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de Oliveira Collet G, de Morais Ferreira F, Ceron DF, de Lourdes Calvo Fracasso M, Santin GC. Influence of digital health literacy on online health-related behaviors influenced by internet advertising. BMC Public Health 2024; 24:1949. [PMID: 39033160 PMCID: PMC11265096 DOI: 10.1186/s12889-024-19506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/16/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND The frequency of health-related information seeking on the internet and social media platforms has increased remarkably. Thus, the ability to understand and select accurate health-related information online, known as EHealth literacy, is crucial for the population. Therefore, this study aimed to evaluate how eHealth literacy influences the critical analysis of oral health-related information obtained from the Internet and its influence on oral health-related behaviors. METHODS: A cross-sectional online study was conducted with 418 Brazilian adults who responded to the eHEALS questionnaire, with questions regarding the influence of online information on oral health decisions. Socioeconomic and demographic characteristics were also collected. RESULTS The mean eHEALS score was 27.85 (± 8.13), with a range spanning from 8 to 40 points. Participants with higher eHEALS scores reported using social media platforms to seek for dentists and to acque information about symptoms, diagnoses, and treatments. Furthermore, this group tended not to disregard professional health recommendations based on Internet information and abstained from utilizing products promoted by digital influencers. In multivariate models, increased eHEALS scores were associated with reduced consumption of products endorsed by digital influencers. CONCLUSIONS The findings from this study suggest that individuals with higher scores on the eHealth literacy questionnaire often conduct research on their health status and seek for health care providers on the Internet. Moreover, these individuals were less likely to be influenced by digital influencers.
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Affiliation(s)
- Giulia de Oliveira Collet
- Department of Dentistry, State University of Maringá, Avenida Mandacarú, 1550, Maringá, PR, 87080-000, Brazil
| | - Fernanda de Morais Ferreira
- Department of Child and Adolescent Oral Health, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Daniela Fernandes Ceron
- Department of Dentistry, State University of Maringá, Avenida Mandacarú, 1550, Maringá, PR, 87080-000, Brazil
| | | | - Gabriela Cristina Santin
- Department of Dentistry, State University of Maringá, Avenida Mandacarú, 1550, Maringá, PR, 87080-000, Brazil.
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Long C, Zheng L, Liu R, Duan Z. Structural Validation and Measurement Invariance Testing of the Chinese Version of the eHealth Literacy Scale Among Undergraduates: Cross-Sectional Study. J Med Internet Res 2023; 25:e48838. [PMID: 37990370 PMCID: PMC10753429 DOI: 10.2196/48838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/15/2023] [Accepted: 11/20/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The eHealth Literacy Scale (eHEALS) was introduced in China in 2013 as one of the most important electronic health literacy measurement instruments. After a decade of development in China, it has received widespread attention, although its theoretical underpinnings have been challenged, thus demanding more robust research evidence of factorial validity and multigroup measurement properties. OBJECTIVE This study aimed to evaluate the Chinese version of the eHEALS in terms of its measurement properties. METHODS A cross-sectional survey was conducted in a university setting in China. Item statistics were checked for response distributions and floor and ceiling effects. Internal consistency reliability was confirmed with Cronbach α, split-half reliability, Cronbach α if an item was deleted, and item-total correlation. A total of 5 representative eHEALS factor structures were examined and contrasted using confirmatory factor analysis. The study used the item-level content validity index (I-CVI) and the average of the I-CVI scores of all items on the scale to assess the content validity of the dominance model. Furthermore, the validated dominance model was subsequently used to evaluate the relevance and representation of elements in the instrument and to assess measurement invariance across genders. RESULTS A total of 972 respondents were identified, with a Cronbach α of .92, split-half reliability of 0.88, and item-total score correlation coefficients ranging from 0.715 to 0.781. Cronbach α if an item was deleted showed that all items should be retained. Acceptable content validity was supported by I-CVIs ≥0.80. The confirmatory factor analysis confirmed that the 3-factor model was acceptable. The measurement model met all relevant fit indices: average variance extracted from 0.663 to 0.680, composite reliability from 0.810 to 0.857, chi-square divided by the df of 4.768, root mean square error of approximation of 0.062, standardized root mean squared residual of 0.020, comparative fit index (CFI) of 0.987, and Tucker-Lewis index of 0.979. In addition, the scale demonstrated error variance invariance (Δnormed fit index=-0.016, Δincremental fit index=-0.012, ΔTucker-Lewis index=0.005, Δcomparative fit index=-0.012, Δrelative fit index=0.005, and Δroot mean square error of approximation=0.005). CONCLUSIONS A 3-factor model of the Chinese version of the eHEALS fits best, and our findings provide evidence for the strict measurement invariance of the instrument regarding gender.
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Affiliation(s)
- Chen Long
- Health Services Management Department, Guizhou Medical University, Guiyang, China
| | - Lin Zheng
- Department of Social Welfare, Jeonbuk National University, Jeonju, Republic of Korea
| | - Runhua Liu
- Health Services Management Department, Guizhou Medical University, Guiyang, China
- Center of Medicine Economics and Management Research, Guizhou Medical University, Guiyang, China
| | - Zhongxian Duan
- School of Public Management, Guizhou University, Guiyang, China
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Heaton-Shrestha C, Hanson K, Quirke-McFarlane S, Delaney N, Vandrevala T, Bearne L. Exploring how members of the public access and use health research and information: a scoping review. BMC Public Health 2023; 23:2179. [PMID: 37936117 PMCID: PMC10629152 DOI: 10.1186/s12889-023-16918-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Making high-quality health and care information available to members of the general public is crucial to support populations with self-care and improve health outcomes. While attention has been paid to how the public accesses and uses health information generally (including personal records, commercial product information or reviews on healthcare practitioners and organisations) and how practitioners and policy-makers access health research evidence, no overview exists of the way that the public accesses and uses high quality health and care information. PURPOSE This scoping review aimed to map research evidence on how the public accesses and uses a specific type of health information, namely health research and information that does not include personal, product and organisational information. METHODS Electronic database searches [CINAHL Plus, MEDLINE, PsycInfo, Social Sciences Full Text, Web of Science and SCOPUS] for English language studies of any research design published between 2010-2022 on the public's access and use of health research or information (as defined above). Data extraction and analysis was informed by the Joanna Briggs Institute protocol for scoping reviews, and reported in accordance with the PRISMA extension for scoping reviews. RESULTS The search identified 4410 records. Following screening of 234 full text studies, 130 studies were included. One-hundred-and-twenty-nine studies reported on the public's sources of health-research or information; 56 reported the reasons for accessing health research or information and 14 reported on the use of this research and information. The scoping exercise identified a substantial literature on the broader concept of 'health information' but a lack of reporting of the general public's access to and use of health research. It found that 'traditional' sources of information are still relevant alongside newer sources; knowledge of barriers to accessing information focused on personal barriers and on independent searching, while less attention had been paid to barriers to access through other people and settings, people's lived experiences, and the cultural knowledge required. CONCLUSIONS The review identified areas where future primary and secondary research would enhance current understanding of how the public accesses and utilises health research or information, and contribute to emerging areas of research.
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Affiliation(s)
- Celayne Heaton-Shrestha
- Kingston University, Faculty of Health, Science, Social Care and Education, Kingston-upon-Thames, KT27LB, UK
| | - Kristin Hanson
- Kingston University, Faculty of Health, Science, Social Care and Education, Kingston-upon-Thames, KT27LB, UK
| | | | - Nancy Delaney
- Guy's and St Thomas' NHS Foundation Trust, Department of Physiotherapy, London, SE1 7EH, UK
| | - Tushna Vandrevala
- Kingston University, Faculty of Health, Science, Social Care and Education, Kingston-upon-Thames, KT27LB, UK
| | - Lindsay Bearne
- Kingston University, Faculty of Health, Science, Social Care and Education, Kingston-upon-Thames, KT27LB, UK.
- St George's, University of London, Population Health Research Institute, 1st Floor Jenner Wing, Cranmer Terrace, London, SW17 0RE, UK.
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Milanti A, Chan DNS, Parut AA, So WKW. Determinants and outcomes of eHealth literacy in healthy adults: A systematic review. PLoS One 2023; 18:e0291229. [PMID: 37792773 PMCID: PMC10550189 DOI: 10.1371/journal.pone.0291229] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/24/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND eHealth has shown many benefits in health promotion and disease prevention. For engaging in and taking advantage of eHealth, eHealth literacy is essential. This systematic review aims to summarise and examine the existing evidence on determinants and outcomes of eHealth literacy in healthy adults. METHODS We searched the relevant peer-reviewed articles published in English in six databases: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library and ProQuest. The inclusion criteria of the review were: 1) studies examining 'eHealth literacy', which refers to the ability to search, select, judge and apply online health information to address or solve health problems and to improve wellbeing; 2) the type of study included observational and experimental studies, mixed method studies or qualitative studies; 3) the participants were healthy adults; 4) the main outcomes were the determinants (i.e. influencing or associated factors) and outcomes (i.e. benefits and disadvantages) of eHealth literacy. Articles were assessed by two reviewers using the Joanna Briggs Institute critical appraisal tool. A conceptual model to map the determinants and outcomes of eHealth literacy in healthy adults into the non-modifiable, individual, social and community networks and structural layers was developed to classify the identified determinants and outcomes. RESULTS Forty-four studies were included in this review, of which 43 studies were cross-sectional and one was qualitative. eHealth literacy determinants included age, sex, literacy factors, socioeconomic factors and language. eHealth literacy outcomes included better general health promotion behavior, COVID-19 preventive behaviors, psychological wellbeing, social support, self-rated health and health service utilisation. CONCLUSIONS Our results showed that eHealth literacy has multi-layered determinants and positive outcomes. Different strategies at different policy levels are needed to improve the eHealth literacy levels of healthy adults.
