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Habiba U, Koli FS. The Mediating Role of Students' Health Information Literacy Skills: Exploring the Relationship Between Web Resource Utilization and Health Information Evaluation Proficiency. Health Expect 2024; 27:e14176. [PMID: 39148230 PMCID: PMC11327112 DOI: 10.1111/hex.14176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/18/2024] [Accepted: 07/30/2024] [Indexed: 08/17/2024] Open
Abstract
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.
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Affiliation(s)
- Umme Habiba
- Institute of Information Sciences, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Foujia Sultana Koli
- Institute of Information Sciences, Noakhali Science and Technology University, Noakhali, Bangladesh
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Wu Q, Ngien A, Jiang S. Descriptive Norms and eHealth Use Among Older Adults: A Cross-Country Comparative Study. HEALTH COMMUNICATION 2023:1-12. [PMID: 38148390 DOI: 10.1080/10410236.2023.2297120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
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.
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Affiliation(s)
- Qiaofei Wu
- Department of Communications and New Media, National University of Singapore
| | - Annabel Ngien
- Department of Communications and New Media, National University of Singapore
| | - Shaohai Jiang
- Department of Communications and New Media, National University of Singapore
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Rosenberg D, Mano R, Mesch GS. Health information seeking on social media: the diversification approach. EQUALITY, DIVERSITY AND INCLUSION: AN INTERNATIONAL JOURNAL 2023. [DOI: 10.1108/edi-12-2021-0309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
PurposeInternet 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/approachThe 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.FindingsArab 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 implicationsThe 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/valueThe study investigates triple social disadvantage in health-related social media use.
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Guo Y, Zu L, Chen D, Zhang H. Research on Influencing Factors of Satisfaction with the Use of Public Health Internet Platform: Evidence from Ding Xiang Doctor (DXY) Internet Medical Platform. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2276. [PMID: 36767643 PMCID: PMC9915869 DOI: 10.3390/ijerph20032276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Yanlong Guo
- Social Innovation Design Research Centre, Anhui University, Hefei 203106, China
| | - Lan Zu
- Social Innovation Design Research Centre, Anhui University, Hefei 203106, China
| | - Denghang Chen
- Department of Science and Technology Communication, University of Science and Technology of China, Hefei 203106, China
| | - Han Zhang
- College of Environmental Science and Engineering, Ocean University of China, Qingdao 266100, China
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Adolescents' disease- and fitness-related online health information seeking behaviors: The roles of perceived trust in online health information, eHealth literacy, and parental factors. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Malik A, Islam T, Ahmad M, Mahmood K. Health information seeking and sharing behavior of young adults on social media in Pakistan. JOURNAL OF LIBRARIANSHIP AND INFORMATION SCIENCE 2022. [DOI: 10.1177/09610006221090228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
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.
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Undergraduate Students' Online Health Information-Seeking Behavior during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413250. [PMID: 34948859 DOI: 10.3390/ijerph182413250] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
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.
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Aslan Kayıran M, Karadağ AS, Alyamaç G, Çevirgen Cemil B, Demirseren DD, Aksoy H, Oğuz Kılıç S, Taş Demircan Y, İnan Yüksel E, Kalkan G, Yaşar G, Şikar Aktürk A, Kutlu Ö, Altıntaş Kakşi S, Elibüyük Aksaç S, Kaya Erdoğan H, Kaya Özden H, Sarıkaya Solak S, Koska MC, Yazıcı S. Social media use in patients with acne vulgaris: What do patients expect from social media? J Cosmet Dermatol 2021; 20:2556-2564. [PMID: 34087036 DOI: 10.1111/jocd.14272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/01/2021] [Indexed: 01/03/2023]
Abstract
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.
