More than search? Informational and participatory eHealth behaviors

The Mediating Role of Students' Health Information Literacy Skills: Exploring the Relationship Between Web Resource Utilization and Health Information Evaluation Proficiency

BACKGROUND

In an increasingly digital age, students rely heavily on web resources to access health information. However, evaluating the reliability and relevance of such information is crucial for informed decision-making. This study examines the importance of students' health information literacy skills (HILS) as mediators, particularly their ability to utilize web resources and successfully evaluate health information.

OBJECTIVES

This research investigates the mediating role of students' HILS in the relationship between their utilization of web resources and their proficiency in evaluating health information.

METHOD

An online survey was distributed to current students at a public university in Bangladesh as part of the data collection process for this study. Using Google Forms, the authors created a structured questionnaire. The survey was distributed through Messenger groups, Facebook pages and email invitations to reach the target audience effectively. The researchers thoroughly analysed the gathered data using structural equation modelling (SEM) techniques and SmartPLS-4 software to look for correlations between the variables.

RESULT

The study revealed that among the 122 participants, a significant number (N = 47) accessed internet health information on an occasional basis, whereas 30 individuals reported using it infrequently. The data revealed that 58 individuals, accounting for 47.5% of the sample, possessed the necessary abilities to access and assess online health information. Additionally, 57 participants, representing 46.7% of the sample, demonstrated proficiency in conducting online health information searches. The measurement model demonstrated good convergent validity, as evidenced by composite reliability (CR) scores and Cronbach's ⍺ values over 0.700 and an average extracted variance (AVE) of 0.500. The structural model demonstrated R2 values exceeding 0.1, thus validating its dependable forecasting capability. Notable effects were seen, with f2 values of 0.335 and 0.317 for the challenges in accessing and evaluating health information (CAEHI) to health information evaluation (HIE) and CAEHI to HILS relationships, respectively. The mediation analysis found that HILS act as a mediator between types of web resources (TWRs) and HIE, with TWR having an indirect impact on HIE through HILS.

DISCUSSION

The result supports all hypotheses. Therefore, it is evident that students' HILS mediate the relationship between utilization of web resources and their proficiency in evaluating health information.

CONCLUSION

This study's findings could significantly impact instructional practices meant to raise students' health information literacy. This initiative seeks to enable students to make informed decisions about their health by providing them with the necessary tools to analyse and evaluate health-related information.

PATIENT OR PUBLIC CONTRIBUTION

Research on health information literacy can assist patients and the general public by instructing them on how to assess trustworthy online health resources. Students gave insightful feedback that assisted in shaping the study and guaranteeing its relevancy. If they better comprehend health information literacy, patients and the general public can use web-based resources and critically evaluate health information more accurately.

Descriptive Norms and eHealth Use Among Older Adults: A Cross-Country Comparative Study

eHealth use enables older adults to access and manage healthcare resources, and benefits their health; however, older adults' uptake of eHealth remains low across societies. Social influences such as descriptive norms may be of critical importance in promoting the elderly's usage of eHealth. Based on the Integrative Model of Behavioral Prediction, this study investigates how descriptive norms relate to eHealth use among the elderly in China and the United States. Analysis of the combined sample (N = 1,070) showed that descriptive norms were positively related to eHealth use. Also, descriptive norms were indirectly associated with eHealth use via injunctive norms, attitudes and self-efficacy. Moderated mediation analysis indicated that these direct and indirect relationships differed across the two countries. This study highlights the important role of descriptive norms in promoting older adults' eHealth use behavior and addresses potential country differences in how the elderly respond to descriptive norms. Several important theoretical and practical implications are also discussed.

Health information seeking on social media: the diversification approach

Purpose

Internet studies have rarely addressed gender and/or ethnic differences in health information seeking on social media. Moreover, the role of locality size in explanation of this phenomenon has been overlooked. This study proposed a diversification approach to address these issues. According to it, belonging to numerous disadvantaged groups increases the probability of health-related Internet/social media use.

Design/methodology/approach

The data were collected via telephone survey. The sample consisted of 798 Israeli Internet users who reported using social media for any purpose, gender, ethnic affiliation and locality of residence. The data were analysed using a logistic regression technique.

Findings

Arab female social media users, who resided in small localities, were more likely than the other studied social groups to seek both non-medical and medical information on social media. Furthermore, Arab female social media users were found having the highest likelihood among all studied social groups to seek information regarding physical activity and medications on social media.