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Affiliation(s)
- Ariesta Milanti
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
| | - Dorothy Ngo Sheung Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
| | | | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
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Lotto M, Maschio KF, Silva KK, Ayala Aguirre PE, Cruvinel A, Cruvinel T. eHEALS as a predictive factor of digital health information seeking behavior among Brazilian undergraduate students. Health Promot Int 2023; 38:daab182. [PMID: 34718563 DOI: 10.1093/heapro/daab182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aimed to perform the cross-cultural adaptation and validation of the eHealth Literacy Scale (eHEALS) for Brazilian Portuguese. The cross-cultural adaptation was conducted through conceptual equivalence, verbatim translation, semantic, item and operational equivalence, and back-translation. Subsequently, 521 undergraduate students answered the adapted version of the eHEALS, the General Perceived Self-Efficacy Scale (GSES), the Oral Health Impact Profile-14 (OHIP-14) and sociodemographic and health-related questions. Statistical analysis was performed to determine the dimensionality, internal consistency, stability and concurrent/convergent/discriminant/predictive validities of the eHEALS (p < 0.05). The adequacy of sample size was confirmed by a non-identity correlation matrix (Bartlett's test of sphericity, p < 0.001), without influence of multicollinearity (determinant = 0.026). The confirmatory factor analysis identified four factors in agreement to the constructs namely as online searching self-efficacy, awareness of available sources, information usage ability, and critical analysis of useful information. The eHEALS displayed an excellent internal consistency (Cronbach's alpha = 0.88), a good stability (ICC = 0.71, 95% CI: 0.49-0.84), and it was significantly correlated with GSES (concurrent validity). Higher eHEALS scores were identified among (i) white and (ii) younger students, (iii) from health sciences courses, (iv) with more years of graduation, (v) who their fathers were working in specialized functions (discriminant validity), and (vi) among those who were frequently interested in digital health information (convergent validity). The students with higher eHealth literacy levels were more likely to seek health information in the last 24 h (predictive validity). In conclusion, the eHEALS demonstrated adequate psychometric properties to be applied for the Brazilian population.
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Affiliation(s)
- Matheus Lotto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Al. Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, 17012-901Bauru, São Paulo, Brazil
| | - Kaiane Fátima Maschio
- Discipline of Public Health, School of Medicine, Federal University of Fronteira Sul, Rodovia SC 484 Km 02, Bairro Fronteira Sul, 89815-899, Chapecó, Santa Catarina, Brazil
| | - Kimberly Kamila Silva
- Discipline of Public Health, School of Medicine, Federal University of Fronteira Sul, Rodovia SC 484 Km 02, Bairro Fronteira Sul, 89815-899, Chapecó, Santa Catarina, Brazil
| | - Patricia Estefania Ayala Aguirre
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Al. Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, 17012-901Bauru, São Paulo, Brazil
| | - Agnes Cruvinel
- Discipline of Public Health, School of Medicine, Federal University of Fronteira Sul, Rodovia SC 484 Km 02, Bairro Fronteira Sul, 89815-899, Chapecó, Santa Catarina, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Al. Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, 17012-901Bauru, São Paulo, Brazil
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Lu X. The Effects of Patient Health Information Seeking in Online Health Communities on Patient Compliance in China: Social Perspective. J Med Internet Res 2023; 25:e38848. [PMID: 36622741 PMCID: PMC9871880 DOI: 10.2196/38848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/13/2022] [Accepted: 11/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Online health communities (OHCs) can alleviate the uneven distribution and use of medical resources and severe hospital congestion. Patients may seek health information through OHCs before or after visiting physicians, which may affect their cognition, health literacy, decision-making preferences, and health-related behaviors such as compliance. Social factors (social support, social presence, and responsiveness) are closely related to patients' health information-seeking behavior and are significantly considered in OHCs. OBJECTIVE This study aimed to explore the effects of patients' health information-seeking behavior (way and effectiveness) on compliance with physicians from the perspectives of patients' perceived social support, social presence, and responsiveness. METHODS This study established a research model from the perspective of social information processing by using the social exchange theory. An anonymous questionnaire survey was conducted with several Chinese OHCs to collect data. Partial least squares and structural equation modeling were adopted to test the hypotheses and develop the model. RESULTS This study received 403 responses, of which 332 were valid, giving a validity rate of 82.4% (332/403). Among the sample, 78.6% (261/332) of the individuals were aged between 20 and 40 years, 59.3% (197/332) were woman, 69.9% (232/332) lived in urban areas, and 50% (166/332) had at least a bachelor's degree. The reliability, convergent validity, and discriminant validity were acceptable. Both the way and effectiveness of patients seeking health information through OHCs have a positive impact on their compliance through the mediation of their perceived social support, social presence, and responsiveness from OHCs and other users, and patient compliance can be improved by guiding patient health information-seeking behavior in OHCs from a social perspective. CONCLUSIONS This study proposes a research model to corroborate that patient health information-seeking behavior (way and effectiveness) in OHCs exerts positive effects on patient compliance with the treatment and physician's advice and provides suggestions for patients, physicians, and OHC service providers in China to help guide patients' health-related behaviors through OHCs to improve patient compliance, patient satisfaction, treatment efficiency, and health outcomes.
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Affiliation(s)
- Xinyi Lu
- School of Management and E-business, Zhejiang Gongshang University, Hangzhou, China
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Sundell E, Wångdahl J, Grauman Å. Health literacy and digital health information-seeking behavior - a cross-sectional study among highly educated Swedes. BMC Public Health 2022; 22:2278. [PMID: 36471284 PMCID: PMC9724302 DOI: 10.1186/s12889-022-14751-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The benefits of digital development in health care may be obscured by unequal opportunities to make use of digital resources. The aim of this study was to investigate the association of health literacy with I) accessing health check test results in the Patient Electronic Health Record (PAEHR), II) searching for information to better understand individual test results, and III) using the national health information online portal provided by the Swedish national health care system. METHODS This cross-sectional study included data from 434 individuals, 50-64 years old, randomly selected from the Swedish population during the year 2017 to a cohort study including health examination and a web-based survey. Health literacy was assessed at baseline using the Swedish Communicative and Critical Health Literacy scale. Digital information outcomes were assessed after three months. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) for the separate outcomes were computed using logistic regression. Covariates included sex, age, education, country of birth, cardiovascular risk factors at baseline, general health, risk perception, referral, and new cardiovascular risk factors detected at health examination. RESULTS About a third of the participants (35%) had limited health literacy, while 65% had sufficient health literacy. Sufficient health literacy was associated with accessing the PAEHR (adjusted OR 1.81 95% CI 1.07-3.06) and use of the online national health information portal provided by the Swedish national health care system (adjusted OR 2.91 95% CI 1.13-7.52) but not with searching information to better understand individual test results (adjusted OR 1.29 0.75-2.20). CONCLUSIONS Individuals with limited health literacy do not access their personal health information nor search for health information on the online national health information portal provided by the Swedish national health care system to the same extent as individuals with sufficient health literacy. More research is needed about how the level of health literacy relates to differences in online health information-seeking behavior and how digital health information sources and e-health services can be designed to ensure that the entire population has equal access to trustworthy and quality-ensured health information.
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Affiliation(s)
- Erica Sundell
- grid.8993.b0000 0004 1936 9457Centre for Research Ethics & Bioethics, Uppsala University, Box 564, 751 22 Uppsala, Sweden
| | - Josefin Wångdahl
- grid.10548.380000 0004 1936 9377Aging Research Center, Karolinska Institute and Stockholm University, Solna, Sweden ,grid.8993.b0000 0004 1936 9457Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Åsa Grauman
- grid.8993.b0000 0004 1936 9457Centre for Research Ethics & Bioethics, Uppsala University, Box 564, 751 22 Uppsala, Sweden
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Mut H, Gok Balci U, Mergen H. An Evaluation of the Health Literacy of Patients Visiting Family Medicine Clinics and The Related Factors. EURASIAN JOURNAL OF FAMILY MEDICINE 2022. [DOI: 10.33880/ejfm.2022110106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: This study aimed to determine the level of health literacy among individuals visiting the Family Medicine Clinic in Tepecik Hospital and to reveal the relationship between health literacy and independent variables.
Methods: This study has a cross-sectional analytical design. A sample size of 141 was found to produce a two-sided 95% confidence interval and an estimated standard deviation of 6141 people who met the inclusion criteria participated in the study. The dependent variable in the study was the health literacy level determined by using the Turkish Health Literacy Scale. Student’s t-test, ANOVA, Pearson correlation analysis, and linear regression analysis were used to analyze the relationship between the dependent and independent variables.
Results: The mean Turkish Health Literacy Scale score was 28.95±5.86; 60.28% of the participants had problematic-limited health literacy, while 20.57% had insufficient, 17.02% had sufficient, and 2.13% had excellent health literacy. The health literacy score of females was 3.204 points lower than that of males. For each unit increase in household disposable income, the Turkish Health Literacy Scale score increased by 0.001 points. The Turkish Health Literacy Scale score was 1.771 points higher for those who have not been hospitalized in the last ten years. The Turkish Health Literacy Scale score increased by 1.306 points for a percent increase in the frequency of obtaining health-related information from the Internet, while it increased by 1.686 points for a percent increase in the frequency of obtaining health-related information from brochures, posters, or books.
