E-Health literacy of medical and health sciences university students in Mashhad, Iran in 2016: a pilot study

Validation of the extended e-health literacy scale: structural validity, construct validity and measurement invariance

BACKGROUND

Given the rapid proliferation and use of online health resources, many of which may be of dubious quality, there is an increasing need to develop electronic health literacy (e-health literacy) skills among the population of internet users. E-health literacy encompasses the skills and abilities needed to access, understand, validate, evaluate, interpret, and apply online health-related information. Measuring e-health literacy has become crucial for developing targeted interventions, assessing their impact, and producing high-quality research findings that can inform health policy and clinical practice, which can lead to improved health outcomes and potentially reducing health inequalities. The scales need to be valid and reliable so that decisions are based on high-quality data. In this regard, the issue of the measurement invariance of scales across different demographic groups has been neglected. This is critical, as assessments should be valid across different sociodemographic groups to avoid bias when comparing them. The aim of this study was to validate the Extended e-health literacy scale (eHEALS-E) on general population and investigate its structural validity and internal consistency, construct validity in terms of convergent and discriminant validity, and examine its measurement invariance across gender, age, education and social status.

METHODS

The data were collected as a part of a national health literacy survey conducted by the Slovenian National Institute of Public Health. For this survey the initial eHEALS-E scale was revised in order to address its limitations and applicability to general population. Based on a nationally representative sample, the final sample for the analysis comprised 1,944 individuals who at least occasionally used one of the various internet services to obtain health-related information. Multiple group confirmatory factor analysis was used to examine the measurement invariance of the scale.

RESULTS

With some adjustments, the measurement model of the revised 6-dimensional eHEALS-E scale demonstrated a good fit to the data (χ2 = 2508, df = 282, RMSEA = 0.064, SRMR = 0.070, CFI = 0.90). The scale had good internal consistency (alpha = 0.89). Although evidence of the scale's convergent and discriminant validity was partially provided, the analysis revealed robust measurement invariance across sociodemographic groups.

CONCLUSIONS

With a minor limitation, the scale ensures an unbiased e-health literacy assessment across different social groups, which is crucial for interventions that aim to reduce health-related social inequalities. This ensures that the interventions derived from the assessment of reality are equally valid and effective for everyone, regardless of their sociodemographic background.

Associations Between Sociodemographic Characteristics, eHealth Literacy, and Health-Promoting Lifestyle Among University Students in Taipei: Cross-Sectional Validation Study of the Chinese Version of the eHealth Literacy Scale

BACKGROUND

The popularization of the internet and rapid development of mobile devices have led to an increased inclination and opportunities to obtain health-related information online. The eHealth Literacy Scale (eHEALS), widely used for measuring eHealth literacy, assesses an individual's ability to search, understand, appraise, and use eHealth information. However, the Chinese version of the eHEALS multiple-factor model remains to be validated, and the correlation between eHEALS and the health-promoting lifestyle profile (HPLP) among university students is rarely explored in Taiwan.

OBJECTIVE

This study aimed to examine the fit, validity, and reliability of the Chinese eHEALS multiple-factor model and to clarify the predictive effects of eHEALS on the HPLP among university students.

METHODS

University students in Taipei, the capital of Taiwan, were recruited, and 406 valid questionnaires including sociodemographic characteristics, eHEALS, and HPLP responses were collected. Confirmatory factor analysis was performed to validate the Chinese eHEALS. Independent sample t test, 1-way ANOVA, and multiple linear regression analyses were conducted to examine the relationship between sociodemographic variables and the HPLP. Pearson product-moment correlation and binary logistic regression analyses were performed to ascertain the predictive effects of eHEALS on the HPLP.

RESULTS

The Chinese eHEALS exhibited an optimal fit when delineated into the search, usage, and evaluation 3-factor model (comparative fit index=0.991, Tucker-Lewis index=0.984, root mean square error of approximation=0.062), and its validity and reliability were confirmed. The mean eHEALS score of university students was 3.17/4.00 (SD 0.48) points, and the score for the evaluation subscale was the lowest (mean 3.08, SD 0.56 points). Furthermore, there were significant sex, institution orientation, daily reading time, daily screen time, primary information channel, and perceived health status differences in the HPLP: male participants (t404=2.346, P=.02), participants attending general university (t404=2.564, P=.01), those reading ≥1 hour daily (F2,403=17.618, P<.001), those spending <3 hours on mobile devices or computers daily (F2,403=7.148, P<.001), those acquiring information from others (t404=3.892, P<.001), and those with a good perceived health status (F2,403=24.366, P<.001) had a significantly higher score. After adjusting for sociodemographic variables, the eHEALS score remained an independent predictor of the HPLP. Compared to students with relatively high eHEALS scores, those with relatively low eHEALS scores had a 3.37 times risk of a negative HPLP (adjusted odds ratio [OR]=3.37, 95% CI 1.49-7.61), which could explain 14.7%-24.4% of the variance (Cox-Snell R2=0.147, Nagelkerke R2=0.244, P=.004).

CONCLUSIONS

There is room for improvement in eHealth literacy among university students in Taipei. eHEALS may be used to screen students who require HPLP improvement, thereby providing appropriate eHealth literacy training programs, particularly those targeting evaluation literacy. Additionally, the 3-factor model of the Chinese eHEALS used in this study results in more definite scale content, thus increasing the practicality and applicability of this scale in health-promoting studies.

Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review

BACKGROUND

Health literacy (HL) is the ability to make informed decisions using health information. As health data and information availability increase due to online clinic notes and patient portals, it is important to understand how HL relates to social determinants of health (SDoH) and the place of informatics in mitigating disparities.

OBJECTIVE

This systematic literature review aims to examine the role of HL in interactions with SDoH and to identify feasible HL-based interventions that address low patient understanding of health information to improve clinic note-sharing efficacy.

METHODS

The review examined 2 databases, Scopus and PubMed, for English-language articles relating to HL and SDoH. We conducted a quantitative analysis of study characteristics and qualitative synthesis to determine the roles of HL and interventions.

RESULTS

The results (n=43) were analyzed quantitatively and qualitatively for study characteristics, the role of HL, and interventions. Most articles (n=23) noted that HL was a result of SDoH, but other articles noted that it could also be a mediator for SdoH (n=6) or a modifiable SdoH (n=14) itself.

CONCLUSIONS

The multivariable nature of HL indicates that it could form the basis for many interventions to combat low patient understandability, including 4 interventions using informatics-based solutions. HL is a crucial, multidimensional skill in supporting patient understanding of health materials. Designing interventions aimed at improving HL or addressing poor HL in patients can help increase comprehension of health information, including the information contained in clinic notes shared with patients.

Perceived and performed electronic health literacy of medical sciences students

BACKGROUND

Evidence indicates that perceived skills for searching the Internet for health information may differ from actual skills in searching, finding, and appraising health information.

OBJECTIVES

This study investigated the perceived and performed eHealth literacy of medical sciences students, as well as the relationships between those literacies.

METHODS

This study enrolled 228 medical sciences students (convenience sample) in Iran. The study tools include the eHEALS literacy scale for the perceived eHealth literacy and a questionnaire designed by the authors to assess performed eHealth literacy (skills around access, understanding, appraising, applying, and generating information). Data were analysed using descriptive statistics and the Pearson correlation coefficient.

RESULTS

In general, over 70% of students perceived their skills of access and appraisal as good/very good, correlating with their estimated performance. Students perceived they were less confident in some appraisal skills (e.g., using information from the Internet to make health decisions) than others. Performed skills in information generation were mostly poor or very good; performed application skills generally good/very good.

