improved significantly from pre to post intervention (P < .001 in all cases; effect sizes were >0.8 with statistical power of 1.00 even at the .01 level in all cases). When controlling for baseline differences, no significant main effect of the learning method was found on computer/Web knowledge, skills, or eHealth literacy efficacy. Thus, collaborative learning did not differ from individualistic learning in affecting the learning outcomes. No significant interaction effect of learning method and time of measurement was found. Group composition based on gender, familiarity with peers, or prior computer experience had no significant main or interaction effect on the learning outcomes. Regardless of the specific learning method used, participants had overwhelmingly positive attitudes toward the intervention and reported positive changes in participation in their own health care as a result of the intervention. Conclusions The findings provide strong evidence that the eHealth literacy intervention tested in this study, regardless of the specific learning method used, significantly improved knowledge, skills, and eHealth literacy efficacy from pre to post intervention, was positively perceived by participants, and led to positive changes in their own health care. Collaborative learning did not differ from individualistic learning in affecting the learning outcomes, suggesting the previously widely reported advantages of collaborative over individualistic learning may not be easily applied to the older population in informal settings, though several confounding factors might have contributed to this finding (ie, the largely inexperienced computer user composition of the study sample, potential instructor effect, and ceiling effect). Further research is necessary before a more firm conclusion can be drawn. These findings contribute to the literatures on adult learning, social interdependence theory, and health literacy.
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Affiliation(s)
- Bo Xie
- University of Maryland, College of Information Studies, College Park, MD 20740, United States.
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