Practical implications

The findings largely supported the diversification approach and signal a major need for a greater supply of public health information for members of minority groups, especially those residing in small localities.

Originality/value

The study investigates triple social disadvantage in health-related social media use.

Research on Influencing Factors of Satisfaction with the Use of Public Health Internet Platform: Evidence from Ding Xiang Doctor (DXY) Internet Medical Platform

With the rapid development of Internet information technology, Internet medical platforms are gradually entering daily life. Especially after the outbreak of the COVID-19 pandemic, it becomes very difficult for patients to go out for medical treatment, and the Internet medical platform plays an important role. The study of the use and influencing factors of Internet medical platforms has become a new topic. In this study, evidence from the Chinese Internet medical platform Ding Xiang Doctor(DXY) is combined with an integrated approach of hierarchical analysis and the entropy value method to construct evaluation indexes and questionnaires from four dimensions of perceived quality, perceived value, user trust, and user involvement to analyze the factors influencing users' satisfaction with Internet medical platforms. The questionnaires were distributed online, and 556 questionnaires were distributed from June to August 2022; 520 questionnaires were collected; the questionnaires' recovery rate was 93.53%; after excluding some invalid questionnaires, 424 questionnaires remained; the questionnaire efficiency was 81.54%; the Cronbach coefficient was 0.978; the KMO(Kaiser-Meyer-Olkin) value was 0.977; and the reliability performance was good. The study concluded that: (1) Users pay more attention to the content of perceived value, including the cost of time, economy, expense, and effort spent, and emphasize the degree of personal benefit. (2) Users are less satisfied with the information accessibility, design aesthetics, information timeliness, information comprehensiveness, and classification clarity of the DXY platform. (3) Users pay most attention to the protection of personal privacy by the platform side in the dimension of perceived value. (4) Users' trust in the platform is relatively high, their willingness to use the platform in the future is strong, and the dimensions of online interactive discussion, willingness to pay, and paid services are highly recognized.

Health information seeking and sharing behavior of young adults on social media in Pakistan

Social media such as Facebook, YouTube, WhatsApp, and Twitter have radically enhanced the public access to health information. Still, studies have unexplored the factors that contribute toward such behaviors especially in developing countries. Therefore, this study identifies the factors that contribute to the likelihood of young adults’ health information seeking and sharing on social media. Specifically, drawing upon health belief model (HBM), the study attempts to understand how health belief and e-Health literacy affects health information seeking and sharing on social media. The study collected data from 413 young adults through Google Forms on a random basis. The results generated applying structural equation modeling confirmed that HBM related factors such as perceived susceptibility, perceived severity and perceived benefits positively while perceived barriers negatively influence young adults’ health information seeking and sharing intentions on social media. Furthermore, e-Health literacy was positively associated with health information seeking and sharing intentions on social media. This study is amongst a first few studies in the context of developing world to investigate the young adults’ intentions of seeking and sharing health information on social media based on HBM.

Undergraduate Students' Online Health Information-Seeking Behavior during the COVID-19 Pandemic

As the COVID-19 pandemic has swept across the world, the amount of health-related information available has skyrocketed. Individuals can easily access health information through the internet, which may influence their thoughts or behavior, causing potential technological risks that may affect their lives. This study examined the online health information-seeking behavior of undergraduate students. Taking health issues as a guiding framework, content analysis was adopted to assess participants' online health information-seeking behavior using a computer screen recording software, and coding analysis was conducted. The study was conducted during the COVID-19 pandemic with a formal sample of 101 participants. In terms of online health information-seeking behavior, 59% of the study participants used nouns as keywords, only 27% used Boolean logic retrieval techniques, 81% paid attention to the date of the data, and 85% did not consider the author's professionalism. The results indicate that health information-seeking behavior and outcome judgments may be a missing piece of the puzzle in higher education. Consequently, the development of online health information-seeking skills through programs for undergraduate students is suggested to ensure that online readers have access to appropriate health information.

Social media use in patients with acne vulgaris: What do patients expect from social media?

BACKGROUND

Acne vulgaris (AV) may affect external appearance and significantly deteriorate the quality of life of patients. Therefore, patients make various inquiries about their disease and seek treatment options.