CONCLUSIONS

The eHEALS score scales with actual skills (access and appraisal). Support is necessary for students in particular types of appraisal skills.

Factors associated with the perceptions of eHealth technology of Chinese nurses and nursing students

AIM

The current study sought to assess the perceptions of eHealth technology of nurses and nursing students in China and to examine the association between these perceptions and demographic factors.

BACKGROUND

Despite the increasing use of eHealth technologies in China and across the globe, the perceptions of practicing and student nurses remain minimally explored. Findings from such an inquiry can potentially inform actions and policies to improve the uptake of eHealth technologies among Chinese nurses.

DESIGN

This was a cross-sectional study with a real-time online survey.

METHODS

A convenience sample of 1338 nurses and nursing students from Mainland China participated in the study. Their perceptions of eHealth technology were collected using the Chinese version of the Perceptions of eHealth Technology Scale. The Kruskal-Wallis test and multiple linear regression analysis were used to examine the relationship between demographic variables (age group, gender, occupation, education level, position and clinical experience) and perceptions of eHealth technology. All study procedures adhered to the STROBE guidelines.

RESULTS

Most participants were aged between 20 and 29 (55.8%). Nearly half (42.5%) were frontline clinical nursing staff, some were nursing students (36.2%), academic nursing staff (12.3%) and clinical nursing management staff (9.0%). Regardless of the differences in their demographic characteristics, the participants had higher mean scores in "Perception of eHealth applications" and lower mean scores in "Knowledge of eHealth technology". Participants with doctoral degree had a higher mean total score and higher sub-scale scores in knowledge of eHealth technology, perception of the advantages of eHealth technology and perception of eHealth applications; and the lowest scores in perception of the disadvantages of eHealth technology and perception of eHealth applications. Occupation, position and clinical experience were found to be the demographic characteristics associated with eHealth perceptions, before adjusting for age and gender. Education level was associated with eHealth perceptions regardless of adjustment.

CONCLUSION

Overall, participants had higher scores on perceptions of eHealth applications but lower scores on knowledge of eHealth technology. Considering the association between education and all subscales and overall scores, it may be essential to implement continuing professional education for nurses to improve their knowledge of eHealth applications. Encouragement to use available eHealth digital technologies may also be helpful to improve perceptions of eHealth.

eHealth literacy, internet use and health-related behaviour among health sciences students: a cross sectional study

BACKGROUND

Health sciences students should have the necessary skills required to find health information from online resources.

OBJECTIVE

To assess the eHealth Literacy Scale (eHEALS) and its association with internet use for health-related purposes, self-perceived health and health-related behaviour.

METHODS

A cross-sectional study was conducted in a sample of 528 health sciences students. Sociodemographic data, questions related to internet use for health-related purposes, self-perceived health and health-related behaviour, and the eHEALS tool were collected.

RESULTS

The overall mean eHEALS score was 3.19 ± 0.78. Students who consider access to health resources on the internet to be very important had the highest eHEALS scores (p = 0.015). There were significant differences between the participants' perceptions of the usefulness of the internet with regard to making health decisions (p < 0.001), the accuracy of information on the internet (p = 0.001) and the eHEALS scores.

CONCLUSIONS

Health sciences students have a moderate level of eHealth literacy. Positive attitude towards internet use and positive self-perception of health are the most relevant factors associated with eHealth literacy.

IMPACT STATEMENT

As future healthcare providers, students need to develop eHealth literacy skills in order to find reliable health information. A positive attitude towards internet use and a positive self-perception of health are factors associated with eHealth literacy. Educators should promote training programmes that ensure students are acquiring suitable skills in eHealth literacy.

COMPETENCIES AND SKILLS NEEDED IN THE MANAGEMENT OF CHRONIC PATIENTS' NEEDS THROUGH TELECARE

OBJECTIVE

Aim: To identify the necessary competencies that future professionals must obtain in order to effectively manage patients with chronic conditions. We employed a multilayer review in PubMed, Scopus and Cochrane.

PATIENTS AND METHODS

Materials and Methods: We applied three searches in PubMed, Scopus, and Cochrane using various terms in order to identify the necessary skills and competences needed for healthcare professionals to provide distance care in patients with chronic conditions. From the initial search, a total of 1008 studies were identified while 54 met the inclusion criteria and were retained for data extraction. After the review of the 54 studies, we grouped the proposed skills and competencies in eight major categories. Those groups were Clinical Knowledge, Critical Thinking Skills, Technological Skills, Clinical skills, Communication skills, Implementation skills, Professionalism and professional ethics, Evidence based Practice.

CONCLUSION

Conclusions: Although telehealth is gaining ground in healthcare practice and healthcare professionals possess the necessary knowledge and skills to provide safe, effective, and personalized care, additional specialized training is nevertheless required to provide telecare. Therefore, the integration of telehealth into various healthcare professions curricula - both at undergraduate and postgraduate levels - is required for the development of education and the dynamic development of healthcare.

The influence of eHealth literacy, reproductive health knowledge, and self-esteem on health-promoting behaviors in early adult women: a cross-sectional survey

PURPOSE

The purpose of this study was to investigate the influence of eHealth literacy, reproductivehealth knowledge, and self-esteem on early adult women's health-promoting behaviors (HPB). Thisstudy was based on Pender's health promotion model as a theoretical underpinning.

METHODS

Early adult women aged 18 to 35 years (n=165) were recruited by posting advertisements on social network sites for a student club and a faith-based community in Ansan, Korea. Willing individuals were invited to participate in the online survey from June 1 to June 30, 2022. Standardized instruments were used to measure HPB, eHealth literacy, reproductive health knowledge,and self-esteem. General characteristics included income level, perceived subjective health, and internet usage time. The collected data were analyzed using the independent t-test, one-way analysisof variance, Pearson correlation coefficients, and multiple regression.

RESULTS

The mean age of the respondents was 21.97±3.87 years. The total HPB score was 120.69,corresponding to a moderate level; and the total scores for eHealth literacy (30.24), knowledge ofreproductive health (23.04), and self-esteem (35.62) were higher than the midpoint. The model explained 53.3% of variance in HPB, and self-esteem (β=.48, p&lt;.001) was the most influential factor.Other influential factors were, in descending order, higher economic level, higher subjective healthstatus, greater eHealth literacy, and less internet use time (&lt;2 hours/day).

CONCLUSION

In order to promote the health of early adult women, counseling or programs that positively improve self-esteem appear promising, and eHealth literacy should be considered as a way topromote HPB using information technology.

The association and intervention effect between eHealth literacy and lifestyle behaviors among Chinese university students

OBJECTIVE

Our aim was to evaluate the association between eHealth literacy and lifestyle behaviors to intervene among Chinese university students.

METHOD

The Chinese eHealth Literacy Scale (C-eHEALS) questionnaire was used to investigate the eHealth literacy level and association with lifestyle behaviors among Chinese university students. Independent sample t-test and Pearson's correlation coefficient were used by statistical software SPSS v20.

RESULTS

In the first round, 5,151 university students participated in the study, including 71.46% female and 28.54% male, aged 18-22 (93.13%).The average eHealth literacy score was 26.81 ± 5.83. Four lifestyle behaviors (e.g., exercise, smoking, drinking and sleeping) were all significantly correlated with eHealth literacy scores and demonstrated significant differences. In the second investigation (N = 2,939), the average eHealth literacy score was 31.64 ± 6.44, a notable improvement compared with the first investigation.

CONCLUSION

Those in the group with high eHealth literacy scores have a healthier lifestyle than those in the low-score group. Training in eHealth-related resources is a positive measure to improve university students' eHealth literacy.

