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Arigorat EJ, Begonia K, Franklin M, Honsky J. Assessment of Electronic Health Literacy Among Filipino Americans. Comput Inform Nurs 2024; 42:530-536. [PMID: 38780453 DOI: 10.1097/cin.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Health literacy requires skills of reading, understanding, and analyzing text, numbers, graphs, and diagrams to make well-informed decisions. The increase advancement in technologies has made health information accessible in electronic format. Individuals must apply health literacy in navigating through health information resources on the Internet. Filipino Americans originating from a diverse background are often underreported and underrepresented in health research. The study aim was to examine electronic health literacy among Filipino Americans using the Electronic Health Literacy Scale survey. The descriptive study recruited 103 participants. Overall Filipino Americans are electronic health literate, with a mean of 32.4 ( SD = 4.6). Females ( P = .017), those with graduate or professional degrees ( P = .004) and working in healthcare ( P = .040) tend to have higher electronic health literacy. The study provided valuable insight on electronic health literacy on a population that is underrepresented in research. The descriptive data gained from the study lays foundational work to help decrease health inequities experienced by Filipino Americans.
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Affiliation(s)
- Ellen J Arigorat
- Author Affiliations: New York-Presbyterian and Fairleigh Dickinson University, Teaneck, NJ (Dr Arigorat); Mount Sinai Hospital, City University of New York University (Dr Begonia); and Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH (Drs Franklin and Honsky)
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Obeid S, Mashiach-Eizenberg M, Gur A, Lavy I. Examining Ethnic Disparities in Digital Healthcare Services Utilization: Insights from Israel. J Multidiscip Healthc 2023; 16:3533-3544. [PMID: 38024120 PMCID: PMC10661913 DOI: 10.2147/jmdh.s429121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The purpose of this study was to examine ethnic disparities in the utilization of digital healthcare services (DHS) in Israel and explore the characteristics and factors influencing DHS use among the Arab minority and Jewish majority populations. Methods A cross-sectional correlational design was employed to collect data from 606 Israeli participants, 445 Jews, and 161 Arabs. Participants completed a digital questionnaire that assessed DHS utilization, digital health literacy, attitudes towards DHS, and demographic variables. Results The findings reveal significant disparities in DHS utilization and attitudes between these ethnic groups, with Jewish participants demonstrating higher rates of utilization and positive attitudes toward DHS. The study also explores the predictive role of digital health literacy and attitudes in DHS use while considering ethnicity as a potential moderator. Significant predicting factors related to DHS utilization among Jews include positive attitudes and high health literacy. Among the Arabs, only attitudes towards DHS significantly predict the extent of DHS use. Digital health literacy affects the extent of use through attitudes at the two groups of the moderator significantly, but it is stronger among the Arab group. Conclusion To improve healthcare outcomes and reduce disparities, efforts should focus on ensuring equitable access to DHS for the Arab minority population. Targeted interventions, including digital literacy education, removing technology access barriers, offering services in Arabic, and collaborating with community organizations, can help bridge the gap and promote equal utilization of DHS.
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Affiliation(s)
- Samira Obeid
- Department of Nursing, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
- Public Health Research Department, North District, the Ministry of Health, Nof Hagalil, Israel
| | - Michal Mashiach-Eizenberg
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Amit Gur
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Ilana Lavy
- Department of Information Systems, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
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Foote D, Giger JT, Murray TD, Engelhardt E, Flaherty C. Validation of the eHEALTH Literacy Scale (Eheals) With Military Service Members. Mil Med 2023; 188:e3621-e3627. [PMID: 37561975 DOI: 10.1093/milmed/usad315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/24/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023] Open
Abstract
INTRODUCTION Medical readiness of individual service members (SMs) is an integral component of operational readiness. Electronic Health (eHealth) literacy, here defined as the ability to seek out, find, evaluate, and appraise, integrate, and apply what is gained in electronic environments toward solving a health problem, is a key skill to enhance individual medical readiness. The World Health Organization (WHO) has identified health literacy as an important social determinant of health. The Internet enables individuals to access information virtually anywhere, at any place, any time, which is especially beneficial for SMs who serve around the globe, often isolated from modern health care facilities. MATERIALS AND METHODS This study examined the utility of the eHealth literacy scale (eHeals) as a potentially valuable tool to assist commanders and medical teams for assessing the health literacy of SMs. The main objective of our study was to examine the validity of the three-factor eHEALS measure for an active duty sample, using confirmatory factorial analysis. RESULTS Our findings support the validity of the eHEALS measure of electronic health literacy among military SMs, potentially identifying a means of measuring SMs' health literacy, and a target for intervention to increase medical readiness, well-being, and overall quality of life for individual SMs. CONCLUSIONS The study highlights a brief 6-item assessment tool that can quickly and efficiently be added to the current validated health and well-being measures for military personnel. This brief assessment can provide a measure of knowledge, skills, and confidence regarding ehealth information leading to better-informed health care decisions in the military context. These findings are especially relevant given the military's current emphasis on modernization and the need to put people first in order to build the overall team and improve unit effectiveness.