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Affiliation(s)
- Melek Aslan Kayıran
- Department of Dermatological and Venereal Diseases, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - Ayşe Serap Karadağ
- Department of Dermatological and Venereal Diseases, Memorial Ataşehir Hospital, Istanbul, Turkey
| | - Gökçen Alyamaç
- Department of Dermatological and Venereal Diseases, Private Medicana Bursa Hospital, Bursa, Turkey
| | - Bengü Çevirgen Cemil
- Department of Dermatological and Venereal Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Health Sciences University
| | - Düriye Deniz Demirseren
- Department of Dermatological and Venereal Diseases, Ankara City Hospital, Health Sciences University, Ankara, Turkey
| | - Hasan Aksoy
- Department of Dermatological and Venereal Diseases, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - Sevilay Oğuz Kılıç
- Department of Dermatological and Venereal Diseases, Faculty of Medicine, 18 Mart University, Canakkale, Turkey
| | - Yuhanize Taş Demircan
- Department of Dermatological and Venereal Diseases, Adana Seyhan State Hospital, Adana, Turkey
| | - Esma İnan Yüksel
- Department of Dermatological and Venereal Diseases, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Göknur Kalkan
- Department of Dermatological and Venereal Diseases, Ankara City Hospital, Health Sciences University, Ankara, Turkey
| | - Gülbin Yaşar
- Department of Dermatological and Venereal Diseases, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Aysun Şikar Aktürk
- Department of Dermatological and Venereal Diseases, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ömer Kutlu
- Department of Dermatological and Venereal Diseases, Faculty of Medicine, Uşak University, Uşak, Turkey
| | - Sümeyye Altıntaş Kakşi
- Department of Dermatological and Venereal Diseases, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | | | - Hilal Kaya Erdoğan
- Department of Dermatological and Venereal Diseases, Faculty of Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Hatice Kaya Özden
- Department of Dermatological and Venereal Diseases, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Sezgi Sarıkaya Solak
- Department of Dermatological and Venereal Diseases, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Mahmut Can Koska
- Department of Dermatological and Venereal Diseases, Artvin State Hospital, Artvin, Turkey
| | - Serkan Yazıcı
- Department of Dermatological and Venereal Diseases, Faculty of Medicine, Uludağ University, Bursa, Turkey
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Rosenberg D. Ethnic Differences in Health Information Seeking Behavior: A Test and the Extension of the Social Diversification Hypothesis. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2021. [DOI: 10.1080/15398285.2021.1901052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Sun M, Jiang LC. Interpersonal influences on self-management in the eHealth era: Predicting the uses of eHealth tools for self-care in America. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:464-475. [PMID: 32716139 DOI: 10.1111/hsc.13107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/01/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- Mengru Sun
- College of Media and International Culture, Zhejiang University, Hangzhou, China
- Department of Media and Communication, City University of Hong Kong, Hong Kong SAR
| | - Li Crystal Jiang
- Department of Media and Communication, City University of Hong Kong, Hong Kong SAR
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The effects of information source and eHealth literacy on consumer health information credibility evaluation behavior. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2020.106629] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Sykes S, Wills J, Frings D, Church S, Wood K. Multidimensional eHealth Literacy for Infertility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E966. [PMID: 32033181 PMCID: PMC7037703 DOI: 10.3390/ijerph17030966] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 12/03/2022]
Abstract
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.
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Affiliation(s)
- Susie Sykes
- School of Health and Social Care, London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - Jane Wills
- School of Health and Social Care, London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - Daniel Frings
- School of Applied Science, London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - Sarah Church
- School of Health and Social Care, London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - Kerry Wood
- School of Applied Science, London South Bank University, 101 Borough Road, London SE1 0AA, UK
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Absolute monopoly, areas of control or democracy? Examining gender differences in health participation on social media. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2019.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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14
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Madrigal L, Escoffery C. Electronic Health Behaviors Among US Adults With Chronic Disease: Cross-Sectional Survey. J Med Internet Res 2019; 21:e11240. [PMID: 30835242 PMCID: PMC6423466 DOI: 10.2196/11240] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/14/2018] [Accepted: 12/10/2018] [Indexed: 01/07/2023] Open
Abstract
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.
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Affiliation(s)
- Lillian Madrigal
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Cam Escoffery
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Jin SW, Lee Y, Dia DA. Analyzing paths from online health information seeking to colorectal cancer screening using health literacy skills frame and cognitive mediation model. PATIENT EDUCATION AND COUNSELING 2019; 102:416-423. [PMID: 30448041 DOI: 10.1016/j.pec.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/19/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
| | - Yeonggeul Lee
- Department of Social Welfare, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, South Korea.
| | - David A Dia
- School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
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Huhta AM, Hirvonen N, Huotari ML. Health Literacy in Web-Based Health Information Environments: Systematic Review of Concepts, Definitions, and Operationalization for Measurement. J Med Internet Res 2018; 20:e10273. [PMID: 30567690 PMCID: PMC6315258 DOI: 10.2196/10273] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 09/07/2018] [Accepted: 09/25/2018] [Indexed: 12/20/2022] Open
Abstract
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.
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Affiliation(s)
- Anna-Maija Huhta
- Department of Information Studies, Faculty of Humanities, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Noora Hirvonen
- Department of Information Studies, Faculty of Humanities, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Information Studies, Faculty of Social Sciences, Business and Economics, Åbo Akademi University, Turku, Finland
| | - Maija-Leena Huotari
- Department of Information Studies, Faculty of Humanities, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Paige SR, Stellefson M, Krieger JL, Anderson-Lewis C, Cheong J, Stopka C. Proposing a Transactional Model of eHealth Literacy: Concept Analysis. J Med Internet Res 2018; 20:e10175. [PMID: 30279155 PMCID: PMC6231800 DOI: 10.2196/10175] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/18/2018] [Accepted: 06/28/2018] [Indexed: 11/24/2022] Open
Abstract
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).