The associations among cognitive social factors, eHealth literacy and health-promoting behaviors in Chinese adolescents

The internet is a critical source of health information. It is important to understand online health information seeking related factors among college students, as modifications in this have the potentials to enhance their health-promoting behaviors in their transition into early adulthood. This study assessed the associations among cognitive social factors, eHealth literacy, online health information seeking and health-promoting behaviors; and examined the potential mediation effect of online health information seeking and eHealth literacy on the association between cognitive social factors and health-promoting behaviors. A cross-sectional, Internet-based survey was conducted in a sample of Chinese college students (n = 289) during April to June 2018. The structural model fitted the data well: X2/df = 2.27; CFI = 0.95; TLI = 0.94; RMSEA = 0.07 (95% CI: 0.06, 0.08); SRMR = 0.07 and the results showed that performance expectancy and health motivation were significantly and positively associated with health-promoting behaviors indirectly through eHealth literacy, adjusting for other cognitive social factors, frequency of online health information seeking and background factors. eHealth literacy is a strong mediator of the association between cognitive social factors (performance expectancy and health motivation) and health-promoting behaviors. Implications and potential interventions to promote eHealth literacy and health-promoting behaviors are discussed.

eHealth Literacy of Australian Undergraduate Health Profession Students: A Descriptive Study

Rapid growth in digital health technologies has increased demand for eHealth literacy of all stakeholders within health and social care environments. The digital future of health care services requires the next generation of health professionals to be well-prepared to confidently provide high-quality and safe health care. The aim of this study was to explore the eHealth literacy of undergraduate health profession students to inform undergraduate curriculum development to promote work-readiness. A cross-sectional survey was undertaken at an Australian university using the seven-domain eHealth Literacy Questionnaire (eHLQ), with 610 students participating. A one-way Multivariate Analysis of Variance (MANOVA) with follow-up univariate analysis (ANOVA) was used to determine if there were differences in eHLQ scores across 11 sociodemographic variables. Students generally had good knowledge of health (Scale 2); however, they had concerns over the security of online health data (Scale 4). There were also significant differences in age and ownership of digital devices. Students who were younger reported higher scores across all seven eHLQ scales than older students. This research provided an understanding of eHealth literacy of health profession students and revealed sub-groups that have lower eHealth literacy, suggesting that digital health skills should be integrated into university curriculums, especially related to practice-based digital applications with special focus to address privacy and security concerns. Preparation of health profession students so they can efficiently address their own needs, and the needs of others, is recommended to minimise the digital divide within health and social care environments.

Modifiable predictors of health literacy in working-age adults - a rapid review and meta-analysis

Background

Health literacy comprises the ability to identify, obtain, interpret and act upon health information. Low health literacy is a major risk factor for hospitalizations, use of emergency care and premature mortality among others. Known risk factors for low health literacy such as lower educational attainment, migration history and chronic illnesses overlap with those for long-term unemployment – in itself a risk factor for low health literacy. These factors are difficult to address in interventions to support health literacy. Therefore, the objective of this review is to identify potentially modifiable predictors of HL in populations potentially affected by long-term unemployment.

Methods

A rapid review (PROSPERO registration number: 290873) was carried out in Pubmed and SCOPUS including quantitative studies on potentially modifiable predictors of health literacy in working-age populations following PRISMA guidelines for systematic reviews. Where possible, reported effect sizes were transformed into r, and random-effects meta-analyses were conducted where appropriate to pool effect sizes for the association between modifiable predictors and health literacy.

Results

In total, 4765 titles and abstracts were screened, 114 articles were assessed in full-text screening, and 54 were included in the review. Forty-one effect sizes were considered for 9 different meta-analyses. Higher language proficiency, higher frequency of internet use, using the internet as a source of health information more often, being more physically active, more oral health behaviours, watching more health-related TV and a good health status were significantly associated with higher health literacy. Significant heterogeneity suggests between-study differences.

Conclusions

Improving language proficiency and/or providing information in multiple and simplified languages, together with reliable and accessible health information on the internet and in linear media are potentially promising targets to improve health literacy levels in working-age populations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13851-0.

eHealth Literacy and its Associated Factors Among Health Professionals During the COVID-19 Pandemic in Resource-Limited Settings: Cross-sectional Study

Background

The COVID-19 pandemic has wreaked havoc on health care systems and governments worldwide. Although eHealth literacy is acknowledged as a critical component of public health, it was overlooked during the pandemic. To assist patients and their families, health professionals should be knowledgeable about online health information resources and capable of evaluating relevant online information. In a resource-constrained situation, the level of eHealth literacy among health professionals is not well documented.

Objective

The aim of this study was to assess the eHealth literacy level and its associated factors among health professionals working in Amhara regional state teaching hospitals, Ethiopia.

Methods

A self-administered questionnaire was used in an institutional-based cross-sectional study design. Descriptive statistics were calculated to describe eHealth literacy statements and key variables using SPSS v.24. Bivariable and multivariable logistic regression models were fit to identify factors related to eHealth literacy. Variables with P<.05 were declared to be statistically significant predictors.

Results

A total of 383 participants completed and returned the questionnaire with a response rate of 90.5%. Health professionals demonstrated a moderate level of eHealth literacy (mean 29.21). Most of the professionals were aware of the available health resources located on the internet, and know how to search and locate these resources. However, they lack the ability to distinguish high-quality health resources from low-quality resources. Factors that were significantly associated with eHealth literacy were computer access, computer knowledge, perceived ease of use, and perceived usefulness of eHealth information resources.

Conclusions

It is crucial to provide training and support to health care workers on how to find, interpret, and, most importantly, evaluate the quality of health information found on the internet to improve their eHealth literacy level. Further research is needed to explore the role of eHealth literacy in mitigating pandemics in developing countries.

Approaches to Improvement of Digital Health Literacy (eHL) in the Context of Person-Centered Care

The skills, knowledge and resources to search for, find, understand, evaluate and apply health information is defined as health literacy (HL). If individuals want to use health information from the Internet, they need Digital Health Literacy (eHL), which in addition to HL also includes, for example, media literacy. If information cannot be found or understood by patients due to low (e)HL, patients will not have the opportunity to make informed decisions. In addition, many health apps for self-management or prevention also require (e)HL. Thus, it follows that active participation in healthcare, in terms of Person-Centered Care (PCC) is only possible through (e)HL. Currently, there is a great need to strengthen these competencies in society to achieve increased empowerment of patients and their health. However, at the same time, there is a need to train and improve competencies in the field of healthcare professionals so that they can counsel and guide patients. This article provides an overview with a focus on HL and eHL in healthcare, shows the opportunities to adapt services and describes the possible handling of patients with low (e)HL. In addition, the opportunities for patients and healthcare professionals to improve (e)HL are highlighted.

The relationship between e-health literacy and health-promoting behaviors of Turkish hospital nurses

The increase in information technologies has made it easy to access much health information online. In this context, e-health literacy emerges as a skill for acquiring health information. Obtaining health information through information technology for health promotion requires e-health literacy. The aim of this study was to examine the e-health literacy and the health-promoting behaviors of Turkish hospital nurses directly involved in patient care. This descriptive and cross-sectional study was carried out with 451 nurses working in two large training and research hospitals in Izmir between June and August 2019. Data were collected using the Turkish version of the Healthy Lifestyle Behavior Scale II and the Turkish version of the e-Health Literacy Scale. Descriptive statistics and multiple linear regression analysis were used for data analysis. Nurses were found to have moderate levels of healthy lifestyle behaviors (130.56 ± 21.90) and e-health literacy (29.87 ± 5.39). There was significant relationship between the e-health literacy levels of the nurses and their overall health-promoting behaviors (R = .349; F = 12,381; p = 0.013), health responsibility (R = .326; F = 10,567; p = 0.014), spiritual development (R = .242; F = 5.276; p = 0.001) and interpersonal relations (R = .343; F = 9.896; p = 0.001) scores. The results of this study showed that the development of strategies to improve the e-health literacy of nurses may contribute to the maintenance of health-promoting behaviors of both nurses and their patients.