Conclusion: This study demonstrated that health literacy was quite limited and insufficient among the participants. Determining the factors influencing health literacy, planning with these factors in mind, developing policies to improve health literacy, and increasing the health literacy of individuals and society may be critical for the improvement of public health.
Keywords: health literacy, health care, information, primary health care
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Affiliation(s)
- Hakan Mut
- MVZ LSH Lungen- und Schlafzentrum Hochfranken
| | - Umut Gok Balci
- Department of Family Medicine, University of Health Sciences Izmir Faculty of Medicine Izmir Tepecik Health Practice and Research Hospital
| | - Haluk Mergen
- Department of Family Medicine, University of Health Sciences Izmir Faculty of Medicine Izmir Tepecik Health Practice and Research Hospital
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Kühn L, Bachert P, Hildebrand C, Kunkel J, Reitermayer J, Wäsche H, Woll A. Health Literacy Among University Students: A Systematic Review of Cross-Sectional Studies. Front Public Health 2022; 9:680999. [PMID: 35127605 PMCID: PMC8814326 DOI: 10.3389/fpubh.2021.680999] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this systematic review was to provide an overview of cross-sectional studies that examined health literacy among university students and to identify possible determinants related to health literacy. METHOD The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Three databases (PubMed, Scopus, and Web of Science) were systematically searched for cross-sectional studies that examined health literacy among university students. Results of included studies were narratively summarized. RESULTS The systematic review includes twenty-one research studies. The majority of studies report health literacy scores among university students that are lower compared to reference samples. The health literacy of students is influenced by different variables (age, gender, number of semesters, course of studies/curriculum, parental education, and socioeconomic background). DISCUSSION Health literacy activities should target all students. Universities should make use of their resources and offer health literacy courses for students in which content is used from disciplines available at the university (e.g., medicine, health, or psychology). To increase effectiveness, health literacy courses should be adapted according to the different needs and characteristics of the student subgroups.
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Affiliation(s)
- Lucas Kühn
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Philip Bachert
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Claudia Hildebrand
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Jule Kunkel
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Jörg Reitermayer
- Central Scientific Institution for Key Competencies, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Hagen Wäsche
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Boonstra MD, Reijneveld SA, Navis G, Westerhuis R, de Winter AF. Co-Creation of a Multi-Component Health Literacy Intervention Targeting Both Patients with Mild to Severe Chronic Kidney Disease and Health Care Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413354. [PMID: 34948960 PMCID: PMC8704507 DOI: 10.3390/ijerph182413354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
Limited health literacy (LHL) is common in chronic kidney disease (CKD) patients and frequently associated with worse self-management. Multi-component interventions targeted at patients and healthcare professionals (HCPs) are recommended, but evidence is limited. Therefore, this study aims to determine the objectives and strategies of such an intervention, and to develop, produce and evaluate it. For this purpose, we included CKD patients with LHL (n = 19), HCPs (n = 15), educators (n = 3) and students (n = 4) from general practices, nephrology clinics and universities in an Intervention Mapping (IM) process. The determined intervention objectives especially address the patients’ competences in maintaining self-management in the long term, and communication competences of patients and HCPs. Patients preferred visual strategies and strategies supporting discussion of needs and barriers during consultations to written and digital strategies. Moreover, they preferred an individual approach to group meetings. We produced a four-component intervention, consisting of a visually attractive website and topic-based brochures, consultation cards for patients, and training on LHL for HCPs. Evaluation revealed that the intervention was useful, comprehensible and fitting for patients’ needs. Healthcare organizations need to use visual strategies more in patient education, be careful with digitalization and group meetings, and train HCPs to improve care for patients with LHL. Large-scale research on the effectiveness of similar HL interventions is needed.
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Affiliation(s)
- Marco D. Boonstra
- Department of Health Sciences, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (S.A.R.); (A.F.d.W.)
- Correspondence: ; Tel.: +31653243985
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (S.A.R.); (A.F.d.W.)
| | - Gerjan Navis
- Department of Nephrology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (G.N.); (R.W.)
| | - Ralf Westerhuis
- Department of Nephrology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (G.N.); (R.W.)
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (S.A.R.); (A.F.d.W.)
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Yuce AE, Albayrak A, Baran B, Kalafat Ö. Role of factors in eHealth literacy in period of COVID-19: a study of Turkey. HEALTH EDUCATION 2021. [DOI: 10.1108/he-07-2021-0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to understand the eHealth literacy skills of chronic patients and to explore the relations, patterns between eHealth literacy skills and different factors such as demographics, search strategies and health information sources and to explain their effects on eHealth literacy in Turkey in Izmir in COVID-19 outbreak.
Design/methodology/approach
A quantitative method was used in the study including a questionnaire. A total of 604 chronic patients responded to the questionnaire who applied the five popularly identified hospitals in Izmir in Turkey. CHAID analysis method was implemented to explore the strongest correlation between eHealth literacy and independent variables.
Findings
Using different social media types were correlated with patients’ eHealth literacy scores. Using Facebook, Twitter were the supportive predictors for the eHealth literacy scores. However, digital literacy was highly important for eHealth literacy.
Originality/value
This study shows that the social media channels which provides much more information such as Facebook and Twitter for the chronic patient. This could be beneficial for the eHealth tools and social media content developers in terms of the supply of health information. Moreover, the study gives ideas about the effect of digital literacy and the importance of health information provided.
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12
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Lim CC, He F, Li J, Tham YC, Tan CS, Cheng CY, Wong TY, Sabanayagam C. Application of machine learning techniques to understand ethnic differences and risk factors for incident chronic kidney disease in Asians. BMJ Open Diabetes Res Care 2021; 9:9/2/e002364. [PMID: 34952839 PMCID: PMC8710867 DOI: 10.1136/bmjdrc-2021-002364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/14/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is increasing in Asia, but there are sparse data on incident CKD among different ethnic groups. We aimed to describe the incidence and risk factors associated with CKD in the three major ethnic groups in Asia: Chinese, Malays and Indians. RESEARCH DESIGN AND METHODS Prospective cohort study of 5580 general population participants age 40-80 years (2234 Chinese, 1474 Malays and 1872 Indians) who completed both baseline and 6-year follow-up visits. Incident CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 in those free of CKD at baseline. RESULTS The 6-year incidence of CKD was highest among Malays (10.0%), followed by Chinese (6.1%) and Indians (5.8%). Logistic regression showed that older age, diabetes, higher systolic blood pressure and lower eGFR were independently associated with incident CKD in all three ethnic groups, while hypertension and cardiovascular disease were independently associated with incident CKD only in Malays. The same factors were identified by machine learning approaches, gradient boosted machine and random forest to be the most important for incident CKD. Adjustment for clinical and socioeconomic factors reduced the excess incidence in Malays by 60% compared with Chinese but only 13% compared with Indians. CONCLUSION Incidence of CKD is high among the main Asian ethnic groups in Singapore, ranging between 6% and 10% over 6 years; differences were partially explained by clinical and socioeconomic factors.
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Affiliation(s)
| | - Feng He
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Jialiang Li
- Department of Statistics and Applied Probability, National University of Singapore, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Chieh Suai Tan
- Department of Renal Medicine, Singapore General Hospital, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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13
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Wang X, Li Y, Li J, Liu Y, Qiu C. A rumor reversal model of online health information during the Covid-19 epidemic. Inf Process Manag 2021; 58:102731. [PMID: 34539040 PMCID: PMC8441309 DOI: 10.1016/j.ipm.2021.102731] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/24/2021] [Accepted: 08/12/2021] [Indexed: 12/24/2022]
Abstract
The development of the Internet and social media has expanded the speed and scope of information dissemination, but not all widely disseminated information is true. Especially during the public health emergencies, the endogenous health information demand generated by the lack of scientific knowledge of health information among online users stimulates the dissemination of health information by mass media while providing opportunities for rumor mongers to publish and spread online rumors. Invalid scientific knowledge and rumors will have a serious negative impact and disrupt social order during epidemic outbreaks such as COVID-19. Therefore, it is extremely important to construct an effective online rumor reversal model. The purpose of this study is to build an online rumor reversal model to control the spread of online rumors and reduce their negative impact. From the perspective of internal and external factors, based on the SIR model, this study constructed a G-SCNDR online rumor reversal model by adopting scientific knowledge level theory and an external online rumor control strategy. In this study, the G-SCNDR model is simulated, and a sensitivity analysis of the important parameters of the model is performed. The reversal efficiency of the G-SCNDR model can be improved by properly adopting the isolation-conversion strategy as the external control approach to online rumors with improving the popularization rate of the level of users' scientific knowledge and accelerating the transformation efficiency of official nodes. This study can help provide a better understanding of the process of online rumor spreading and reversing, as well as offering ceritain guidance and countermeasures for online rumor control during public health emergencies.