AIMS

To investigate the social media usage habits of patients with AV concerning their diseases, and their recommendations for dermatologists related to social media use.

METHODS

A total of 1609 patients with AV completed the survey prepared by the authors and the Cardiff Acne Disability Index questionnaire. The Food and Drug Administration severity scores and clinical information of the patients were noted by their physicians.

RESULTS

Of the 1,489 patients who stated that they used social media, 46.31% regularly and 28.77% sometimes referred to these sources to make inquiries about AV. Social media usage for AV was statistically significantly higher in women, participants with short term and severe disease, those with a moderate income level, and those using topical treatment and cosmetics. They mostly used Google (67%), Instagram (54%), and YouTube (49%). While 76% of the participants stated that they did not share what they saw on the Internet with their doctor. Of the respondents, 18.5% were trying to contact their dermatologists through the Internet, and 69.73% would prefer experts such as dermatologists to post-AV-related content.

CONCLUSIONS

Our study shows that patients frequently resort to social media to seek information about AV. In the changing digital world order, it is observed that there is a need for dermatologists to use social media more actively to share accurate information about AV.

Interpersonal influences on self-management in the eHealth era: Predicting the uses of eHealth tools for self-care in America

Drawing on the social cognitive theory and the comprehensive model of information seeking, this study proposes a theoretical framework that systematically examines the role of interpersonal factors in individuals' self-management in the eHealth context. The framework was tested with a sample of 965 eHealth users drawn from the National Cancer Institute's 2018 Health Information National Trends Survey. Structural equation modelling was performed to model the relationships among patient-centred communication, social support, self-efficacy, perceptions of eHealth tools and eHealth behaviours. The results established social support and patient-centred communication as two important sources of self-efficacy. Self-efficacy together with characteristics of eHealth tools were associated with higher utility of eHealth tools, which further predicted higher levels of eHealth behaviours. The results show that incorporating interpersonal factors in health interventions may enhance the targets' self-efficacy in self-management and indirectly motivates eHealth behaviours.

Multidimensional eHealth Literacy for Infertility

Infertility is a major public health issue and increasingly, the internet is used as a source of information and advice. The aim of this study is to understand the eHealth literacy of individuals and couples in relation to infertility. A non-probability sample of 27 participants was recruited from existing support groups, online advertising and snowballing representing the diverse population groups for whom involuntary childlessness is an issue. Information online was used both for decision making and developing interactive health literacy for health consultations. Participants may be both consumers and purveyors of information to others in distributed health literacy. Cognitive skills are required to appraise an inconsistent evidence base and potentially biased information from private providers of treatments. Accounts of geographical variations in treatment options, the cost of private treatment and for some, a sense that information and services were directed towards female and heterosexual couples, led some participants to political action online creating an important sense of empowerment. The study offers a new conceptual framework for eHealth literacy in the context of infertility, that combines use of the web and virtual communities in which functional, interactive, critical and distributed health literacy play a part in an online environment.

Electronic Health Behaviors Among US Adults With Chronic Disease: Cross-Sectional Survey

BACKGROUND

With increased access to technology and the internet, there are many opportunities for utilizing electronic health (eHealth), internet, or technology-delivered health services and information for the prevention and management of chronic diseases.

OBJECTIVE

The aim of this paper was to explore (1) the differences in technology use, (2) Web-based health information seeking and use behaviors, (3) attitudes toward seeking health information on the Web, and (4) the level of eHealth literacy between adults aged 18 and 64 years with and without chronic disease.

METHODS

A cross-sectional internet survey was conducted in March 2017 with 401 US adults. Participant responses were examined to understand associations between chronic disease status and eHealth behaviors such as internet health-seeking behaviors and Web-based behaviors related to health, tracking health indicators with a mobile app, patient portal use, and preferences for health information.