Evaluating e-health literacy, knowledge, attitude and practice regarding COVID-19 prevention and Self-Protection among Iranian students: a cross-sectional online survey

BACKGROUND

The coronavirus 2019 (COVID-19) pandemic requires integrated intervention by both the governments and individuals. University students have a great role in distributing reliable information about disease prevention behaviors. The aim of this study was to identify the Knowledge, Attitude and Practice of COVID-19 Prevention and Self-Protection behaviors in students.

METHODS

This cross-sectional online survey was conducted on Iranian university students. All students filled a questionnaire consisting of demographic characteristics, e-Health Literacy Scale (EHEALS) questionnaire and a researcher-made knowledge, attitude and practice (KAP) questionnaire. Data was analyzed using the SPSS software.

RESULTS

A total of 925 students (69.9% female) participated in this study. The median age of the students was 23 years old. Majority of students (641, 69.3%) were non-medical students. The median and interquartile range (IQR) for knowledge, attitude, practice and P-EHEALS scores in Medical students were 52.00 (27.00), 4.00 (1.00), 28.00 (8.00), and 26.00 (9.00), respectively which were significantly higher than non-medical students, 28.00 (15.00), 3.00 (2.00), 20.00 (8.00), and 26.00 (9.00), respectively (p < 0.001). Practice score was a significant related to knowledge (p < 0.001), attitude (p < 0.001), having a COVID-19 infected family member (p < 0.001), older age (p < 0.001), medical field of education (p = 0.001), higher EHEALS score (p = 0.018), and female gender (p = 0.013). Knowledge, attitude and having a COVID-19 infected person in family were the strongest predictors of preventive practices.

CONCLUSIONS

KAP and E-Health literacy of university students, especially non-medical students, should be considered in order to improve COVID-19 preventive behaviors in the society.

Exploring the eHealth literacy and mobile health application utilisation amongst Malaysian pharmacy students

Introduction

Pharmacy students should be eHealth literate by being skilful in searching, evaluating and applying online health information. Mobile health applications should be utilised when making clinical decisions to achieve optimal patient care with the ever-changing pharmacy practice. This study aims to explore the eHealth literacy and mobile health application utilisation amongst pharmacy undergraduates.

Methods

A cross-sectional study was conducted from March to April 2021. An online survey, consisting of socio-demographic characteristics, Internet use, eHealth Literacy Scale and mobile health application utilisation, was distributed amongst pharmacy undergraduates in public and private universities in Malaysia. Data analysis included descriptive statistics, one-way analysis of variance test, Mann–Whitney U test and Kruskal–Wallis test

Results

A total of 415 participants completed the survey (response rate    =    82.5%). The median eHealth Literacy Scale score (out of 40) was 31.0    ±    3.0 (interquartile range). More than one-third of participants (34.7%) were found to have low eHealth literacy. Many lacked confidence in making health decisions from online information (42.4%) and skills in distinguishing between high-quality and low-quality health resources (35.2%). Only 70.4% of the participants had mobile health applications installed on their smartphones and/or tablets. Some students felt that they were neither knowledgeable nor skilful enough to utilise mobile health applications (24.8%), whereas 23.9% were unaware of the mobile health applications available.

Conclusion

In summary, the eHealth literacy of Malaysian pharmacy students can be further enhanced by incorporating eHealth literacy-focused programmes into the curriculum. Moreover, pharmacy students’ mobile health application utilisation can be improved through increased awareness and support from universities.

COVID-19 crisis: Influence of eHealth literacy on mental health promotion among Saudi nursing students

Objective

This study aims to determine the influence of eHealth literacy on mental health promotion among Saudi nursing students.

Method

This cross-sectional study was conducted from 19 April to 21 May 2020. A total of 468 nursing students responded to the self-administered online survey. Two instruments, namely, the eHealth Literacy Scale and the Positive Mental Health Scale, were used. Statistical tools such as frequency, percentage, mean, and standard deviation were used for the descriptive analysis. Multiple regression analysis was employed to analyse the relationship between eHealth literacy, health promotion, and its predictors.

Results

The results showed that 30.3% of nursing students were dissatisfied with their general health. Students perceived high self-assessed eHealth literacy and positive mental health. Students in the 4th year had lower scores than those of students in the 2nd year. Nursing students perceived that the quarantine and public social distancing lowered their mental health scores. Finally, the eHealth literacy mean scores resulted in a 0.21-point increase in the positive mental health scores.

Conclusion

The finding of the study shows that the eHealth literacy positively influnce the mental health status of Saudi Nursing students.

Digital Health Literacy About COVID-19 as a Factor Mediating the Association Between the Importance of Online Information Search and Subjective Well-Being Among University Students in Vietnam

Introduction: Digital health literacy (DHL) has recently been proposed as a means of enabling healthy decisions for protective behavior, preventive measures, and adherence with COVID-19 policies and recommendations especially in the era of the “infodemic”. This study aimed to (1) identify COVID-19 related DHL and its association with online information seeking; (2) to elucidate COVID-19 related DHL as a mediator predictor between the importance of online information search and its association with subjective well-being among Vietnamese university students.

Methods: A cross-sectional web-based survey was used to elicit the responses of Vietnamese students over 2 consecutive weeks (from April 25 to May 9, 2020, n = 1,003, 70.1% female students, mean age 21.4 ± 3.1). The online survey questionnaire collected data on the sociodemographic characteristics of participants, DHL about COVID-19, information seeking behavior, and subjective well-being. Mediation analysis was conducted using the importance of searching COVID-19 related information as independent variables, subjective well-being as a dependent variable, and DHL as a mediator variable.

Results: Among 1,003 students, the mean (SD) of DHL related to COVID-19 was 2.87 ± 0.32. In the survey, 87.2% of the students reported sufficient well-being, while almost 13% reported low or very low well-being. The findings also indicated that search engines were the most popular platform for information seeking by Vietnamese students (95.3%) and 92.8% of participants had searched for information related to the current spread of COVID-19. Not searching for hygiene regulation as part of infection control and an average level of information satisfaction were associated with limited DHL (p < 0.05). The importance of online information searching related to COVID-19 increased the subjective well-being of students significantly and limited DHL (p < 0.05). DHL was found to mediate the relationship between the importance of online information searching and the subjective well-being of students.

Conclusion: The finding provides insight into DHL about COVID-19 among university students, and their ability to find, understand, appraise, and use online health related information during lockdown throughout the first COVID-19 pandemic wave. DHL should be highlighted as a mediating factor that enhances the positive effect of the importance of information seeking on psychological well-being. However, further studies are needed to better define the mediating role of DHL across other factors.

Investigation of the effect of cyberchondria behavior on e-health literacy in healthcare workers

This study aims to examine the effects of nurses' and other healthcare workers' perceptions of cyberchondria on e-health literacy. No sample was selected in the research, and a total of 220 people were surveyed. According to the result of the regression analysis, the perception of cyberchondria explains 12.4% of the total variance on e-health literacy. Based on the findings of the research, it can be said that the increase in the perception of the participants about the excessiveness dimension increases the levels of e-health literacy statistically.