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Affiliation(s)
- Xiwei Wang
- School of Management, Jilin University, Changchun 130000, China.,Research Center for Big Data Management, Jilin University, Changchun 130000, China
| | - Yueqi Li
- School of Management, Jilin University, Changchun 130000, China
| | - Jiaxing Li
- School of Information Management, Nanjing University, Nanjing 210023, China
| | - Yutong Liu
- School of Management, Jilin University, Changchun 130000, China
| | - Chengcheng Qiu
- School of Management, Jilin University, Changchun 130000, China
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14
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Lu X, Zhang R. Association Between eHealth Literacy in Online Health Communities and Patient Adherence: Cross-sectional Questionnaire Study. J Med Internet Res 2021; 23:e14908. [PMID: 34515638 PMCID: PMC8477298 DOI: 10.2196/14908] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 10/31/2020] [Accepted: 01/29/2021] [Indexed: 01/19/2023] Open
Abstract
Background eHealth literacy is significantly associated with patients’ online information behavior, physician-patient relationship, patient adherence, and health outcomes. As an important product of the internet, online health communities (OHCs) can help redistribute idle medical resources, increase medical resource utilization, and improve patient adherence. However, studies on eHealth literacy in OHCs are limited. Therefore, this study examined patients’ eHealth literacy regarding health information–seeking behavior and physician-patient communication in OHCs. Objective This study aimed to investigate the association between eHealth literacy in OHCs and patient adherence by employing social cognitive theory. Methods This was an empirical study, in which a research model consisting of 1 independent variable (patients’ eHealth literacy), 3 mediators (physician-patient communication in OHCs, patient health information–seeking behavior in OHCs, and patients’ perceived quality of health information in OHCs), 1 dependent variable (patient adherence), and 4 control variables (age, gender, living area, and education level) was established to examine the associations. Multi-item scales were used to measure variables. An anonymous online survey involving 560 participants was conducted through Chinese OHCs in July 2018 to collect data. Partial least squares and structural equation modeling were adopted to analyze data and test hypotheses. Results The survey response rate was 79.6% (446/560). The reliability, convergent validity, and discriminant validity were acceptable. Age, gender, living area, and education level were positively associated with patient adherence, and gender was positively associated with physician-patient communication and patients’ perceived quality of internet health information in OHCs. Patients’ eHealth literacy was positively associated with patient adherence through the mediations of physician-patient communication, internet health information–seeking behavior, and perceived quality of internet health information in OHCs. Conclusions Results indicate that physician-patient communication, internet health information–seeking behavior, and the perceived quality of internet health information are significantly associated with improving patient adherence via a guiding of eHealth literacy in OHCs. These findings suggest that physicians can understand and guide their patients’ eHealth literacy to improve treatment efficiency; OHCs’ operators should this strengthen the management of information quality, develop user-friendly features, and minimize the gap between the actual and perceived information quality.
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Affiliation(s)
- Xinyi Lu
- School of Management and E-business, Zhejiang Gongshang University, Hangzhou, China
| | - Runtong Zhang
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
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15
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Asharani PV, Lau JH, Roystonn K, Devi F, Peizhi W, Shafie S, Chang S, Jeyagurunathan A, Yiang CB, Abdin E, Vaingankar JA, Sum CF, Lee ES, Dam RV, Chong SA, Subramaniam M. Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9316. [PMID: 34501905 PMCID: PMC8431510 DOI: 10.3390/ijerph18179316] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Health literacy is a key determinant of the public health and health climate of the nation. This study examined the functional health literacy of the nation, factors associated with health literacy, and its relationship with diabetes recognition. This cross-sectional survey recruited participants (N = 2895) who were 18 years and above from a population registry through disproportionate stratified sampling. The Brief Health Literacy Screen and other questionnaires were administered through face-to-face interviews, in one of the four national languages (English, Chinese, Malay or Tamil). The majority (80.5%) had adequate functional health literacy and were able to recognise symptoms of diabetes correctly (83.5% overall; 83.7% and 82.2% in those with adequate and inadequate health literacy, respectively). Those with inadequate health literacy had a higher incidence of chronic conditions (p < 0.001) compared to those with adequate health literacy in bivariate analysis. The majority of the sample had sufficient levels of physical activity (83.3%), and more than half reported an unhealthy lifestyle (57.4%). Older age, Chinese ethnicity, those who were employed, with lower education (secondary or below), and were married had significantly higher odds of inadequate health literacy. Health literacy was not associated with lifestyle, physical activity, chronic conditions and diabetes recognition. Health literacy interventions should focus on the disadvantaged social groups for improving their health literacy.
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Affiliation(s)
- P. V. Asharani
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Wang Peizhi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Chua Boon Yiang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore 730676, Singapore;
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics 3 Fusionopolis Link, Singapore 138543, Singapore;
| | - Rob Van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
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16
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Huang LY, Lin YP, Glass GF, Chan EY. Health literacy and patient activation among adults with chronic diseases in Singapore: A cross-sectional study. Nurs Open 2021; 8:2857-2865. [PMID: 33942559 PMCID: PMC8363362 DOI: 10.1002/nop2.873] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/08/2021] [Accepted: 02/15/2021] [Indexed: 12/25/2022] Open
Abstract
AIMS Increased patient activation levels can improve health outcomes. Hence, this study aims to examine the relationships between sociodemographic variables and domain-specific health literacies with patient activation. DESIGN A cross-sectional design. METHODS 200 outpatient adults with chronic diseases completed a survey that assessed their domain-specific health literacy and patient activation levels. Univariate and multivariate analysis of the variables were conducted on patient activation with 95% confidence interval (CI). RESULTS Multiple linear regression analyses observed a positive linear relationship between the following domain-specific health literacy variables-"actively manage my health" (p < .0001, 95% CI: 0.89-2.29), "understanding health information" (p = .008, 95% CI: 0.28-1.85), and "finding good health information" (p = .02, 95% CI 0.13-1.51) with patient activation. The other sociodemographic and clinical variables were not statistically significant. Increased focus from healthcare professionals is needed on helping patients better find and understand health information and encouraging them to actively manage their health; elements which would raise their activation levels.
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Affiliation(s)
- Laura Yuqi Huang
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Yongxing Patrick Lin
- Nursing Research Unit, Nursing Service, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Ee-Yuee Chan
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore.,Nursing Research Unit, Nursing Service, Tan Tock Seng Hospital, Singapore, Singapore
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17
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Gartrell K, Han K, Trinkoff A, Cho H. Three-factor structure of the eHealth Literacy Scale and its relationship with nurses' health-promoting behaviours and performance quality. J Adv Nurs 2021; 76:2522-2530. [PMID: 33463741 DOI: 10.1111/jan.14490] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/02/2020] [Accepted: 06/19/2020] [Indexed: 12/19/2022]
Abstract
AIMS To examine the factorial validity of the eHealth Literacy Scale among hospital nurses and to investigate the associations of its components with health-promoting behaviours and nursing performance quality. DESIGN This cross-sectional study used survey data of 484 Korean hospital nurses, which were collected between March-May 2016. METHODS The three-factor structure was tested using confirmatory factor analyses. Multiple linear regression was conducted to test associations of the three components' scores with health-promoting behaviours and self-rated nursing performance quality. RESULTS The eHealth Literacy Scale supported a three-factor structure: awareness of internet health resources (awareness), having skills needed to access resources (skills), and the ability to evaluate the quality of internet health resources (evaluation). All the three components were significantly associated with higher quality of nursing performance and better interpersonal relations. Stress management, spiritual growth, and health responsibility were linked with evaluation or skills but physical activity and nutrition were not. CONCLUSION Strategies to enhance eHealth literacy among nurses could improve nurses' health and further patient care. Training to build nurses' self-efficacy to evaluate internet health information could improve eHealth literacy and should be developed and examined. IMPACT To improve nurses' health and patient care, training programs to build nurses' self-efficacy to access and evaluate internet health information should be developed.
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Affiliation(s)
| | - Kihye Han
- Chung-Ang University College of Nursing, Seoul, Republic of Korea
| | - Alison Trinkoff
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Hyeonmi Cho
- University of Wisconsin-Madison School of Nursing, Madison, WI, USA
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18
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Boonstra MD, Reijneveld SA, Foitzik EM, Westerhuis R, Navis G, de Winter AF. How to tackle health literacy problems in chronic kidney disease patients? A systematic review to identify promising intervention targets and strategies. Nephrol Dial Transplant 2020; 36:gfaa273. [PMID: 33351936 PMCID: PMC8237988 DOI: 10.1093/ndt/gfaa273] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Limited health literacy (LHL) is associated with multiple adverse health outcomes in chronic kidney disease (CKD). Interventions are needed to improve this situation, but evidence on intervention targets and strategies is lacking. This systematic review aims to identify potential targets and strategies by summarizing the evidence on: (i) patient- and system-level factors potentially mediating the relation between LHL and health outcomes; and (ii) the effectiveness of health literacy interventions customized to CKD patients. METHODS We performed a systematic review of peer-reviewed research articles in Medline, Embase and Web of Science, 2009-19. We assessed the quality of the studies and conducted a best-evidence synthesis. RESULTS We identified 860 publications and included 48 studies. Most studies were of low quality (n = 26) and focused on dialysis and transplantation (n = 38). We found strong evidence for an association of LHL with smoking and having a suboptimal transplantation process. Evidence was weak for associations between LHL and a variety of factors related to self-care management (n = 25), utilization of care (n = 23), patient-provider interaction (n = 8) and social context (n = 5). Six interventions were aimed at improving knowledge, decision-making and health behaviours, but evidence for their effectiveness was weak. CONCLUSIONS Study heterogeneity, low quality and focus on kidney failure largely impede the identification of intervention targets and strategies for LHL. More and higher quality studies in earlier CKD stages are needed to unravel how LHL leads to worse health outcomes, and to identify targets and strategies to prevent disease deterioration. Healthcare organizations need to develop and evaluate efforts to support LHL patients.