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Affiliation(s)
- Douglas Foote
- Army-University of Kentucky Master of Social Work Program, Joint Base San Antonio - Fort Sam Houston, TX 78234, USA
| | - Jarod T Giger
- University of Nevada, Las Vegas, School of Social Work, Las Vegas, NV 89154, USA
| | - Teresa D Murray
- Army-University of Kentucky Master of Social Work Program, Joint Base San Antonio - Fort Sam Houston, TX 78234, USA
| | - Ethan Engelhardt
- Auburn University, College of Liberal Arts, Auburn, AL 36849, USA
| | - Christopher Flaherty
- University of Kentucky, College of Social Work, 619 Patterson Office Tower, Lexington, KY 40506, USA
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Değer MS, Sezerol MA, Atak M. Rational Drug and Antibiotic Use Status, E-Health Literacy in Syrian Immigrants and Related Factors: A Cross-Sectional Study. Antibiotics (Basel) 2023; 12:1531. [PMID: 37887232 PMCID: PMC10604171 DOI: 10.3390/antibiotics12101531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Rational drug use is a pivotal concept linked with morbidity and mortality. Immigration plays a significant role as a determinant affecting individuals' health-related attitudes, behaviors, and the pursuit of health services. Within this context, the study was initiated to assess the factors influencing health literacy and rational drug use among Syrian immigrants in Istanbul. A cross-sectional study was undertaken on 542 Syrian adults utilizing a three-part questionnaire encompassing sociodemographics, rational drug use, and the e-health literacy scale (eHEALS). With an average age of 39.19 ± 13.10 years, a majority of participants believed medications should solely be doctor-prescribed (97%) and opposed keeping antibiotics at home (93.7%). Yet, 62.5% thought excessive herbal medicine use was harmless. The mean eHEALS score stood at 20.57 ± 7.26, and factors like age, marital status, income, and duration of stay in Turkey influenced e-health literacy. Associations were seen between low e-health literacy and being female, being older, having a lower education level, and regular medication use. Syrian immigrants displayed proper knowledge concerning antibiotics yet exhibited gaps in their understanding of general drug usage, treatment adherence, and herbal medicines. Approximately 80.3% had limited health literacy, pointing to the need for targeted interventions for enhanced health and societal assimilation.
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Affiliation(s)
- Mehmet Sait Değer
- Department of Public Health, Medical Faculty, Hitit University, Corum 19030, Türkiye;
| | - Mehmet Akif Sezerol
- Epidemiology Program, Institute of Health Sciences, Istanbul Medipol University, Istanbul 34810, Türkiye;
- Sultanbeyli District Health Directorate, Istanbul 34935, Türkiye
- Health Management Program, Graduate Education Institute, Maltepe University, Istanbul 34857, Türkiye
- Department of Public Health, School of Medicine, Istanbul Medipol University, Istanbul 34810, Türkiye
| | - Muhammed Atak
- Department of Public Health, Istanbul Medical Faculty, Istanbul University, Istanbul 34093, Türkiye
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Feng W, Zhang J. Childhood environmental harshness and unpredictability negatively predict eHealth literacy through fast life-history strategy. Front Psychol 2023; 14:1197189. [PMID: 37663344 PMCID: PMC10473102 DOI: 10.3389/fpsyg.2023.1197189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023] Open
Abstract
Background eHealth literacy-the ability to obtain, understand, evaluate, and use health information from the Internet-is important to maintaining and improving personal health. Prior research found that people differ notably in the levels of eHealth literacy, and this study tests a theoretical account of some of those individual differences. Drawing on life history theory, we propose that low eHealth literacy is partly the outcome of people adopting a resource-allocation strategy emphasizing early and fast reproduction, namely, a fast life-history strategy. Methods We conducted a cross-sectional survey study (N = 1,036) that measured Chinese adult respondents' eHealth literacy, childhood environmental harshness and unpredictability, and fast life-history strategy. Covariates included health-information seeking online, self-rated health, sex, age, education level, and monthly income. Results Supporting a life-history explanation of eHealth literacy, childhood environmental harshness and unpredictability negatively predicted eHealth literacy through fast life-history strategy and mainly the insight-planning-control dimension of it. Harshness, not unpredictability, also directly and negatively predicted eHealth literacy after fast life-history strategy was controlled for. Conclusion Our findings suggest that the psychological mechanisms associated with human life-history strategies produce at least some of the individual differences in levels of eHealth literacy, including those related to neuroticism, socioeconomic status, self-rated health and social capital. Thus, a possible way to increase future generation's eHealth literacy and thereby their health is to reduce the harshness and unpredictability of the environment in which they grow up, thereby making them more likely to adopt a relatively slow life-history in their adulthood.