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Affiliation(s)
- Samantha R Paige
- STEM Translational Communication Center, College of Journalism and Communications, University of Florida, Gainesville, FL, United States.,Department of Health Education & Behavior, University of Florida, Gainesville, FL, United States
| | - Michael Stellefson
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, United States
| | - Janice L Krieger
- STEM Translational Communication Center, College of Journalism and Communications, University of Florida, Gainesville, FL, United States
| | | | - JeeWon Cheong
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, United States
| | - Christine Stopka
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, United States
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Scheerder A, van Deursen A, van Dijk J. Determinants of Internet skills, uses and outcomes. A systematic review of the second- and third-level digital divide. TELEMATICS AND INFORMATICS 2017. [DOI: 10.1016/j.tele.2017.07.007] [Citation(s) in RCA: 386] [Impact Index Per Article: 55.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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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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Petrič G, Atanasova S, Kamin T. Ill Literates or Illiterates? Investigating the eHealth Literacy of Users of Online Health Communities. J Med Internet Res 2017; 19:e331. [PMID: 28978496 PMCID: PMC5647457 DOI: 10.2196/jmir.7372] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/24/2017] [Accepted: 07/31/2017] [Indexed: 12/19/2022] Open
Abstract
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.
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Affiliation(s)
- Gregor Petrič
- Centre for Methodology and Informatics, Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Sara Atanasova
- Centre for Methodology and Informatics, Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Tanja Kamin
- Centre for Social Psychology, Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
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Kim H, Xie B. Health literacy in the eHealth era: A systematic review of the literature. PATIENT EDUCATION AND COUNSELING 2017; 100:1073-1082. [PMID: 28174067 DOI: 10.1016/j.pec.2017.01.015] [Citation(s) in RCA: 182] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/29/2016] [Accepted: 01/24/2017] [Indexed: 06/06/2023]
Abstract
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.
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Affiliation(s)
- Henna Kim
- School of Information, The University of Texas at Austin, 1616 Guadalupe Suite #5.518, Austin, TX, 78701, USA.
| | - Bo Xie
- School of Nursing & School of Information, The University of Texas at Austin, Austin, USA.
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22
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23
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Investigating Relationships Between Health-Related Problems and Online Health Information Seeking. Comput Inform Nurs 2017; 35:29-35. [PMID: 26950091 DOI: 10.1097/cin.0000000000000234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
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.
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Quinn S, Bond R, Nugent C. Quantifying health literacy and eHealth literacy using existing instruments and browser-based software for tracking online health information seeking behavior. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2016.12.032] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Fonseca A, Gorayeb R, Canavarro MC. Women's use of online resources and acceptance of e-mental health tools during the perinatal period. Int J Med Inform 2016; 94:228-36. [PMID: 27573331 DOI: 10.1016/j.ijmedinf.2016.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 07/28/2016] [Accepted: 07/30/2016] [Indexed: 02/01/2023]
Abstract
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.
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Affiliation(s)
- Ana Fonseca
- Cognitive-Behavioral Center for Research and Intervention (CINEICC) of the Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3001-802 Coimbra, Portugal.
| | - Ricardo Gorayeb
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre - Campos Universitário, 14048-900 Ribeirão Preto, São Paulo, Brazil.
| | - Maria Cristina Canavarro
- Cognitive-Behavioral Center for Research and Intervention (CINEICC) of the Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3001-802 Coimbra, Portugal.
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Li X, Chen W, Popiel P. What happens on Facebook stays on Facebook? The implications of Facebook interaction for perceived, receiving, and giving social support. COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2015.04.066] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Abstract: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.
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Mano RS. Social media and online health services: A health empowerment perspective to online health information. COMPUTERS IN HUMAN BEHAVIOR 2014. [DOI: 10.1016/j.chb.2014.07.032] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Chen W, Lee KH, Straubhaar JD, Spence J. Getting a second opinion: Social capital, digital inequalities, and health information repertoires. J Assoc Inf Sci Technol 2014. [DOI: 10.1002/asi.23130] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Wenhong Chen
- Department of Radio-Television-Film; University of Texas at Austin; 2504 Whitis Avenue Stop A0800 Austin TX 78712-1067
| | - Kye-Hyoung Lee
- Department of Educational Administration; The University of Texas at Austin; 1912 Speedway D5400 Austin TX 78712-1604
| | - Joseph D. Straubhaar
- Department of Radio-Television-Film; University of Texas at Austin; 2504 Whitis Avenue Stop A0800 Austin TX 78712-1067
| | - Jeremiah Spence
- Department of Radio-Television-Film; University of Texas at Austin; 2504 Whitis Avenue Stop A0800 Austin TX 78712-1067
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