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Affiliation(s)
- Marco D Boonstra
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elisabeth M Foitzik
- Institute for Applied Health Sciences, Coburg University of Applied Sciences and Arts, Coburg, Germany
| | - Ralf Westerhuis
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerjan Navis
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrea F de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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19
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Diviani N, Obrenovic J, Montoya CL, Karcz K. Disentangling health information appraisal competence: Results from an interdisciplinary scoping review and online consultation among Swiss stakeholders. PLoS One 2020; 15:e0235474. [PMID: 32614869 PMCID: PMC7332022 DOI: 10.1371/journal.pone.0235474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The ability to critically appraise health information-often referred to as critical health literacy-is recognized as a crucial component of health literacy. Yet to date, it is not clear what specific abilities are needed to adequately accomplish this task, thereby hindering both its assessment and the development and evaluation of related interventions. By systematically building on past research, this study aimed to operationally define the concept of health information appraisal competence. METHODS We systematically searched five scholarly databases to identify the conceptualizations and operational definitions of information appraisal in different disciplines. The resulting operationalization was subsequently validated through an online consultation exercise among 85 Swiss stakeholders. RESULTS Ninety-four publications were included in the review to the point of saturation. We extracted 646 skills, attitudes, and knowledge for health information appraisal. We then collated overlapping or duplicate statements, which produced a list of 43 unique statements belonging to six emergent themes or core competences: (1) basic competence, (2) predisposition, (3) identification competence, (4) critical evaluation competence, (5) selection competence, and (6) application competence. The consultation exercise enriched the operationalization of some of the core competences and confirmed the importance of all competences. Most skills, attitudes, and knowledge, however, were assigned low feasibility by the stakeholders. CONCLUSIONS This study was the first attempt to systematically operationalize health information appraisal competence. From a theoretical perspective, it sheds light on an understudied, health literacy domain, thus contributing to clarity around the concept. From a practical perspective, it provides a strong theoretical basis for the development of a tool to measure health information appraisal competence. This could be used routinely as a screening tool, as an outcome measure for public health interventions, or to identify citizens who are most at risk. Furthermore, it will provide support for the development of future interventions to build health information appraisal competence in the population.
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Affiliation(s)
- Nicola Diviani
- University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | | | | | - Katarzyna Karcz
- University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
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20
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Turin TC, Chowdhury N, Ferdous M, Vaska M, Rumana N, Dahal R, Rahman N, Chowdhury MZI. Health and well-being literacy initiatives focusing on immigrant communities: an environmental scan protocol to identify "what works and what does not". Syst Rev 2020; 9:84. [PMID: 32312314 PMCID: PMC7168966 DOI: 10.1186/s13643-020-01340-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Most of the major cities in the developed western countries are characterized by an increasing multiculturalism brought by the immigrant population. The immigrant communities face challenges in the new environment with their health and wellness related unmet needs. It is imperative to find sustainable ways to empower these diverse communities to champion their health and wellness. Community-based health and wellness literacy initiatives (CBHWLI) focusing on immigrant communities can be an important step towards citizen empowerment in this regard. The aim of the present environmental scan is to identify the key factors that might impact a CBHWLI in immigrant communities in Canada in order to facilitate the process in practice and identify the competencies and training required for its implementation. METHODS This study will gather information from existing literature and online sources as well as will capture expert and lay perspectives on the factors that can impact the effectiveness and sustainability of CBHWLIs through conducting a comprehensive environmental scan: (i) a systematic scoping review of published literature and grey literature, (ii) a comprehensive Internet search, (iii) key informant interviews, and (iv) community consultation. Specific methodological and analytical frameworks will guide each step. ETHICS AND DISSEMINATION This study is the first step in establishing a practical base for developing CBHWLI implementation research. Once the initial findings have been generated, the second step will involve inviting experts to provide their input. We first plan to disseminate the results of our scoping review and Internet scan through meetings with key stakeholders, to be followed by journal publications and conference or workshop presentations. Ethical approval is not required for the scoping review or Internet scan; however, approval to conduct interviews with key informants and community consultations in the second stage of the study will be sought from the Conjoint Health Research Ethics Board.
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Affiliation(s)
- Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Nashit Chowdhury
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Mahzabin Ferdous
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Marcus Vaska
- Knowledge Resource Service, Tom Baker Cancer Centre, Alberta Health Services, 1331-29 St. NW, Calgary, AB, T2N 4N2, Canada
| | - Nahid Rumana
- Sleep Center, Foothills Medical Center, University of Calgary, 1403-29 St NW, Calgary, AB, T2N 2TN, Canada
| | - Rudra Dahal
- Community Based Citizen Researcher, Calgary, AB, Canada
| | - Nafiza Rahman
- Community Based Citizen Researcher, Calgary, AB, Canada
| | - Mohammad Z I Chowdhury
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
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21
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Griva K, Yoong RKL, Nandakumar M, Rajeswari M, Khoo EYH, Lee VYW, Kang AWC, Osborne RH, Brini S, Newman SP. Associations between health literacy and health care utilization and mortality in patients with coexisting diabetes and end‐stage renal disease: A prospective cohort study. Br J Health Psychol 2020; 25:405-427. [DOI: 10.1111/bjhp.12413] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/09/2020] [Indexed: 01/20/2023]
Affiliation(s)
- Konstadina Griva
- Centre for Population Health Sciences Lee Kong Chian School of Medicine Imperial College and Nanyang Technological University Singapore City Singapore
| | | | | | | | - Eric Y. H. Khoo
- Department of Medicine Yong Loo Lin School of Medicine National University Singapore Singapore
- Division of Endocrinology University Medicine Cluster National University Health System Singapore City Singapore
| | | | | | - Richard H. Osborne
- Centre for Global Health and Equity Faculty of Health, Arts and Design Swinburne University of Technology Melbourne Australia
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Engagement with a Web-Based Health Promotion Intervention among Vocational School Students: A Secondary User and Usage Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072180. [PMID: 32218251 PMCID: PMC7177298 DOI: 10.3390/ijerph17072180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 12/27/2022]
Abstract
Engagement with web-based interventions is both generally low and typically declining. Visits and revisits remain a challenge. Based on log data of a web-based cluster randomized controlled trial conducted in vocational schools, the present secondary analysis aimed to identify influencing factors on initially logging in to a health promotion platform among young adults and to examine the engagement over the course of an eight-week intervention. Data of 336 students (62.2% female, age span 18–25) from two intervention arms (web-based intervention and web-based intervention with an additional initial face-to-face contact) was included. Binary logistic regression and log-data visualization were performed. An additional initial face-to-face contact (odds ratio (OR) = 2.971, p = 0.005), female sex (OR = 2.237, p = 0.046) and the health-related skill “dealing with health information” (OR = 2.179, p = 0.030) significantly increased the likelihood of initially logging in. Other variables showed no influence. 16.6% of all potential users logged in at least once, of which 57.4% revisited the platform. Most logins were tracked at the beginning of the intervention and repeated engagement was low. To increase the engagement with web-based interventions, health-related skills should be fostered. In addition, a strategy could be to interlink comparable interventions in vocational schools more regularly with everyday teaching through multi-component interventions.
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Seifi B, Seyedin H, Ghanizadeh G. The Role of Academic Partnership in Disaster Risk Management: A Systematic Review. Disaster Med Public Health Prep 2019; 13:1047-1058. [PMID: 31169115 DOI: 10.1017/dmp.2018.164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The aim of this systematic review is to investigate the community-based academic partnership roles in disaster risk management. METHODS The assessment of the documents was conducted by reviewing abstracts and full papers of the available studies, which provided considerable background and promoted knowledge in academic interventional roles in disaster risk management. The articles were searched with a wide range of key words related to the research topic. The studies included the research available between 2000 and September 2017 in the English language. The selection of articles was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. RESULTS Of 997 articles, we selected 12 full-text articles that met the criteria for the final review based on the study objective. The results show that, although universities can play multidirectional roles in disaster risk management phases, the development of the academic partnership potential and collaboration for disaster risk management and disaster risk reduction for stakeholders is necessary. CONCLUSION The universities' potential in providing sufficient disaster health literacy is not currently considered important enough in communities.Therefore, the proper context-bound models of development based on a community's skills and universities' potential should receive more attention.
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Affiliation(s)
- Bahar Seifi
- Department of Health in Emergencies and Disasters, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hesam Seyedin
- Department of Health in Emergencies and Disasters, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ghader Ghanizadeh
- Environmental Health Engineering, Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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24
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Wang RH, Hsu HC, Chen SY, Hsieh CH, Lee YJ. Modeling patient empowerment and health literacy to glycemic control in insulin-treated patients: A prospective study. PATIENT EDUCATION AND COUNSELING 2019; 102:1336-1341. [PMID: 30773291 DOI: 10.1016/j.pec.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 01/28/2019] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To model the pathways of patient empowerment (PE) and health literacy (HL) to glycemic control specific to insulin-treated patients by prospective design. METHODS Insulin-treated patients with type 2 diabetes (T2DM) (N = 185) were recruited by convenience sampling. Data of personal characteristics, PE, and HL were collected by questionnaires at baseline and 9 months later. The 9-month glycosylated hemoglobin (HbA1c) levels of each participant were collected from medical records. Structural equation modeling was used to test a hypothesized model. RESULTS Baseline and 9-month communicative HL and critical HL significantly and negatively correlated with 9-month HbA1c levels. Structural equation modeling supported that baseline and 9-month PE significantly affected HL at corresponding time points. Baseline PE indirectly affected 9-month HL through 9-month PE. The 9-month HL directly affected 9-month HbA1c. Baseline HL indirectly affected 9-month HbA1c through 9-month HL. CONCLUSION Communicative HL and critical HL rather than functional HL were crucial in improving glycemic control. PE is essential to improve HL in insulin-treated patients. PRACTICE IMPLICATIONS Healthcare providers could apply the empowerment approach to educate insulin-treated patients. Through reciprocal dynamic process of PE, insulin-treated patients with T2DM might improve their communicative and critical HL; and finally, glycemic control could be improved.