RESULTS

About 1 in 3 (252/401, 37.2%) participants reported at least 1 chronic disease diagnosis. Seventy-five percent (301/401) of all participants reported having ever searched for health information on the Web. Participants with a chronic disease reported significantly higher instances of visiting and talking to a health care provider based on health information found on the Web (40.0% [48/120] vs 25.8% [46/178], χ²₂=6.7; P=.01; 43.3% [52/120] vs 27.9% [50/179]; χ²₂=7.6; P=.006). The uses of health information found on the Web also significantly differed between participants with and without chronic diseases in affecting a decision about how to treat an illness or condition (49.2% [59/120] vs 35.0% [63/180], χ²₃=6.7; P=.04), changing the way they cope with a chronic condition or manage pain (40.8% [49/120] vs 19.4% [35/180], χ²₂=16.3; P<.001), and leading them to ask a doctor new questions or get a second opinion (37.5% [45/120] vs 19.6% [35/179], χ²₂=11.8; P<.001). Chronic disease participants were significantly more likely to be tracking health indicators (43.9% [65/148] vs 28.3%, [71/251] χ²₂=10.4; P=.006). In addition, participants with chronic disease diagnosis reported significantly higher rates of patient portal access (55.0% [82/149] vs 42.1% [106/252], χ²₂=6.3; P=.01) and use (40.9% [61/149] vs 21.0% [53/252], χ²₂=18.2; P<.001). Finally, both groups reported similar perceived skills in using the internet for health information on the eHealth Literacy Scale (eHEALS). The majority of participants responded positively when asked about the usefulness of health information and importance of accessing health resources on the Web.

CONCLUSIONS

The high rates of reported information seeking and use of internet-based health technology among participants with chronic disease may reflect the uptake in eHealth to help manage chronic disease conditions. Health care providers and educators should continue to seek ways to interact and support patients in their management of chronic disease through eHealth platforms, including capitalizing on Web-based resources, patient portals, and mobile phone apps for disease education and monitoring.

Analyzing paths from online health information seeking to colorectal cancer screening using health literacy skills frame and cognitive mediation model

OBJECTIVE

To test the hypothesized paths for Online Health Information Seeking (OHIS) behaviors in developing health literacy, leading to colorectal cancer (CRC) screening among Korean Americans (KAs) using Health Literacy Skills Frameworks (HLSF) and Cognitive Mediation Model (CMM).

METHODS

A total of 433 KAs aged 50 through 75 in a metropolitan area in the Southeastern U.S. completed a cross-sectional survey regarding sociodemographics, OHIS behaviors, information overload, health literacy, decisional balance, and CRC screening history. Path analyses were implemented to assess the hypothesized causal models by examining the relationships among these variables.

RESULTS

OHIS was positively associated with information overload and health literacy; information overload was negatively associated with health literacy. Health literacy was positively associated with decisional balance; decisional balance was positively associated with uptake of sigmoidoscopy and colonoscopy.

CONCLUSION

The findings supported both theoretical frameworks, HLSF and CMM, for OHIS to develop health literacy, leading to CRC screening. These findings highlight the significant roles of information overload and attitudes and beliefs about screening in enhancing health literacy and CRC screening among KAs.

PRACTICE IMPLICATIONS

Practice efforts for facilitating CRC screening among medically underserved older KAs should target improving access to and use of OHIS and culturally-tailored health information delivery.

Health Literacy in Web-Based Health Information Environments: Systematic Review of Concepts, Definitions, and Operationalization for Measurement

Background

Health literacy research seems to lack a consensus on what aspects to include into literacy in the context of health and on how to operationalize these concepts for measurement purposes. In addition to health literacy, several other concepts, such as electronic health (eHealth) literacy and mental health literacy, have been developed across disciplines. This study examines how these different concepts are used when studying health-related competencies in Web contexts.

Objective

This study systematically reviews health literacy concepts and definitions and their operationalization in studies focused on Web-based health information environments.

Methods

A systematic literature search was conducted in April 2016 in 6 electronic databases with a limitation to articles in English published between January 2011 and April 2016. Altogether, 1289 unique records were identified and screened according to the predefined inclusion criteria: (1) original, peer-reviewed research articles written in English; (2) the topic of the article concerned literacy in the context of health; (3) informants of the study were lay people, not health professionals or students of the field; and (4) the focus of the study was placed on an Web-based information environment. In total, 180 full texts were screened, of which 68 were included in the review. The studies were analyzed with an emphasis on the used health literacy concepts and measures.

Results

On the basis of the included studies, several concepts are in use when studying health-related literacy in Web environments, eHealth literacy and health literacy being the most common ones. The reviewed studies represent a variety of disciplines, but mostly medical sciences. Typically, quantitative research methods are used. On the basis of the definitions for health literacy, 3 thematic categories were identified: general and skill-based, multidimensional, and domain-specific health literacy. Most studies adopted a domain-specific concept, followed by the ones that used a general and skill-based concept. Multidimensional concepts occurred least frequently. The general health literacy concepts were usually operationalized with reading comprehension measures, the domain-specific concepts with self-efficacy measures, and multidimensional concepts with several types of measures. However, inconsistencies in operationalization were identified.