Is Electronic Health Literacy Associated with Learning Outcomes among Medical Students in the First Clinical Year?: A Cross-Sectional Study

Medical students tend to use the internet as a primary resource when seeking health information. This study aims to assess the patterns of internet use, eHL level, and learning outcomes with eHL among medical students at Chiang Mai University. A cross-sectional study was conducted among 88 medical students in the first clinical year. The eHL level was determined using the Thai version of the electronic Health Literacy Scale or eHEALS. The patient case report scores were obtained representing the learning outcome. Linear regression was used to identify factors influencing their eHL level and case report scores. Students recognized the importance and usefulness of the internet. The mean eHEALS score was 33.45. There was a lower degree of agreement on questions regarding internet usage, having skills to evaluate the resources, and confidence in using health information to make health decisions. The eHEALS score had no statistically significant association with most variables and case report scores, but with the longer time of internet use (p-value = 0.014). Although medical students perceived that they have high eHL levels, they report lower confidence in using the information. Including critical thinking skills for electronic health information in the medical curriculum could be useful.

A model of digital health communication media use during the Covid-19 pandemic

Purpose

This research aims to develop and test a model of digital health communication media (DHCM) use for healthy food information – DHCM usage – during the Covid-19 pandemic. More specifically, this research investigated the simultaneous effects of perceived threat of Covid-19, e-health literacy, attitude toward DHCM usage, knowledge toward DHCM usage, facilitating conditions and information quality on the DHCM usage.

Design/methodology/approach

The empirical data were collected through a survey. The respondents of the survey are 192 DHCM users who lived in Tangerang Regency. Structural equation modelling (SEM) analysis was performed.

Findings

The DHCM usage during the Covid-19 pandemic is significantly affected by the attitude towards the DHCM usage and the facilitating conditions. However, the DHCM usage during the Covid-19 pandemic is not significantly affected by the perceived threat of Covid-19, e-health literacy, information quality and knowledge of the DHCM usage.

Research limitations/implications

This research was conducted only in Tangerang Regency and employed a purposive sampling technique. Future research should be conducted in other contexts to examine the stability of the research findings.

Practical implications

In order to improve DHCM usage for healthy food information, it is important for building a positive attitude towards DHCM usage and ensuring the availability of the facilitating conditions.

Originality/value

This paper is the first that develops and tests a model of DHCM usage for healthy food information during the Covid-19 pandemic.

Determining the healthy lifestyle behaviors and e-health literacy levels in adolescents

OBJECTIVE

The aim of this study is to determine the healthy lifestyle behaviors and e-health literacy levels of adolescents.

METHOD

A descriptive research design was used in this study. It was conducted with a total of 390 students in the Faculty of Health Sciences. The data were collected using a personal information form, the Healthy Lifestyle Behaviors Scale II and the e-Health Literacy Scale for Adolescents. For data analysis, descriptive analyses, t-test, variance, Kruskal-Wallis, the Mann-Whitney U and Pearson Correlation tests were used. Necessary approvals were obtained to conduct this study.

RESULTS

The present study found that the e-Health Literacy Scale mean score of adolescents was 27.51 and their HLBS-II mean score was 129.01. A positive significant relationship was found between the e-health literacy and healthy lifestyle behavior in adolescents.

CONCLUSION

This study emphasizes the importance of e-health literacy in developing nursing procedures designed to increase the healthy lifestyle behaviors of adolescents.

eHealth Literacy of Medical and Health Science Students and Factors Affecting eHealth Literacy in an Ethiopian University: A Cross-Sectional Study

BACKGROUND

eHealth literacy is individual's ability to look for, understand, and evaluate health information from electronic sources. Integrating eHealth literacy to the health system could help lower health care costs and ensure health equity. Despite its importance, the eHealth literacy level in Ethiopia has not been studied on medical and health science students, who are important parties in the health system. Understanding their level of eHealth literacy augments practice of health care, efficiency in education, and use of eHealth technologies.

OBJECTIVE

This research study aims to determine eHealth literacy level and identify its associated factors among medical and health science students in University of Gondar (UoG).

METHODS

An institution-based cross-sectional study was conducted from March to May 2019 among undergraduate medical and health science students in the UoG. Stratified multistage sampling was used. The eHealth literacy scale was used to measure eHealth literacy. A binary logistic regression model was fitted to measure association between eHealth literacy and the independent variables.

RESULTS

A total of 801 students participated in this study with a 94.6% of response rate. The majority (60%) were male and previously lived-in urban areas (68%). The mean eHealth literacy score was 28.7 and 60% of the participants possessed high eHealth literacy. Using health-specific Web sites (adjusted odds ratio [AOR] = 2.84, 95% confidence interval [CI]: 1.86-4.33), having higher Internet efficacy (AOR = 2.26, 95% CI: 1.56-3.26), perceived usefulness of the Internet (AOR = 3.33, 95% CI: 1.95-5.69), medical app use (AOR = 1.70, 95% CI: 1.13-2.55), being female (AOR = 1.55, 95% CI: 1.08-2.22), and being health informatics student (AOR = 2.02, 95% CI: 1.149-3.148) affect a high eHealth literacy level.

CONCLUSION

The level of eHealth literacy in this study was moderate. Using specific reputable health Web sites, using smartphone medical applications, and Internet efficacy determine eHealth literacy significantly.

The effects of mobile apps on stress, anxiety, and depression: overview of systematic reviews

OBJECTIVES

Despite a large number of mobile apps in the field of mental health, it is difficult to find a useful and reliable one, mainly due to the fact that the effectiveness of many apps has not been assessed scientifically. The present study aimed to assess the effects of mental health apps on managing the symptoms of stress, anxiety, and depression.

METHODS

A comprehensive literature search was conducted in PubMed, Scopus, EMBASE, Cochrane, and Web of Science databases for the papers published from 2000 to 2019. Studies were included if they reviewed articles or mobile apps for their effectiveness in stress, anxiety, and depression. The reviews that had considered mobile apps or web-based mobile applications as an intervention or part of intervention were included, as well.

RESULTS

A total of 4,999 peer-reviewed articles were identified, out of which nine systematic reviews met the inclusion criteria. Seven systematic reviews measured depression outcomes, three measured stress, and five systematic reviews measured anxiety symptoms. The applications that used behavior change strategies, such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Behavioral Activation, reported significant effects on depression, anxiety, and stress.

CONCLUSION

It seems that mental health apps can be promising media for reducing depressive symptoms. This field is an emerging area of mobile health, and further research should be done in future in order to reach conclusive evidence.

Impact of mobile health and medical applications on clinical practice in gastroenterology

Mobile health apps (MHAs) and medical apps (MAs) are becoming increasingly popular as digital interventions in a wide range of health-related applications in almost all sectors of healthcare. The surge in demand for digital medical solutions has been accelerated by the need for new diagnostic and therapeutic methods in the current coronavirus disease 2019 pandemic. This also applies to clinical practice in gastroenterology, which has, in many respects, undergone a recent digital transformation with numerous consequences that will impact patients and health care professionals in the near future. MHAs and MAs are considered to have great potential, especially for chronic diseases, as they can support the self-management of patients in many ways. Despite the great potential associated with the application of MHAs and MAs in gastroenterology and health care in general, there are numerous challenges to be met in the future, including both the ethical and legal aspects of applying this technology. The aim of this article is to provide an overview of the current status of MHA and MA use in the field of gastroenterology, describe the future perspectives in this field and point out some of the challenges that need to be addressed.