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Affiliation(s)
- Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Department of Medical Research, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Kaohsiung City, 807, Taiwan, ROC.
| | - Hui-Chun Hsu
- Lee's Endocrinology Clinic, No. 396, Guangdong Road, Pingtung City, 900, Taiwan, ROC.
| | - Shi-Yu Chen
- Tri-Service General Hospital, No. 325, Sec. 2, Chenggong Road, Taipei City, 114, Taiwan, ROC.
| | - Chang-Hsun Hsieh
- Tri-Service General Hospital, No. 325, Sec. 2, Chenggong Road, Taipei City, 114, Taiwan, ROC.
| | - Yau-Jiunn Lee
- Lee's Endocrinology Clinic, No. 396, Guangdong Road, Pingtung City, 900, Taiwan, ROC.
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25
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Alhuwail D, Abdulsalam Y. Assessing Electronic Health Literacy in the State of Kuwait: Survey of Internet Users From an Arab State. J Med Internet Res 2019; 21:e11174. [PMID: 31127723 PMCID: PMC6555123 DOI: 10.2196/11174] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 01/14/2019] [Accepted: 04/10/2019] [Indexed: 01/17/2023] Open
Abstract
Background The internet and social media have become an important source for health information. In 2017, the State of Kuwait ranked first in mobile subscription penetration in the Arab world; nearly 90% of its population uses the internet. Electronic health (eHealth) literacy is important in populations that have easy and affordable access to internet resources to more effectively manage health conditions as well as improve general population health. Objective The aim of this study was to assess eHealth literacy levels across internet users in Kuwait and identify demographic characteristics that influence eHealth literacy. Furthermore, the study aimed to identify the reasons and type of information that people seek online. Finally, this study examined the utilization of various social media channels for accessing online health information. The social media platforms considered were as follows: WhatsApp, Twitter, Instagram, YouTube, Facebook, and Snapchat. Methods A cross-sectional anonymous Web-based survey was used to collect data about eHealth literacy and related information. The eHealth literacy scale (eHEALS), originally developed by Norman and Skinner, is measured using 8 Likert-type scales. A linear regression model estimates the effect of demographic variables such as age, gender, and education on eHealth literacy while controlling for participants’ perceived usefulness and importance of the internet. Participants were also surveyed about their frequency in using social media platforms for seeking health information. Results Kuwait’s composite eHEALS, based on a sample of 386 participants, was 28.63, which is very similar to eHEALS observed among adult populations in other developed countries. Females in Kuwait demonstrated a higher average eHEALS compared with males. Among the social media platforms, the survey results indicated that YouTube is the most frequently used to seek health information, with Facebook being the least frequently used. Conclusions Internet users in Kuwait appear confident in their ability to search for health-related information online compared with other populations, as indicated by aggregate eHEALS scores. Considering this finding, government and health care organizations should shift more efforts from traditional media toward online health information, focusing on the social media outlets that people in Kuwait find more useful for seeking health information.
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Affiliation(s)
- Dari Alhuwail
- Department of Information Science, College of Computing Sciences and Engineering, Kuwait University, Al-Adailiya, Kuwait.,Health Informatics Unit, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Yousef Abdulsalam
- Department of Quantitative Methods and Information Systems, College of Business Administration, Kuwait University, Shuwaikh, Kuwait
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Lu X, Zhang R. Impact of Physician-Patient Communication in Online Health Communities on Patient Compliance: Cross-Sectional Questionnaire Study. J Med Internet Res 2019; 21:e12891. [PMID: 31094342 PMCID: PMC6535977 DOI: 10.2196/12891] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/14/2019] [Accepted: 04/06/2019] [Indexed: 02/06/2023] Open
Abstract
Background In China, the utilization of medical resources is tense, and most hospitals are highly congested because of the large population and uneven distribution of medical resources. Online health communities (OHCs) play an important role in alleviating hospital congestions, thereby improving the utilization of medical resources and relieving medical resource shortages. OHCs have positive effects on physician-patient relationships and health outcomes. Moreover, as one of the main ways for patients to seek health-related information in OHCs, physician-patient communication may affect patient compliance in various ways. In consideration of the inevitable development of OHCs, although they have several shortcomings, identifying how physician-patient communication can impact patient compliance is important to improve patients’ health outcomes through OHCs. Objective This study aimed to investigate the impact of physician-patient communication on patient compliance in OHCs through the mediation of the perceived quality of internet health information, decision-making preference, and physician-patient concordance, using an empirical study based on the self-determination theory. Methods A research model was established, including 1 independent variable (physician-patient communication), 3 mediators (perceived quality of internet health information, decision-making preference, and physician-patient concordance), 1 dependent variable (patient compliance), and 4 control variables (age, gender, living area, and education level). Furthermore, a Web-based survey involving 423 valid responses was conducted in China to collect data, and structural equation modeling and partial least squares were adopted to analyze data and test the hypotheses. Results The questionnaire response rate was 79.2% (487/615) and the validity rate was 86.9% (423/487); reliability and validity are acceptable. The communication between physicians and patients in OHCs positively affects patient compliance through the mediation of the perceived quality of internet health information, decision-making preference, and physician-patient concordance. Moreover, physician-patient communication exhibits similar impacts on the perceived quality of internet health information, decision-making preference, and physician-patient concordance. Patients’ decision-making preference shows the weakest impact on patient compliance compared with the other 2 mediators. Ultimately, all 3 mediators play a partially mediating role between physician-patient communication and patient compliance. Conclusions We conclude that physician-patient communication in OHCs exhibits a positive impact on patient compliance; thus, patient compliance can be improved by guiding physician-patient communication in OHCs. Furthermore, our findings suggest that physicians can share high-quality health information with patients, discuss benefits, risks, and costs of treatment options with patients, encourage patients to express their attitudes and participate in health-related decision making, and strengthen the emotional connection with patients in OHCs, thereby decreasing patients’ misunderstanding of information and increasing concordance between physicians and patients. OHCs are required to not only strengthen the management of their published health information quality but also understand users’ actual attitudes toward information quality and then try to reduce the gap between the perceived and actual quality of information.
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Affiliation(s)
- Xinyi Lu
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Runtong Zhang
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
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27
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Im H, Swan LET. Qualitative exploration of critical health literacy among Afghan and Congolese refugees resettled in the USA. HEALTH EDUCATION JOURNAL 2019; 78:38-50. [DOI: 10.1177/0017896918785932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Objectives: Previous research that revealed a high prevalence of low health literacy among immigrants and refugees tended to over emphasise functional health literacy as a risk factor for low health status and poor disease management. Despite a significant knowledge gap, little has been investigated regarding critical health literacy (CHL) in refugee populations whose culture deeply interweaves individual and contextual capacity to promote health. Design: This study adopted a qualitative approach to explore CHL that is built through community health workshops (CHWs) with Afghan and Congolese refugee communities in US resettlement. Setting: As part of a community-based participatory research project, the study was conducted with Afghan and Congolese refugees resettled in the USA. Method: A series of open-ended questions for focus group interviews were embedded in each workshop session explore health literacy skills and capacity over time. This study adopted a hybrid thematic design whereby the conceptual framework of CHL was applied to emergent themes from the data. Results: Thematic analysis revealed four major CHL thematic domains, as experienced and demonstrated by Afghan and Congolese refugee participants: (1) critical appraisal, (2) self-efficacy and confidence, (3) empowerment, and (4) collective problem solving. Conclusion: Study findings underline the importance of health education validating existing cultural knowledge and practices in a group setting so as to facilitate the building and enhancement of social support systems and community action for health promotion.
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Affiliation(s)
- Hyojin Im
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
| | - Laura ET Swan
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
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28
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Im H, Swan LET. Qualitative exploration of critical health literacy among Afghan and Congolese refugees resettled in the USA. HEALTH EDUCATION JOURNAL 2019; 78:38-50. [DOI: https:/doi.org/10.1177/0017896918785932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Objectives: Previous research that revealed a high prevalence of low health literacy among immigrants and refugees tended to over emphasise functional health literacy as a risk factor for low health status and poor disease management. Despite a significant knowledge gap, little has been investigated regarding critical health literacy (CHL) in refugee populations whose culture deeply interweaves individual and contextual capacity to promote health. Design: This study adopted a qualitative approach to explore CHL that is built through community health workshops (CHWs) with Afghan and Congolese refugee communities in US resettlement. Setting: As part of a community-based participatory research project, the study was conducted with Afghan and Congolese refugees resettled in the USA. Method: A series of open-ended questions for focus group interviews were embedded in each workshop session explore health literacy skills and capacity over time. This study adopted a hybrid thematic design whereby the conceptual framework of CHL was applied to emergent themes from the data. Results: Thematic analysis revealed four major CHL thematic domains, as experienced and demonstrated by Afghan and Congolese refugee participants: (1) critical appraisal, (2) self-efficacy and confidence, (3) empowerment, and (4) collective problem solving. Conclusion: Study findings underline the importance of health education validating existing cultural knowledge and practices in a group setting so as to facilitate the building and enhancement of social support systems and community action for health promotion.