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Affiliation(s)
- Wenfei Feng
- School of Journalism and Communication, Sun Yat-sen University, Guangzhou, China
| | - Jinguang Zhang
- School of Journalism and Communication, Sun Yat-sen University, Guangzhou, China
- Center for Big Data and Public Communication, Sun Yat-sen University, Guangzhou, China
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Hakeem FF, Abdouh I, Hamadallah HH, Alarabi YO, Almuzaini AS, Abdullah MM, Altarjami AA. The Association between Electronic Health Literacy and Oral Health Outcomes among Dental Patients in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:1804. [PMID: 37372921 DOI: 10.3390/healthcare11121804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE This cross-sectional study aimed to investigate the association between electronic health (eHealth) literacy and oral health outcomes, including the number of teeth and brushing frequency. METHODS A total of 478 participants were included in the study and assessed for their eHealth literacy levels. Demographic variables, including age, gender, income, and education, were collected. The participants' number of teeth and brushing frequency were also recorded. Multiple regression analyses were performed to examine the relationship between eHealth literacy and oral health outcomes, adjusting for sociodemographic variables. RESULTS The study sample consisted of both males (66.5%) and females (33.5%), with a mean age of 31.95 years. Among the participants, 16.95% were classified as having inadequate eHealth literacy, 24.06% had problematic eHealth literacy, and the majority (59.00%) demonstrated sufficient eHealth literacy. There was a significant association between eHealth literacy and oral health outcomes. Individuals with problematic eHealth literacy had a higher likelihood of having a greater number of teeth (RR = 1.12, 95% CI: 1.05-1.20, p < 0.001) compared to those with inadequate eHealth literacy. Similarly, individuals with sufficient eHealth literacy showed a higher likelihood of having more teeth (RR = 1.14, 95% CI: 1.07-1.21, p < 0.001) compared to the inadequate eHealth literacy group controlling for age, gender, income, and education. Individuals with problematic eHealth literacy exhibited a tendency towards lower odds of irregular brushing (OR = 0.39, 95% CI: 0.15-1.02, p = 0.054), although this result was marginally significant. In contrast, individuals with sufficient eHealth literacy had significantly lower odds of irregular brushing frequency (OR = 0.24, 95% CI: 0.10-0.62, p = 0.003) compared to the inadequate eHealth literacy group. CONCLUSION The findings suggest a positive association between eHealth literacy and oral health outcomes. Improving eHealth literacy may have implications for promoting better oral health behaviors and outcomes.
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Affiliation(s)
- Faisal F Hakeem
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia
- Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester M13 9PL, UK
| | - Ismail Abdouh
- Department of Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah 42313, Saudi Arabia
| | - Hatem Hazzaa Hamadallah
- College of Dentistryand Hospital, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia
| | - Yunus Osama Alarabi
- College of Dentistryand Hospital, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia
| | | | - Majed Maher Abdullah
- College of Dentistryand Hospital, Taibah University, Al-Madinah Al-Munawwarah 42353, Saudi Arabia
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Abd Kadir NA, Azzeri A, Mohd Noor MI, Kefeli Z, Abdullah MF, Ramlee MNA, Jaafar MH. Health literacy status among community in the protected area: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33590. [PMID: 37115076 PMCID: PMC10146038 DOI: 10.1097/md.0000000000033590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Adequate health literacy is necessary for individuals as it enables them to readily acquire information, process it, and apply it to health-related decisions. Various factors including geographical area will determine the disparity in health literacy status. Communities living in protected areas have limited health literacy and health status owing to a lack of access to infrastructure and medical facilities. Existing studies have discussed health literacy among various populations disproportionately affected by certain diseases. However, research remains underdeveloped, and the causal factors are largely untested. This research aims to better understand how population living conditions especially those who are living in protected areas are affected and exposed to limited health literacy. METHOD This study will comprehensively review full-text papers published between 2013 and 2023. We will search 3 databases, PubMed, SCOPUS, and Web of Science, using the keyword search strategy to find articles related to the issue. Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used to guide the selection of relevant studies. The results will then be assessed using the standard Cochrane Quality assessment method. The outcome is addressed in light of a narrative synthesis that utilizes a theme category and focuses on each component's main conclusions. RESULT This protocol describes the planned scope and methodology for the systematic review and meta-analysis that will provide current evidence on; The status of health literacy among the community in protected areas and; The effect of Protected Areas on health literacy according to their types and characteristics. CONCLUSION Meta-analysis of low-to-high health literacy status will benefit the development of policy recommendations for protected areas.