The Views of Medical Faculty Students in Turkey Concerning the COVID-19 Pandemic

The aim of this study was to elicit the views of medical faculty students regarding the COVID-19 pandemic. This descriptive study was performed with Ondokuz Mayıs University Medical Faculty students on 24-27 March, 2020. The Medical Faculty currently has 2051 students. A questionnaire was used as a data collection tool. For that purpose, the authors designed a questionnaire specifically for this research via the "Google Forms" web. This consisted of 40 open- and close-ended questions. The questionnaire was completed by 1375 (67.1%) students. Accordingly, 52.4% of medical students reported feeling mentally unwell. Although 50.8% of medical students reported generally/usually obtaining information about COVID-19 through the social media, 82.0% did not trust information/messages arriving through the social media and WhatsApp. We found that 86.7% of students regarded frequent hand washing as the most important means of protection against COVID-19, and 19.3% of students did not regard the COVID-19 pandemic as a severe public health problem for Turkey at that moment. In addition, 61.6% of students stated that a suppression strategy involving tight restrictions need to be applied to being the pandemic under control in Turkey. Use can be made of medical students in the transmission of accurate information during the COVID-19 pandemic. Students can be excellent activists on these subjects in countries in which medical education is suspended. Measures therefore need to be taken concerning the transmission of up to date and accurate information to medical students.

Relationship between electronic health literacy, quality of life, and self-efficacy in Tehran, Iran: A community-based study

BACKGROUND

The concept of electronic health literacy has become a main focus of health-care professionals along with the increasing use of the Internet. In Iran, the Internet not yet has much impact on providing health services, and the physicians' and patients' community are now more willing to use the traditional method for diagnosing disease and prescribing medicines. This study aimed to determine the correlation between electronic health literacy, quality of life (QoL), and self-efficacy among Tehran citizens.

MATERIALS AND METHODS

The present study is a descriptive, cross-sectional study with a correlation approach that was conducted on 400 clients of community health centers of Shahid Beheshti University of Medical Sciences in 2019. Samples were selected by stratified random sampling method. Data were collected using E-Health Literacy Questionnaire (α = 0.88), 12-item Short-Form Health Survey (α = 0.73), and General Self-Efficacy Scale (α = 0.87). Analytic statistics were using by descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation coefficient and regression analysis) at the significant level (P < 0.05).

RESULTS

Correlation between electronic health literacy and QoL was 0.14 and with self-efficacy was 0.10, which was positive and statistically significant (P < 0.05). In addition, the correlation between QoL and self-efficacy was 0.33, which was positive, statistically significant, and moderate (P < 0.05).

CONCLUSION

According to the findings of this study, it is possible to improve the QoL through the promotion of electronic health literacy and self-efficacy. The results of this study can be used as a basis for health service providers and policymakers in designing and implementing health-related interventions.

Association of eHealth Literacy With Lifestyle Behaviors in University Students: Questionnaire-Based Cross-Sectional Study

Background

Maintenance of good health and a healthy lifestyle have significant impacts on the lives of university students. However, university students are prone to engage in risky health behaviors, resulting in impaired health status. Electronic health (eHealth) literacy is an important factor in maintaining a healthy lifestyle. However, no studies have assessed the eHealth literacy levels and the associated lifestyle behaviors among university students in Japan.

Objective

The purposes of this study were to clarify the eHealth literacy level, the participant characteristics associated with eHealth literacy, and the association of eHealth literacy with lifestyle behaviors of students in a Japanese university.

Methods

A questionnaire-based cross-sectional study of 3183 students at a national university in Japan was conducted. eHealth literacy was quantified using the Japanese version of the eHealth Literacy Scale (eHEALS). The association between participant characteristics (gender, school year, department of study, and living status) and eHEALS score was assessed using t tests. Additionally, the associations of eHealth literacy with lifestyle behaviors (exercise, smoking, alcohol consumption, etc.) were evaluated using logistic regression analyses.

Results

The mean eHEALS score was 23.6/40 points. The mean eHEALS score for students in medical departments was 27.0/40 points, which was 2.9 points higher than that of nonmedical students (P<.001). Similarly, the graduate school participants had higher scores than the undergraduate students. The proportion of participants who exercised regularly was higher in the high eHEALS score group than in the low score group, with an adjusted odds ratio of 1.39 (P<.001).

Conclusions

The eHealth literacy level of university students in Japan was comparable to that of the general Japanese population. Graduate students, as well as those in medical departments, had higher eHealth literacy. Furthermore, students with higher eHealth literacy had better exercise routines.

Investigation E-health literacy and correlates factors among Alborz medical sciences students: a cross sectional study

Background Health literacy is one of the goals of public health and the key challenge of health education in the 21st century. This study aimed to determine E-health literacy and correlates among medical sciences students in Karaj, Iran 2017. Methods This cross-sectional study was performed on a thousand students of Alborz University of Medical Sciences. A multi-sectional questionnaire was used to collect data. The first section included age, major, marital status; educational grade, mother and father education, socioeconomic status, health status, membrane in social network and the second compromised a validated Persian version of the E-health literacy. We used t-test and analysis of variance (ANOVA) to compare the mean of variables and for categorical variables x2 was used with SPSS version 19. Results The mean age of the subjects was 25.5 ± 5.6 years, of which 65.3% were male. The medical students constituted the most number of participants (28.6%). Mean eHEALS score was 26.11 ± 6.6 years. There was a significant difference between female and male regarding E-health literacy (P = 0.04). Internet was the most commonly used sources for health information (67%), the majority of the students were members of one of the social networks (77.7%) that telegram and Instagram were among the most popular networks. Conclusion Improving search skills and assessing of health resources in students, especially in medical and Para-medical sciences, is recommended. Social networks can be used as channels for the transmission of the health messages due to high usage among students.

Internet Use, eHealth Literacy, and Dietary Supplement Use Among Young Adults in Pakistan: Cross-Sectional Study

Background

Increased access to the internet has facilitated widespread availability of health information. Thus, electronic health (eHealth) literacy—the ability to seek, find, understand, and appraise health information from electronic resources and apply that knowledge in making a health-related decision—is a crucial skill. Despite the increasing use of the internet as a source of health information in developing countries, only a few studies have examined the eHealth literacy of young adults, who frequently use the internet to access health information in these developing countries.

Objective

The aim of this study was to assess the patterns of internet use and eHealth literacy levels among university students pursuing a non–health-related degree in Pakistan. We also examined the association of the eHealth literacy levels of these young adults with their physical activity levels and dietary supplement intake.

Methods

Students from 2 leading engineering universities in Pakistan were invited to participate in a cross-sectional anonymous web-based survey in order to collect data on their internet use, eHealth literacy, and dietary supplement intake. Of the 900 eligible university students who were invited to participate, 505 (56.1%) students who completed the questionnaire were included in the analysis. The findings were converted to median values and frequency analyses were performed. The associations between the variables were determined using the chi-square test; P≤.05 was considered significant.

Results

In this study, the median eHealth literacy scale (eHEALS) score was 29, which did not vary across gender. The most common type of health-related information that was searched by the participants was that related to maintaining a healthy lifestyle (305/505, 60.4%). Participants with high eHEALS scores were those who used the internet frequently for finding people with similar health issues (P<.001). The use of specific social media platforms was not associated with the perceived eHealth literacy levels. Neither the frequency of physical activity nor the dietary supplement use was associated with the eHealth literacy of the participants.