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Affiliation(s)
- Hyojin Im
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
| | - Laura ET Swan
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
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29
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Seven M, Paşalak Şİ, Sahin E, Akyuz A. Genetic Literacy of pregnant women and their use of prenatal screening and diagnostic tests in Turkey. J Genet Couns 2019; 28:578-586. [PMID: 30680841 DOI: 10.1002/jgc4.1082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/03/2018] [Indexed: 11/07/2022]
Abstract
This study evaluated how genetic literacy of pregnant women in Turkey affects their use of prenatal screening and diagnostic tests. As a descriptive cross-sectional study, a Participant Identification Form and the Genetic literacy and Comprehension Measure (GLAC) were used to collect data. The sample of study consisted of 189 pregnant women who made regular antenatal care visits in Giresun, Turkey. The mean age was 29.5 ± 5.9 years and mean gestational week was 34.9 ± 5.09. Of the women, 76.7% had undergone prenatal screening tests, and 85.5% of them had learned about the tests from their doctors. The mean GLAC score of familiarity was 3.67 ± 1.78 (out of seven), and the genetic concepts answered correctly were 5.30 ± 1.79 (out of eight). No statistically significant relationship emerged between the women's genetic literacy and their use of prenatal screening or diagnostic tests. However, relationships were statistically significant between the genetic literacy of the women and the educational levels of the women themselves or their spouses, consanguineous marital status, parity, and use of folic acid supplements. Primiparous women who were highly educated, had a highly educated spouse, were not in consanguineous marriages, and had taken folic acid supplements during pregnancy were more literate in genetics. There is a need for more educational opportunities in order for women to increase their familiarity with genetic terms. Educating women will improve their understanding of genetics-related health services and increase their awareness of genetic diseases, which will allow them to take the appropriate actions for primary prevention.
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Affiliation(s)
- Memnun Seven
- Koç University School of Nursing, İstanbul, Turkey
| | | | - Eda Sahin
- Faculty of Health Sciences, Giresun University, Giresun, Turkey
| | - Aygul Akyuz
- Koç University School of Nursing, İstanbul, Turkey
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30
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Seifi B, Ghanizadeh G, Seyedin H. Disaster Health Literacy of Middle-aged Women. J Menopausal Med 2018; 24:150-154. [PMID: 30671406 PMCID: PMC6336570 DOI: 10.6118/jmm.2018.24.3.150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 09/11/2018] [Accepted: 09/23/2018] [Indexed: 11/16/2022] Open
Abstract
As disasters have been increasing in recent years, disaster health literacy is gaining more important for a population such as middle-age women. This is because they face developmental crises (menopause) and situational crisis (disaster). Due to the growing elderly population, it is imperative to seriously consider the issue of aging women's healthcare, and their educational needs relative to emergencies and disasters. The purpose of study was to clarify the importance of disaster health literacy for middle-age women. This study is a review of the literature using PubMed, ScienceDirect, Web of Science, Google Scholar, SCOPUS, OVID, ProQuest, Springer, and Wiley. Data was collected with keywords related to the research topic (“Women's health” OR “Geriatric health”) AND (“Health literacy” OR “Disaster health literacy” OR “Disaster prevention literacy” OR “Risk knowledge” OR “Knowledge management”) AND (“Disasters” OR “Risk” OR “Crises”) in combination with the Boolean-operators OR and AND. We reviewed full text English-language articles published November 2011 November 2017. Additional references were identified from reference lists in targeted publications, review articles and books. This review demonstrated that disaster health literacy is critical for elderly women, because they may suffer from physical and psychological problems triggered by developmental crises such as menopause and situational crises such as disasters. Disaster literacy could enable them to improve resiliency and reduce disaster risk. Education has vital role in health promotion of middle-age women. Policymakers and health managers should be aware of the challenges of elderly women as a vulnerable group in disasters and develop plans to incorporate disaster health literacy for preparedness and prevention in educating this group.
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Affiliation(s)
- Bahar Seifi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.,Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Ghader Ghanizadeh
- Department of Environmental Health Engineering, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hesam Seyedin
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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31
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Choi SK, Rose ID, Friedman DB. How Is Literacy Being Defined and Measured in Dementia Research? A Scoping Review. Gerontol Geriatr Med 2018; 4:2333721418812246. [PMID: 30505890 PMCID: PMC6256312 DOI: 10.1177/2333721418812246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 10/14/2018] [Accepted: 10/18/2018] [Indexed: 01/22/2023] Open
Abstract
Literacy plays an important role in Alzheimer's disease and related dementias (ADRD); however, less is known about how literacy is being used and defined in ADRD studies. This study reviewed terminology being used to describe types and definitions of literacy and instruments used to assess literacy in ADRD research. Among the 219 studies retrieved from 3 databases, 50 met our inclusion criteria. Literacy terms used in ADRD studies varied: literacy (n = 28), health literacy (n = 9), and dementia literacy (n = 7) were the most often used terms, followed by financial literacy (n = 4), dementia knowledge (n = 3), AD knowledge (n = 2), mental health literacy (n = 2), AD literacy, digital literacy, health literacy about incontinence, and financial knowledge (n = 1 each). Thirty studies did not define literacy terms used. Among the 20 studies defining literacy, definitions were inconsistent across studies even when they used the same term. Surveys (n = 30), open-ended questions, vignettes, or focus groups (n = 10), self-perceived (n = 3) or interviewer assessed (n = 1) literacy levels were used to assess literacy. Ten studies did not specify literacy measurement. Various literacies have been examined in ADRD research with unclear definitions and some inadequate measures. Well-defined terms with valid measures are needed to better understand the role of literacies in ADRD research.
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Affiliation(s)
| | - India D Rose
- Health Research Informatics and Technology Division, Atlanta, GA, USA
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32
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Piltch-Loeb R, Merdjanoff AA, Abramson DM. How the US Population Engaged with and Prioritized Sources of Information about the Emerging Zika Virus in 2016. Health Secur 2018; 16:165-177. [PMID: 29927341 DOI: 10.1089/hs.2017.0107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Emerging disease threats like Zika pose a risk to naïve populations. In comparison to chronic diseases, there is scientific uncertainty surrounding emerging diseases because of the lack of medical and public health information available as the threat emerges. Further complicating this are the multiple, diverse channels through which people get information. This article used bivariate and multivariate analysis to first describe the breadth of information sources individuals accessed about the Zika virus, and then describe individuals' primary sources of information for Zika using a nationally representative pooled cross-sectional data set collected at 3 time points in 2016 (N = 3,698). The analysis also highlights how 3 subgroups-high-education, high-income adults; Hispanic women of childbearing age; and retirees over the age of 65 with less than a high school education-varied in their use of information. Results suggest individuals accessed multiple sources, but TV and radio were the primary sources of Zika information for the public, followed by print news. Demographic variation in primary source of information means public health officials should consider alternative channels to reach target groups in an emerging event. Without an understanding of how information has reached people, and who individuals engaged with regarding that information, public health practitioners are missing a key piece of the puzzle to improving public health campaigns during a future event like Zika. This analysis aims to inform the public health community about the message channels the US population uses during an emerging disease event and the most prevalent channels for different demographic groups, who can be targeted with particular messaging.
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Mature or Emerging? The Impact of Treatment-Related Internet Health Information Seeking on Patients' Trust in Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091855. [PMID: 30154309 PMCID: PMC6165357 DOI: 10.3390/ijerph15091855] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 11/26/2022]
Abstract
Years of clinical trials have proven the maturity and safety of certain treatments, however, some of these mature treatments may not be highly effective. Several treatments have emerged through technological innovations, but their long-term safety, efficacy, and adverse effects remain unknown. At present, many patients seek information related to their treatments on the Internet, which may impact their attitudes towards different treatments and their trust in physicians. In this study, a research model was developed to examine how patients’ trust in their physicians is influenced by related online information on mature or emerging treatments. The hypotheses were tested using confirmatory factor analysis (CFA) and structural equation modelling (SEM). A total of 336 valid responses were collected through an online survey. Mature treatments related health information was found to significantly improve patients’ trust. Thus, physicians should pay more attention to mature treatments, and encourage their patients to seek related information online. Moreover, the quality of online information should be developed further to increase patients’ satisfaction. Physicians should also consider their patients’ psychological safety in communication with patients to strengthen their trust.
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34
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Roberts MC, Taber JM, Klein WM. Engagement with Genetic Information and Uptake of Genetic Testing: the Role of Trust and Personal Cancer History. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:893-900. [PMID: 28105554 DOI: 10.1007/s13187-016-1160-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We used national survey data to (1) determine the extent to which individuals trust the sources from which they are most likely to receive information about cancer-related genetic tests (BRCA1/2, Lynch syndrome), (2) examine how level of trust for sources of genetic information might be related to cancer-related genetic testing uptake, and (3) determine whether key factors, such as cancer history and numeracy, moderate the latter association. We used cross-sectional data from the Health Information National Trends Survey. Our study sample included individuals who responded that they had heard or read about genetic tests (n = 1117). All analyses accounted for complex survey design. Although respondents trusted information from health professionals the most, they were significantly less likely to report hearing about genetic testing from such professionals than via television (p < 0.01). Regardless of source, higher levels of trust in the information source from which participants heard about genetic tests were associated with increased odds of genetic testing uptake, particularly among those with a personal cancer history. Numeracy was not associated with genetic testing uptake. Because health professionals were among the most trusted health information sources, they may serve as important brokers of genetic testing information for those with a personal cancer history.