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Affiliation(s)
- Nor Aziah Abd Kadir
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, Malaysia
- Faculty of Business Management, Universiti Teknologi MARA (UiTM) Cawangan Pahang, Raub, Pahang, Malaysia
| | - Amirah Azzeri
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, Malaysia
| | - Mohd Iqbal Mohd Noor
- Faculty of Business Management, Universiti Teknologi MARA (UiTM) Cawangan Pahang, Raub, Pahang, Malaysia
- Institute for Biodiversity and Sustainability Development, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Zurina Kefeli
- Faculty of Economics and Muamalat, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, Malaysia
| | - Muhammad Fuad Abdullah
- Faculty of Business Management, Universiti Teknologi MARA (UiTM) Cawangan Pahang, Raub, Pahang, Malaysia
- Institute for Biodiversity and Sustainability Development, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Mohd Noor Afiq Ramlee
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, Malaysia
| | - Mohd Hafiz Jaafar
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, Malaysia
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Bergman L, Nilsson U, Dahlberg K, Jaensson M, Wångdahl J. Validity and reliability of the swedish versions of the HLS-EU-Q16 and HLS-EU-Q6 questionnaires. BMC Public Health 2023; 23:724. [PMID: 37081538 PMCID: PMC10117247 DOI: 10.1186/s12889-023-15519-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Health Literacy is a crucial factor for health. In Europe, many people have limited health literacy (i.e. difficulties with accessing, understanding, appraising and using health information). This study aimed to evaluate the psychometrics of the Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6, instruments that aims to assess health literacy. METHODS In this prospective psychometric study convenience sampling was used, which gave a study population of 347 Swedish-speaking adults. The psychometric evaluation included item distributional statistics, construct validity testing, and principal component analysis to assess structural validity. Internal consistency and test-retest reliability was also investigated. RESULTS For the Swedish version of HLS-EU-Q16, no floor effects were detected but a ceiling effect was noted among 28% of the respondents. Construct validity was supported as four out of five expected correlations was confirmed (educational level, self-perceived health, electronic health literacy and HLS-EU-Q6). In terms of structural validity, the principal component analysis yielded a four-factor structure with most items loading significantly only to one factor. The Swedish version of HLS-EU-Q16 had acceptable internal consistency (Cronbach's α = 0.89, split-half reliability = 0.93) and test-retest reliability showed stability over time (Cohen's κ = 0.822). For the Swedish version of HLS-EU-Q6, neither floor nor ceiling effects were observed. Construct validity was supported as HLS-EU-Q6 correlated as our a priori stated hypothesis. The principal component analysis did not support the unidimensionality of the scale as a two-factor structure was identified. The Swedish version of HLS-EU-Q6 had acceptable internal consistency (Cronbach's α = 0.77, split-half reliability = 0.80) and test-retest reliability showed stability over time (Cohen's κ = 0.812). According to the Swedish version of the HLS-EU-Q16, 71% of the participants were classified as having sufficient comprehensive health knowledge (CHL), while only 33% were classified as having this when the HLS-EU-Q6 was used. CONCLUSIONS The Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6 have acceptable psychometric properties, and based on the results we recommend its use to measure CHL. However, we are hesitant to use Sw-HLS-EU-Q6 in estimating different CHL levels and further studies need to be conducted to establish validity and accuracy of the thresholds of HLS-EU-Q6.
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Affiliation(s)
- Lina Bergman
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
| | - Ulrica Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Karuna Dahlberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Maria Jaensson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Josefin Wångdahl
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden.