Conclusions

University students in non–health-related disciplines in Pakistan expressed high confidence in their skills to find health-related information on the internet, as indicated by the aggregate eHEALS scores. However, the findings of our study show that the perceived eHealth literacy was not associated with health behaviors such as physical activity and dietary supplement intake. Further research is necessary to investigate the extent to which eHealth literacy can be considered as a panacea for solving public health challenges in developing countries.

Exploring Canadian pharmacy students' e-health literacy: a mixed method study

Background:

While much has been described about technology use by digital natives in general, understanding of pharmacy student’s knowledge and understanding of technology is lacking.

Objective:

This study explores the current state of pharmacy students’ self-rated digital health literacy in British Columbia, Canada, and seeks to identify future opportunities for technology training in pharmacy education and in practice.

Methods:

A mixed methods design using surveys and semi-structured interviews was conducted. An online, validated survey (eHEALS) was conducted among currently enrolled 2^nd to 4^th year pharmacy students at the University of British Columbia. An additional interview was offered to consenting participants to further explore the use of technology in daily lives, pharmacy practicums, and implications on future pharmacy curricula. Both quantitative and qualitative thematic analysis was done of all data.

Results:

A total of 30 pharmacy students completed the eHEALS survey and 5 completed interviews. Most participants were 2^nd year students (50%), were 25 years and younger (80%), and female (87%). Ranking of digital health literacy was lower than expected with participants stating they know what (87%), where (87%) and how to find (77%) health resources on the Internet. Even less students (77%) rated that they have the skills to evaluate the health resources that they find on the Internet and only 53% felt confident in using information from the Internet to make health decisions. Most students mentioned that they had limited technology related training at school and would like more training opportunities throughout their program and connect what they have learned at school to their practice.

Conclusions:

These results expose significant and surprising gaps in student understanding of technology despite modifications seen in the entry-to-practice PharmD curriculum. Regional differences and digital health literacy of practicing pharmacists are areas that require better understanding and hold significant impact as practice evolves.

Web-based health Information Seeking and eHealth Literacy among College students. A Self-report study

OBJECTIVES

This study aimed to assess web-based health information seeking and eHealth literacy among Iranian college students.

METHODS

The study was conducted in five colleges of the Shiraz University of Medical Sciences in Iran during 2018. The data were collected by a researcher-made questionnaire consisting of seven questions on a 4-point Likert-type scale, with scores ranging from 7 to 28. These questions were: 'I know how to use the Internet to answer my questions about health', 'I think there is enough information about health-related issues on the Internet', 'I know the vocabulary used in health issues on the Internet', 'I can tell high-quality health resources from low-quality health resources on the Internet', 'I know how to use the health information I find on the Internet to help me', 'I feel confident in using information from the Internet to make health decisions', and 'Searching for health-related information on the Internet will increase my knowledge in this field'. High eHealth literacy level is defined as above the total mean score and low eHealth literacy level is defined as lower than the total mean score.

RESULTS

In all, 386 college students participated in the study. The results showed that the mean score of eHealth literacy was 19.11 out of 28; 205 participants (54.4%) had low eHealth literacy. In addition, the students used the Internet to search for information regarding diseases symptoms (70%), physical illnesses (67.1%), existing treatments (65%), and diagnosis (63.1%).

CONCLUSIONS

The results showed that participants in this study usually searched for illnesses, symptoms, and treatments after they got sick and paid little attention to other aspects related to integral health.

Adapting the eHealth Literacy Scale for Carers of People With Chronic Diseases (eHeals-Carer) in a Sample of Greek and Cypriot Carers of People With Dementia: Reliability and Validation Study

BACKGROUND

As the population ages, many more people will be in need of long-term care. According to a recent report by Alzheimer's Disease International and the Karolinska Institute, 84% of people with dementia are cared for at home and 16% in nursing homes. Several Web-based interventions have been developed to assist the work of carers at home. Measuring the levels of electronic health (eHealth) literacy is of top priority to facilitate inclusion of this population and develop training programs to enhance eHealth literacy skills.

OBJECTIVE

This study aimed to adapt the eHealth Literacy Scale (eHeals) for carers of people with dementia, who speak Greek as their native language and live in Greece and Cyprus, and to test the reliability and validity of the scale for carers.

METHODS

The content validity of the eHealth Literacy Scale for Carers of People With Chronic Diseases (eHeals-Carer) was assessed with an expert panel (N=10). A descriptive study with face-to-face interviews among 101 primary carers of people with dementia was conducted. In addition to the eHeals-Carer to assess their perceived eHealth literacy, participants responded to a brief questionnaire regarding characteristics of internet use and provided sociodemographic data. The internal consistency of the tool and the construct validity via an exploratory factor analysis (EFA) were explored.

RESULTS

The Mean Item-Level Content Validity Index (CVI) and Scale-Level CVI Average was 0.93. The participants were mostly women (75.2%, 76/101), aged less than 60 years (67.3%, 68/101) with secondary education. The internal consistency was estimated at a Cronbach alpha of .83. Two factors were extracted from the EFA: information seeking questions 1 to 5 (factor 1) and evaluation questions 6 to 8 (factor 2).

CONCLUSIONS

eHeals-Carer is the first perceived eHealth literacy tool adapted for carers of people with dementia. The use of Web-based services available for carers could help them and improve the health care system in the long term. In Greece and Cyprus, there is a lack of services, and improving the digital skills of carers could provide them with the means to support themselves at home and improve care provision.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/resprot.8080.

Assessing the eHealth literacy skills of family caregivers of medically ill elderly

Objectives

The purpose of current research is to assess the eHealth literacy level in the family caregivers of the elderly with hypertension and type-II diabetes.

Methods

A total of 160 caregivers completed the eHEALS questionnaire. The effect of participants' gender, education, and age on eHealth literacy was evaluated. For evaluation of the correlation between the accession of health information importance and the internet usefulness for decision-making, Spearman's correlation coefficient was applied.

Results

The participants eHealth literacy mean score was 26.163(SD=8.83). The age of participants had a meaningful impact on the level of eHealth literacy (t=6.074; P<0.001). Furthermore, among variant education levels in terms of eHealth literacy score significant differences existed (F=5.222; P=0.001).

Discussion

The family caregivers have a poor level of eHealth literacy. eHealth information is more important for family caregivers with a higher eHealth literacy, which may be due to their higher skills in obtaining health and medical information from the internet. Caregivers' age should be considered once recommending them for the internet using to obtain health information, as the age was an affecting factor.

Conclusion

Health centers and authorities in charge of the elderly health are recommended to train caregivers with proper skills to use online health information, such that the elderly enjoy the benefits, including improved care conditions and savings in terms of treatment costs and time.

Electronic health-literacy skills among nursing students

BACKGROUND

The Internet has become a major source of health-related information. In order to provide better health services and health-care education to society, nurses should have acceptable electronic health (eHealth) literacy.

OBJECTIVE

The main aim was to measure eHealth-literacy skills among nursing students of Kathmandu Medical College Teaching Hospital, Nepal.

METHODS

A cross-sectional study was conducted among 152 Bachelor of Science nursing students at the hospital. Data were collected using the self-administered eHealth Literacy Scale. This is an eight-item tool that is assessed on 5-point likert scale to measure consumers' perceived skills at finding, evaluating, and applying eHealth information to health problems. Demographical and personal variables were collected to explore their relationship with eHealth literacy.

RESULTS

A total of 152 nursing students with mean age of 19.84±1.62 years participated in the study. While 44.7% perceived that they had average Internet skills, 65.1% found the Internet useful in helping them make decisions about their health. Nursing students had a moderate self-perceived level of eHealth literacy (median 3.69, IQR 0.87). Related factors included students' Internet skills, frequency of using the Internet for health related purposes, and self-perception of the usefulness and importance of the Internet.