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Affiliation(s)
- Megan C Roberts
- The National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
| | - Jennifer M Taber
- The National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - William M Klein
- The National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
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35
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Wu B. Patient Continued Use of Online Health Care Communities: Web Mining of Patient-Doctor Communication. J Med Internet Res 2018; 20:e126. [PMID: 29661747 PMCID: PMC5928330 DOI: 10.2196/jmir.9127] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 12/15/2017] [Accepted: 02/01/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND In practice, online health communities have passed the adoption stage and reached the diffusion phase of development. In this phase, patients equipped with knowledge regarding the issues involved in health care are capable of switching between different communities to maximize their online health community activities. Online health communities employ doctors to answer patient questions, and high quality online health communities are more likely to be acknowledged by patients. Therefore, the factors that motivate patients to maintain ongoing relationships with online health communities must be addressed. However, this has received limited scholarly attention. OBJECTIVE The purpose of this study was to identify the factors that drive patients to continue their use of online health communities where doctor-patient communication occurs. This was achieved by integrating the information system success model with online health community features. METHODS A Web spider was used to download and extract data from one of the most authoritative Chinese online health communities in which communication occurs between doctors and patients. The time span analyzed in this study was from January 2017 to March 2017. A sample of 469 valid anonymous patients with 9667 posts was obtained (the equivalent of 469 respondents in survey research). A combination of Web mining and structural equation modeling was then conducted to test the research hypotheses. RESULTS The results show that the research framework for integrating the information system success model and online health community features contributes to our understanding of the factors that drive patients' relationships with online health communities. The primary findings are as follows: (1) perceived usefulness is found to be significantly determined by three exogenous variables (ie, social support, information quality, and service quality; R2=0.88). These variables explain 87.6% of the variance in perceived usefulness of online health communities; (2) similarly, patient satisfaction was found to be significantly determined by the three variables listed above (R2=0.69). These variables explain 69.3% of the variance seen in patient satisfaction; (3) continuance use (dependent variable) is significantly influenced by perceived usefulness and patient satisfaction (R2=0.93). That is, the combined effects of perceived usefulness and patient satisfaction explain 93.4% of the variance seen in continuance use; and (4) unexpectedly, individual literacy had no influence on perceived usefulness and satisfaction of patients using online health communities. CONCLUSIONS First, this study contributes to the existing literature on the continuance use of online health communities using an empirical approach. Second, an appropriate metric was developed to assess constructs related to the proposed research model. Additionally, a Web spider enabled us to acquire objective data relatively easily and frequently, thereby overcoming a major limitation of survey techniques.
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Affiliation(s)
- Bing Wu
- School of Economics and Management, Tongji University, Shanghai, China
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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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Schulz PJ, Fitzpatrick MA, Hess A, Sudbury-Riley L, Hartung U. Effects of eHealth Literacy on General Practitioner Consultations: A Mediation Analysis. J Med Internet Res 2017; 19:e166. [PMID: 28512081 PMCID: PMC5449647 DOI: 10.2196/jmir.6317] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 12/06/2016] [Accepted: 03/15/2017] [Indexed: 11/28/2022] Open
Abstract
Background Most evidence (not all) points in the direction that individuals with a higher level of health literacy will less frequently utilize the health care system than individuals with lower levels of health literacy. The underlying reasons of this effect are largely unclear, though people’s ability to seek health information independently at the time of wide availability of such information on the Internet has been cited in this context. Objective We propose and test two potential mediators of the negative effect of eHealth literacy on health care utilization: (1) health information seeking and (2) gain in empowerment by information seeking. Methods Data were collected in New Zealand, the United Kingdom, and the United States using a Web-based survey administered by a company specialized on providing online panels. Combined, the three samples resulted in a total of 996 baby boomers born between 1946 and 1965 who had used the Internet to search for and share health information in the previous 6 months. Measured variables include eHealth literacy, Internet health information seeking, the self-perceived gain in empowerment by that information, and the number of consultations with one’s general practitioner (GP). Path analysis was employed for data analysis. Results We found a bundle of indirect effect paths showing a positive relationship between health literacy and health care utilization: via health information seeking (Path 1), via gain in empowerment (Path 2), and via both (Path 3). In addition to the emergence of these indirect effects, the direct effect of health literacy on health care utilization disappeared. Conclusions The indirect paths from health literacy via information seeking and empowerment to GP consultations can be interpreted as a dynamic process and an expression of the ability to find, process, and understand relevant information when that is necessary.
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Affiliation(s)
- Peter Johannes Schulz
- Institute of Communication and Health, Faculty of Communication Science, Università della Svizzera italiana, Lugano, Switzerland
| | | | - Alexandra Hess
- School of Communication, Journalism and Marketing, Massey University, Auckland, New Zealand
| | | | - Uwe Hartung
- Institute of Communication and Health, Faculty of Communication Science, Università della Svizzera italiana, Lugano, Switzerland
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Hayat TZ, Brainin E, Neter E. With Some Help From My Network: Supplementing eHealth Literacy With Social Ties. J Med Internet Res 2017; 19:e98. [PMID: 28360024 PMCID: PMC5391437 DOI: 10.2196/jmir.6472] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 12/07/2016] [Accepted: 02/28/2017] [Indexed: 01/10/2023] Open
Abstract
Background eHealth literacy is defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem. Previous research has shown high reliance on both online and face-to-face interpersonal sources when sharing and receiving health information. Objective In this paper, we examine these interpersonal sources and their interplay with respondents’ eHealth literacy and perceived health outcomes. Specifically, we look at how the relationship between eHealth literacy and health outcomes is moderated by (1) finding help while performing online activities, (2) finding others with similar health concerns online, and (3) the importance of finding others with similar health concerns for people from ethnic minorities, specifically Palestinian citizens of Israel versus Israeli Jews. Methods We used a nationally representative random-digit dial telephone household survey of an Israeli adult population (age ≥21 years, N=819). The collected data were analyzed using two regression models. The first examined how the correlation between eHealth literacy and perceived outcomes was moderated by the availability of help. The second examined how the correlation between eHealth literacy and perceived outcomes was moderated by finding others with similar health concerns and by ethnicity. Results Respondents with low eHealth literacy who were able to recruit help when performing online activities demonstrated higher perceived health outcomes compared to similar respondents who did not find help. Respondents with low eHealth literacy, who were able to find others with similar health concerns (online), demonstrated higher perceived health outcomes when compared to similar respondents who did not find others with similar health concerns. Finally, finding similar others online was more helpful in enhancing health outcomes for ethnic minorities; Palestinian citizens of Israel gained more health benefits by finding similar others compared to Israeli Jews. Conclusions Although the availability of help and the notion of ethnicity have been discussed extensively within the context of social capital and health, our findings offer initial evidence for the relevancy of these concepts when studying individuals’ eHealth literacy. Specifically, our findings enable a better understanding of the role of social ties and ethnicity in moderating the interplay between eHealth literacy and perceived health outcomes. Given the increased importance of eHealth information, our findings enhance understanding of how social ties can potentially compensate for low eHealth literacy.
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Sudbury-Riley L, FitzPatrick M, Schulz PJ. Exploring the Measurement Properties of the eHealth Literacy Scale (eHEALS) Among Baby Boomers: A Multinational Test of Measurement Invariance. J Med Internet Res 2017; 19:e53. [PMID: 28242590 PMCID: PMC5348620 DOI: 10.2196/jmir.5998] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 10/23/2016] [Accepted: 01/30/2017] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. OBJECTIVE The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. METHODS Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. RESULTS We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). CONCLUSIONS To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and random samples drawn from an increasingly important cohort. The results give increased confidence to researchers using the scale in a range of eHealth assessment applications from primary care to health promotions.
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Affiliation(s)
| | - Mary FitzPatrick
- Waikato Management School, University of Waikato, Hamilton, New Zealand
| | - Peter J Schulz
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Lugano, Switzerland
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Jeong SH, Kim HK. Health literacy and barriers to health information seeking: A nationwide survey in South Korea. PATIENT EDUCATION AND COUNSELING 2016; 99:1880-1887. [PMID: 27373962 DOI: 10.1016/j.pec.2016.06.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/22/2016] [Accepted: 06/16/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To identify the level of health literacy and barriers to information seeking and to explore the predictors of health literacy. METHODS A cross-sectional descriptive design was used. A total of 1000 Korean adults were recruited through proportional quota sampling. Health literacy, barriers to health information seeking, sociodemographics, and health-related characteristics were surveyed. Descriptive statistics and binary logistic regression were performed for data analysis. RESULTS About 61% of participants were classified as inadequately health literate. "No health fairs/activities near home" was the most frequently reported barrier. Older age, lower education, living in the capital city, barriers regarding how to get information and access to expensive books and magazines were predictors of inadequate health literacy. CONCLUSION Strategies for improving health literacy and reducing barriers to health information seeking should be designed. Education on how to access health-related information with easily accessible sources either free or inexpensive could be a way to help adults with limited health literacy. PRACTICE IMPLICATIONS Health care professionals should assess clients' health literacy levels, particularly amongst those who are older or have less education. They should provide clients with information on how to access credible and readily available sources of health-related information, considering their health literacy level.
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Affiliation(s)
- Seok Hee Jeong
- College of Nursing, Chonbuk Research Institute of Nursing Science, Chonbuk National University, Jeonju-si, Republic of Korea.
| | - Hyun Kyung Kim
- College of Nursing, Chonbuk Research Institute of Nursing Science, Chonbuk National University, Jeonju-si, Republic of Korea.
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