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
- Aging Research Center, Karolinska Institutet & Stockholm University, Tomtebodavägen 18a, Solna, 171 77, Sweden.
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Zhang Y, Xu P, Sun Q, Baral S, Xi L, Wang D. Factors influencing the e-health literacy in cancer patients: a systematic review. J Cancer Surviv 2023; 17:425-440. [PMID: 36190672 PMCID: PMC9527376 DOI: 10.1007/s11764-022-01260-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE As Internet technology evolves, electronic health (e-health) literacy gradually becomes a key factor in healthy behaviors and health-related decision-making. However, little is known about the influencing factors of e-health literacy among cancer survivors. Thus, the objective of this study was to systematically review the status quo, assessment tools, and influencing factors of e-health literacy in cancer patients. METHODS We conducted a comprehensive search in several databases, including PubMed, MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese BioMedical Literature Database, and Chinese Science and Technology Journal Database between January 2000 and December 2021. RESULTS A total of nine articles were included in this review, all of which were cross-sectional studies. Following the JBI critical appraisal tool, seven of them were rated as high quality. The e-Health Literacy Scale (eHEALS) was the most commonly used measurement for e-health literacy in cancer patients. The level of e-health literacy in cancer survivors was not high, which was associated with a variable of factors. The behavioral model of health services use was adopted to summarize related influencing factors. From an individual's perspective, predisposing characteristics and enabling resources were the most significant factors, without factors related to needs characteristics. CONCLUSION The study has identified the influencing factors of e-health literacy among cancer survivors, including age, gender, domicile place, education level, information-seeking behavior, and social support. In the future, e-health literacy lectures need to be carried out for elderly cancer patients, especially those who live in rural areas and have no access to the Internet. Families and friends of cancer survivors should also be encouraged to offer them more support. IMPLICATIONS FOR CANCER SURVIVORS These findings of this review provide novel insights for both family members and medical workers to improve e-health literacy in cancer patients. Further research is required to develop easy-to-use electronic health information acquisition devices and establish propagable e-health literacy intervention programs for cancer survivors.
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Affiliation(s)
- Yan Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Peirong Xu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Qiannan Sun
- Clinical Medical College, Yangzhou University, Yangzhou, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
| | - Shantanu Baral
- Clinical Medical College, Yangzhou University, Yangzhou, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
| | - Lijuan Xi
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Daorong Wang
- Clinical Medical College, Yangzhou University, Yangzhou, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
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Bergman L, Nilsson U, Dahlberg K, Jaensson M, Wångdahl J. Validity and reliability of the arabic version of the HLS-EU-Q16 and HLS-EU-Q6 questionnaires. BMC Public Health 2023; 23:304. [PMID: 36765302 PMCID: PMC9912492 DOI: 10.1186/s12889-023-15226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Health literacy is an important social determinant of health and affects the ability to make decisions and take action to manage one's health. The purpose of this study was to psychometrically examine the Arabic versions of HLS-EU-Q16 and HLS-EU-Q6 and their response patterns among Arabic-speaking persons in Sweden. METHODS By convenience sampling from a variety of settings, a total of 335 participants were invited to participate. The participants completed a self-assessment of comprehensive health literacy by answering the Ar-HLS-EU-Q16 questionnaire, also including the six items for Ar-HLS-EU-Q6. Statistical analysis was guided by The COnsensus-based Standards for the selection of health Measurement Instruments. Floor/ceiling effects, construct, structural and criterion validity, test-retest reliability and internal consistency reliability were analysed. RESULTS In total, 320 participants were included in the psychometric evaluation. Mean age was 42.1 (SD 12.5), 63% (n = 199) were females and 53% (n = 169) had at least 10 years of education. No floor or ceiling effect were found for the Ar-HLS-EU-Q16 or Ar-HLS-EU-Q6. For both instruments, construct validity was confirmed in four out of five expected correlations (weak positive correlation to educational level, self-perceived health, and years in Sweden; moderate positive correlation with higher sum score on the Arabic electronic health literacy scale, and strong positive correlation to higher Ar-HLS-EU-Q16/Ar-HLS-EU-Q6). For Ar-HLS-EU-Q16, the principal component analysis resulted in a three-factor model with all items significantly correlating to only one factor. For Ar-HLS-EU-Q6, the principal component analysis supported a one-factor solution. Criterion validity showed poor agreement between the two questionnaires with a Cohen κ 0.58 (p < 0.001). Test-retest reliability showed a substantial agreement, Cohen's κ for Ar-HLS-EU-Q16 and Ar-HLS-EU-Q6 were both 0.89. The internal consistency of both versions was acceptable, Cronbach alpha for Arabic-HLS-EU-Q16 was 0.91 and for Arabic-HLS-EU-Q6, 0.79. Split-half reliability was 0.95 and 0.78, respectively. CONCLUSION The Arabic version of HLS-EU-Q16 shows good psychometric properties, validated in a Swedish setting. The findings can further inform and guide future validation studies in other settings worldwide. Furthermore, the results of the present study did not support criterion validity of Ar-HLS-EU-Q6.