CONCLUSION

This study represents a baseline reference for eHealth literacy among nursing students. Students have some basic necessary skills, while other skills still need to be improved. There is a need to pay attention to eHealth-literacy needs of nursing students.

Understanding the Factors Influencing Patient E-Health Literacy in Online Health Communities (OHCs): A Social Cognitive Theory Perspective

Although online health communities (OHCs) are increasingly popular in public health promotion, few studies have explored the factors influencing patient e-health literacy in OHCs. This paper aims to address the above gap. Based on social cognitive theory, we identified one behavioral factor (i.e., health knowledge seeking) and one social environmental factor (i.e., social interaction ties) and proposed that both health knowledge seeking and social interaction ties directly influence patient e-health literacy; in addition, social interaction ties positively moderate the effect of health knowledge seeking on patient e-health literacy. We collected 333 valid data points and verified our three hypotheses. The empirical results provide two crucial findings. First, both health knowledge seeking and social interaction ties positively influence patient e-health literacy in OHCs. Second, social interaction ties positively moderate the effect of health knowledge seeking on patient e-health literacy. These findings firstly contribute to public health literature by exploring the mechanism of how different factors influence patient e-health literacy in OHCs and further contribute to e-health literacy literature by verifying the impact of social environmental factors.

Psychometric properties of the Hungarian version of the eHealth Literacy Scale

BACKGROUND

We adapted the eHealth Literacy Scale (eHEALS) for Hungary and tested its psychometric properties on a large representative online sample of the general population.

METHODS

The Hungarian version of eHEALS was developed using forward-backward translation. For the valuation study, 1000 respondents were recruited in early 2019 from a large online panel by a survey company. We tested internal consistency, test-retest reliability and construct and criterion validity using classical test theory, as well as item characteristics using an item-response theory (IRT) graded response model (GRM).

RESULTS

55% of respondents were female, and 22.1% were ≥ 65 years old. Mean eHEALS score was 29.2 (SD: 5.18). Internal consistency was good (Cronbach's α = 0.90), and test-retest reliability was moderate (intraclass correlation r = 0.64). We identified a single-factor structure by exploratory factor analysis, explaining 85% of test variance. Essential criteria for GRM analysis were met. Items 3 and 4 (search of health resources) were the least difficult, followed by items 5 and 8 (utilisation of health information), and then items 1 and 2 (awareness of health resources). Items 6 and 7 (appraisal of health resources) were most difficult. The measurement properties of eHEALS were not affected by gender, age, education or income levels. Female gender, older age, intensity of health information seeking, formal health education and visit at the electronic health-record website were associated with higher eHEALS scores, as well as best and worst self-perceived health states, BMI < 25 and participation at health screenings over the past year.

CONCLUSIONS

The Hungarian eHEALS is a useful and valid tool for measuring subjective eHealth literacy.

Health literacy of nursing students and its effective factors

BACKGROUND

The insufficiency of health literacy negatively affects the national economy as it leads to increased health service expenditure. It is very important for individuals to have accurate health-related information to reduce these negative effects.

AIM

The aim of the study is to examine the health literacy of nursing students and its effective factors.

METHODS

This descriptive study was carried out with students from the nursing department of a vocational school of health sciences between September and October 2018 in Turkey. A semi-structured questionnaire regarding the descriptive features of the participants and the European Health Literacy Scale were used for data collection.

RESULTS

The study included 283 nursing students; 29.3% had a problematic-limited health literacy level. The study found a statically significant difference between student year, high school graduation and family's income level and the total mean score of the HLS-EU scale.

CONCLUSION

The subject of health literacy should be integrated into the educational program of nursing students. The nurses are the most important workforce in health services, and awareness about this subject should be raised.

Implementing a connected health intervention for remote patient monitoring in Saudi Arabia and Pakistan: explaining 'the what' and 'the how'

Background

Recent developments in connected health technology provide an opportunity to remotely monitor and provide health care to the patient needing long-term medical care. However, information about how any connected health interventions should be implemented for remote patient monitoring, and how patients should be educated and enabled for active participation in treatment is still not available to a sufficient degree.

Discussion

In this paper, we discussed what the components of a connected health intervention, entitled Remotely Accessible Health Care at Home (RAHAH), are, and how this intervention has been implemented in Saudi Arabia and Pakistan. The aim of this intervention is to remotely monitor, treat and educate patients needing long-term medical care. The description of the intervention is presented based on the Template for Intervention Description and Replication (TIDieR) checklist for the transparent, comprehensive and explicit reporting.

Conclusion

We believe, successful implementation of RAHAH would be crucial to monitor and manage growing chronic care populations more effectively and efficiently in Saudi Arabia and Pakistan.

Internet use and eHealth literacy among health-care professionals in a resource limited setting: a cross-sectional survey

BACKGROUND

Health-care professionals should be able to identify and use reputable health care-information sources from the Internet and other relevant sources of information, in order to make good medical decisions. The level in health professional eHealth literacy and the extent of Internet use in a resource-constrained setting is not well documented. The aim of this study was to assess the extent of Internet use and eHealth literacy among a cross section of health-care professionals at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia.

METHODS

An institution-based cross-sectional study was conducted to assess Internet use and eHealth literacy among health professionals working at the hospital from November 20 to January 17, 2018. Descriptive analysis was used to describe Internet use and eHealth literacy. Multivariable logistic regression was done to identify which factors were associated with the eHealth literacy of participants.

RESULTS

In total, 291 study subjects were approached and included in the study, with a response rate of 98.6%. The majority of respondents were female (53.7%) and the mean age was 30.09±5.025 years. Only 47.4% of survey respondents said that they used the Internet regularly for professional/medical updates. The mean eHealth literacy was 27.840±5.691. The majority of participants with high eHealth literacy were aged 21-29 years. and females were slightly more literate regarding eHealth than males (33.1%). Age, type of profession, salary, and years of experience were significantly associated with eHealth literacy.

CONCLUSION

The present data confirm that Internet use and eHealth literacy of health professionals is noticeably good, which clearly suggests that there is an opportunity for eHealth to be integrated in the health-care system in tertiary-health facilities in northern Ethiopia if appropriate training and education is provided.

eHealth and adolescents in Serbia: psychometric properties of eHeals questionnaire and contributing factors to better online health literacy

Internet is important resource of health-related information and health services. Factors associated with higher level of online health (eHealth) literacy among adolescence have been understudied. The aim of this study was to assess psychometric properties of the eHealth Literacy Scale (eHEALS) in Serbian language and to evaluate eHealth literacy among adolescents in Serbia. The study was carried out in four high schools in Belgrade, Serbia in the period December 2016 to January 2017. A total of 702 students comprised the study sample. The eHEALS was translated according to internationally accepted methodology and its psychometric properties were analyzed. The Cronbach’s alpha coefficient for the entire eHEALS was 0.849. On exploratory factor analysis we obtained two-factorial structure. Our adolescents reported low confidence in knowing what health resources are available online. High confidence was observed for knowing how to use and how to find health information online. There was no difference in eHEALS score between genders or between school years. After adjustment for gender, type of school program, parental marital status, fathers’ education level and household income, being female was associated with higher eHealth literacy (B = 1.12, 95% confidence interval 0.07–2.18; p = 0.036). Serbian version of the eHEALS is a valid instrument in assessment of online health literacy and can be further used in evaluation of eHealth literacy in other population groups in Serbian language. It is advised that some classes in school are dedicated to appraisal and use of online health websites. This could be achieved through peer-education.