Conclusions

The results show that in studies conducted in Web-based information environments, several different health literacy concepts are in use, and there is no clear consensus on the definitions for these concepts. Future studies should place emphasis on the conceptual development of health literacy in Web contexts to gain better results on operationalization for measurement. Researchers are encouraged to provide clear operational definitions for the concepts they use to ensure transparency in reporting.

Proposing a Transactional Model of eHealth Literacy: Concept Analysis

Background

Electronic health (eHealth) literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information. Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth. This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts.

Objective

The objective of our study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC.

Methods

Walker and Avant’s concept analysis method was used to guide the systematic review of eHealth literacy definitions (n=10), rating scales (n=6), models (n=4), and peer-reviewed model applications (n=16). Subsequent cluster analyses showed salient themes across definitions. Dimensions, antecedents, and consequences reflected in models and measures were extracted and deductively analyzed based on codes consistent with the TMC.

Results

Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal. Despite the transactional capabilities of eHealth, the role of “communication” in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions.

Conclusions

The Transactional Model of eHealth Literacy and a corresponding definition are proposed. In this novel model, eHealth literacy comprises a hierarchical intrapersonal skillset that mediates the reciprocal effect of contextual factors (ie, user oriented and task oriented) on patient engagement in health care. More specifically, the intrapersonal skillset counteracts the negative effect of “noise” (or impediments) produced by social and relational contexts. Cutting across health and technology literacies, the intrapersonal skillset of eHealth literacy is operationalized through four literacies that correspond with discrete operative skills: (1) functional (ie, locate and understand); (2) communicative (ie, exchange); (3) critical (ie, evaluate); and (4) translational (ie, apply).

eHealth literacy research-Quo vadis?

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.

Ill Literates or Illiterates? Investigating the eHealth Literacy of Users of Online Health Communities

Background

Electronic health (eHealth) literacy is an important skill that allows patients to navigate intelligibly through the vast, often misleading Web-based world. Although eHealth literacy has been investigated in general and specific demographic populations, it has not yet been analyzed on users of online health communities (OHCs). Evidence shows that OHCs are important Web 2.0 applications for patients for managing their health, but at the same time, warnings have been expressed regarding the quality and relevance of shared information. No studies exist that investigate levels of eHealth literacy among users of OHCs and differences in eHealth literacy between different types of users.

Objective

The study aimed to investigate eHealth literacy across different types of users of OHCs based on a revised and extended eHealth literacy scale (eHEALS).

Methods

The study was based on a cross-sectional Web survey on a simple random sample of 15,000 registered users of the most popular general OHC in Slovenia. The final sample comprised 644 users of the studied OHC. An extended eHEALS (eHEALS-E) was tested with factor analytical procedures, whereas user types were identified with a hierarchical clustering algorithm. The research question was analyzed with analysis of variance (ANOVA) procedure and pairwise comparison tests.

Results

Factor analysis of the revised and extended eHEALS revealed six dimensions: awareness of sources, recognizing quality and meaning, understanding information, perceived efficiency, validating information, and being smart on the Net. The factor solution demonstrates a good fit to the data (root mean square error of approximation [RMSEA]=.059). The most developed dimension of eHEALS-E is awareness of different Internet sources (mean=3.98, standard deviation [SD]=0.61), whereas the least developed is understanding information (mean=3.11, SD=0.75). Clustering resulted in four user types: active help-seekers (48.3%, 311/644), lurkers (31.8%, 205/644), core relational users (16.9%, 109/644), and low-engaged users (3%, 19/644). Analysis of the research question showed statistically significant differences among user types across all six dimensions of eHEALS-E. Most notably, core relational users performed worse than lurkers on the validating information dimension (P=.01) and worse than active help-seekers on the being smart on the Net dimension (P=.05). Active help-seekers have the highest scores in all dimensions of the eHEALS-E, whereas low-engaged users have statistically significantly lower scores on all dimensions of the eHEALS-E in comparison with the other groups.