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Affiliation(s)
- Lina Bergman
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Ulrica Nilsson
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Karuna Dahlberg
- grid.15895.300000 0001 0738 8966Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Maria Jaensson
- grid.15895.300000 0001 0738 8966Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Josefin Wångdahl
- Aging Research Center, Karolinska Institute and Stockholm University, Stockholm, Sweden. .,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. .,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Tomtebodavägen 18a, 171 77, Solna, Sweden.
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Reder M, Soellner R. Factor Structure of the eHEALS. DIAGNOSTICA 2022. [DOI: 10.1026/0012-1924/a000294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. The dimensionality of the eHEALS has been the subject of some controversy. Sample populations and language versions vary widely, as do the employed statistical methods to assess dimensionality. In previous research, we assessed the factor structure in two different samples testing 1 vs. 2 and 1 vs. 2 vs. 3 correlated factors. The objective of this reanalysis was to assess whether the 3-factor model fitted better than the 2- and 1-factor models. We analyzed data from a 2009 cross-sectional survey on health literacy in grade 12 ( n = 327) using CFA. All factor models of the eHEALS showed unsatisfactory model fit. A subsequent exploratory bifactor analysis confirmed multidimensionality and indicated that Item 2 was problematic. When this item was excluded from the correlated factor models, model fit improved, and the 3-factor model showed the best fit. The results in our sample of 12th-grade students offer some support to the German eHEALS having a 3-factor structure similar to the results from our previous research in women aged 50. The replicability of the fit pattern in a different sample and setting was limited by diverging results on Item 2.
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Affiliation(s)
- Maren Reder
- Institute of Psychology, University of Hildesheim, Germany
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Hassanien NS, Adawi AM, Alzahrani TA, Adawi EA. The Mediating Role of Resilience and Electronic Health Literacy in the Relationship Between Pandemic Fatigue and Adherence to Preventive Behaviours Against COVID-19. Cureus 2022; 14:e29553. [PMID: 36312626 PMCID: PMC9595032 DOI: 10.7759/cureus.29553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction: There is emerging literature on the decline in adherence to preventive measures against the COVID-19 pandemic, a phenomenon of pandemic fatigue (PF). However, academics and policymakers have debated its existence and consequences. We conducted this study to explore this phenomenon, its existence, determinants, and relation to adherence to COVID-19 preventive measures, and the mediating role of resilience, fear of COVID-19, and electronic health literacy about COVID-19 in this relationship. Methods: This cross-sectional online study was conducted from April to June 2021 using a convenience sample of 650 Saudi adults from all regions of Saudi Arabia using a reliable questionnaire. A structural equation model (SEM) was used for mediation analysis. Results: The results revealed a moderate level of PF among Saudi adults. Younger patients experienced more PF. Fear of COVID-19 had a non-significant (p=0.127) effect on PF. SEM analysis revealed that both resilience and electronic health literacy significantly (p=0.000) mediated the relationship between PF and adherence to preventive measures, and acted as protective factors. In conclusion, there is evidence that PF exists and negatively affects adherence to preventive measures. Conclusion: Policymakers should apply evidence-based programs to increase public resilience, particularly targeting young adults, as the results of the current study shed light on its protective mediating role against PF. Increasing electronic health literacy is an effective strategy for preventing PF through an increase in the perceived effectiveness of preventive measures.
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Cross-cultural adaptation and psychometric properties of the Sinhala version of electronic health literacy scale: A cross-sectional validation study. PLoS One 2022; 17:e0266515. [PMID: 35395027 PMCID: PMC8993018 DOI: 10.1371/journal.pone.0266515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/23/2022] [Indexed: 11/19/2022] Open
Abstract
eHealth Literacy Scale (eHEALS) is the most widely used, valid and reliable tool to assess eHealth literacy skills, but no culturally appropriate tool exists to assess these skills among Sinhala-speaking Sri Lankans, including health professionals. This study aimed to cross-culturally adapt the original eHEALS from English to Sinhala and evaluate its psychometric properties. The study was conducted in two phases. The first phase involved translation and cross-cultural validation of the questionnaire. The second phase involved a cross-sectional survey conducted online among 268 health science students from a state university in Sri Lanka to confirm the psychometric properties of the questionnaire. An analysis of test-retest reliability was conducted with a subset of 72 students. The pre-final version of Sinhala eHEALS (Si-eHEALS) was developed following the cross-cultural adaptation process. The mean score of Si-eHEALS was 28.51±4.87. A satisfactory level of internal consistency was achieved (Cronbach’s alpha = 0.91). The test-retest reliability was acceptable (intraclass correlation coefficient -.776). Content validity index of Si-eHEALS was.97. The principal component analysis supported the unidimensionality of the scale, explaining 61.2 variance. There was a significant positive association between Si-eHEALS score with academic year (rs = .146, p = .017), self-rated internet skills (rs = .122, p = .046), usefulness of internet in health decision making (rs = .212, p < .001) and importance of ability to access health resources on the internet (rs = .230, p < .001), confirming concurrent validity. No significant difference based on gender (U = 5854, p = .550) and degree program (X2(2) = 2.965, p = .564) was found, confirming discriminant validity. In line with many previous validation studies, our study demonstrated good psychometric properties for Si-eHEALS. Si-eHEALS is a valid and reliable tool that assesses eHealth literacy in Sinhala speaking Sri Lankans, particularly health professionals.
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Bardus M, Keriabian A, Elbejjani M, Al-Hajj S. Assessing eHealth literacy among internet users in Lebanon: A cross-sectional study. Digit Health 2022; 8:20552076221119336. [PMID: 35968030 PMCID: PMC9373133 DOI: 10.1177/20552076221119336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/25/2022] [Indexed: 12/31/2022] Open
Abstract
Objective Assessing the level of eHealth literacy in a population is essential to
designing appropriate public health interventions. This study aimed to
assess eHealth literacy among adult internet users in Lebanon, recruited
through social media and printed materials. The study examined the
relationship between internet use, perceived eHealth literacy, and
sociodemographic characteristics. Methods A cross-sectional study based on a web-based questionnaire was conducted
between January and May 2020. The survey assessed internet use and eHealth
literacy using the homonymous scale (eHEALS) in English and Arabic.
Cronbach's alpha and factor analyses were used to evaluate eHEALS’
psychometric properties. A generalized linear model was used to identify
factors predicting the eHEALS. Results A total of 2715 respondents were recruited mostly through Facebook (78%) and
printed materials (17%). Most respondents completed the survey in English
(82%), were aged 30 ± 11 years, female (60%), Lebanese (84%), unmarried
(62%), employed (54%), and with a graduate-level education (53%). Those who
completed the eHEALS questionnaire (n = 2336) had a
moderate eHealth literacy (M = 28.7,
SD = 5.5). eHEALS was significantly higher among older
females with a high education level, recruited from Facebook, Instagram, or
ResearchGate, and perceived the Internet as a useful and important source of
information. Conclusions Future internet-delivered public health campaigns in Lebanon should account
for moderate-to-low levels of eHealth literacy and find ways to engage older
males with low education levels representing neglected segments (e.g.
Syrians). To be more inclusive, campaigns should reach neglected population
segments through non-digital, community-based outreach activities.
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Affiliation(s)
- Marco Bardus
- Institute of Applied Health Research, University of Birmingham, Edgbaston, UK
- Department of Health Promotion & Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Arda Keriabian
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Martine Elbejjani
- Clinical Research Institute & Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Samar Al-Hajj
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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A Comprehensive Analysis of E-Health Literacy Research Focuses and Trends. Healthcare (Basel) 2021; 10:healthcare10010066. [PMID: 35052230 PMCID: PMC8775877 DOI: 10.3390/healthcare10010066] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 12/04/2022] Open
Abstract
Objective: To sort out the research focuses in the field of e-health literacy, analyze its research topics and development trends, and provide a reference for relevant research in this field in the future. Methods: The literature search yielded a total of 431 articles retrieved from the core dataset of Web of Science using the keywords “ehealth literacy”, “E-health literacy” and “electronic health literacy”. A bibliometric analysis was performed by using CiteSpace to explore the development history, hot themes, and trends of future research in the field of e-health literacy. Results: The thematic evolution path in e-health literacy was divided into three stages. The research focuses were inspected from four aspects: evaluation, correlation with health-promotion behaviors, influencing factors, and intervention measures for improvement. Conclusion: E-health literacy research faces challenges such as the development of the connotation of the term, the objectivity of evaluation methods, and the long-term impact of interventions. Future research themes in e-health literacy will include the standardization of evaluation instruments and the individualization of therapeutic strategies.