Conclusions

Those who are looking for advice and support in OHCs by making queries are well equipped with eHealth literacy skills to filter potential misinformation and detect bad advice. However, core relational users (who produce the most content in OHCs) have less-developed skills for cross-validating the information obtained and navigating successfully through the perils of the online world. Site managers should monitor their activity to avoid the spread of misinformation that might lead to unhealthy practices.

Health literacy in the eHealth era: A systematic review of the literature

OBJECTIVES

This study aimed to identify studies on online health service use by people with limited health literacy, as the findings could provide insights into how health literacy has been, and should be, addressed in the eHealth era.

METHODS

To identify the relevant literature published since 2010, we performed four rounds of selection-database selection, keyword search, screening of the titles and abstracts, and screening of full texts. This process produced a final of 74 publications.

RESULTS

The themes addressed in the 74 publications fell into five categories: evaluation of health-related content, development and evaluation of eHealth services, development and evaluation of health literacy measurement tools, interventions to improve health literacy, and online health information seeking behavior.

CONCLUSION

Barriers to access to and use of online health information can result from the readability of content and poor usability of eHealth services. We need new health literacy screening tools to identify skills for adequate use of eHealth services. Mobile apps hold great potential for eHealth and mHealth services tailored to people with low health literacy.

PRACTICE IMPLICATIONS

Efforts should be made to make eHealth services easily accessible to low-literacy individuals and to enhance individual health literacy through educational programs.

Investigating Relationships Between Health-Related Problems and Online Health Information Seeking

Online health information seeking (OHIS) functions as a coping strategy to relieve health-related stress and problems. When people rate their health as poor or felt concern about their health, they frequently visit the Internet to seek health-related information in order to understand their symptoms and treatments. Regarding this role of OHIS, it is important to understand the relationships between health-related problems and OHIS. This study applies the Common-Sense Model as a theoretical lens to examine the relationship between health-related problems (ie, diagnosis of cancer, poor self-rated health, and psychological distress) and OHIS of adults in the US. Using the Health Information National Trends Survey 4 Cycle 1 (2012), a total of 2351 adult Internet users was included in this research. Hierarchical logistic regression analyses were conducted to examine the research model, and the model adding psychological distress resulted in a statistically significant improvement in model fit. In this study, lower levels of self-rated health and higher levels of psychological distress were significantly associated with higher odds of OHIS. Study findings support the idea that individuals' low levels of self-rated health and high levels of perceived psychological distress make people search for health-related information via the Internet in order to cope with health-related concern and distress.

Women's use of online resources and acceptance of e-mental health tools during the perinatal period

OBJECTIVES

The women's professional help-seeking rate for perinatal depression is low, despite the prevalent and disabling nature of this condition. Therefore, new approaches should be implemented to increase women's access and utilization of treatment resources, namely e-mental health tools. This study aimed to characterize women's current pattern of use of online resources for mental heal issues and women's acceptance of e-mental health tools during the perinatal period, and to investigate its main determinants.

METHODS

This study used an online cross-sectional survey that was completed by 546 women during the perinatal period.

RESULTS

31.3% had prior knowledge of websites targeting mental health illness. Women presenting an actual need for help (i.e., a positive screen for depression) reported greater use of online resources and greater engagement in e-health behaviors related to mental health (d=0.46-0.61), and being more accepting of e-mental health tools, particularly of informative websites. Women's perceptions concerning the e-mental tools were found to predict their intentions to use them.

CONCLUSIONS

The results seem to globally support Portuguese women's acceptance of e-mental health tools. To improve the level of acceptance, women should be involved as stakeholders in the development of new e-mental health tools and provided with specific information before their utilization.

Emerging Ethical Issues in Digital Health Information

The problems of poor or biased information and of misleading health and well-being advice on the Internet have been extensively documented. The recent decision by the Internet Corporation for Assigned Names and Numbers to authorize a large number of new generic, top-level domains, including some with a clear connection to health or healthcare, presents an opportunity to bring some order to this chaotic situation. In the case of the most general of these domains, “.health,” experts advance a compelling argument in favor of some degree of content oversight and control. On the opposing side, advocates for an unrestricted and open Internet counter that this taken-for-granted principle is too valuable to be compromised, and that, once lost, it may never be recovered. We advance and provide evidence for a proposal to bridge the credibility gap in online health information by providing provenance information for websites in the .health domain.