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Bergman L, Nilsson U, Dahlberg K, Jaensson M, Wångdahl J. Health literacy and e-health literacy among Arabic-speaking migrants in Sweden: a cross-sectional study. BMC Public Health 2021; 21:2165. [PMID: 34823499 PMCID: PMC8614220 DOI: 10.1186/s12889-021-12187-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/03/2021] [Indexed: 11/23/2022] Open
Abstract
Background Health inequities arise when the public cannot access and understand health information in an easy, accessible, and understandable way. Evidence supports that health literacy (HL) is a determinant for health outcomes, and when HL is limited this may have a major impact on morbidity as well as mortality. Migrants are known to have limited HL. Therefore, this study aimed to explore comprehensive health literacy (CHL) and electronic health literacy (eHL) among Arabic-speaking migrants in Sweden. Methods This was a cross-sectional observational study conducted in Sweden. A total of 703 persons were invited to participate between February and September 2019. Two questionnaires – the Health Literacy Survey European Questionnaire (HLS-EU-Q16) and the eHealth Literacy Scale (eHEALS) – and questions about self-perceived health and Internet use were distributed in Swedish and Arabic. Various statistical analyses were performed to determine the associations for limited CHL and eHL. Results A total of 681 respondents were included in the analysis. Of these, 334 (49%) were native Arabic-speaking migrants and 347 (51%) were native Swedish-speaking residents. CHL and eHL differed between the groups. The Arabic speakers had significantly lower mean sum scores in eHL 28.1 (SD 6.1) vs 29.3 (6.2), p = 0.012 and lower proportion of sufficient CHL 125 (38.9%) vs 239 (71.3%), p < 0.001 compared to Swedish speakers. Multiple regression analysis showed on associations between limited CHL and eHL and being Arabic speaking, less Internet use, and not finding the Internet to be important or useful. Furthermore, longer time spent in Sweden was associated with higher levels of CHL among the Arabic speakers, (OR 0.94, 95% CI 0.91–0.98, p < 0.01). Conclusions CHL and eHL differ between Arabic-speaking migrants and native Swedish speakers, but also between Arabic speakers who have lived different lengths of time in Sweden. Though it seems that the eHealth literacy is less affected by language spoken, the Internet is suggested to be an appropriate channel for disseminating health information to Arabic-speaking migrants. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12187-5.
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Affiliation(s)
- Lina Bergman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Box 23 300, 141 83, Huddinge, Sweden.
| | - Ulrica Nilsson
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Box 23 300, 141 83, Huddinge, Sweden.,Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Karuna Dahlberg
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Maria Jaensson
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Josefin Wångdahl
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Khasawneh RA, Nusair MB, Arabyat RM, Karasneh R, Al-Azzam S. The Association Between e-Health Literacy and Willingness to Deprescribe Among Patients with Chronic Diseases: A Cross-Sectional Study from Jordan. Telemed J E Health 2021; 28:1001-1008. [PMID: 34807738 DOI: 10.1089/tmj.2021.0331] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background: Deprescribing refers to the partnered discontinuation of chronic medications to limit the negative impacts of polypharmacy. Polymedicated patients play a key role in the success of deprescribing efforts. eHealth literacy reflects patients' ability to appraise electronically available health-related information to make informed health care decisions, which partly reflect their desire to deprescribe. Objectives: The current study aimed to explore the relationship between eHealth literacy and willingness to deprescribe among patients with chronic diseases. Additionally, the predictors of willingness to deprescribe were examined. Materials and Methods: This cross-sectional study was conducted among adult patients with chronic diseases in Jordan. An online questionnaire comprising two validated tools, namely the Electronic Health Literacy Scale (eHEALS) and the Revised Patients' Attitudes Toward Deprescribing (rPATD) Questionnaire, was used for data collection. The questionnaire targeted adult patients with chronic medical conditions in Jordan and was posted to social media portals, following a convenience sampling technique. Results: A total of 719 responses were recorded and included in the final analysis. Participants with higher levels of eHealth literacy were more willing to get their medications deprescribed, as indicated by the perceived use of unneeded medications (p = 0.042). Meanwhile, participants with low levels of eHealth literacy were more likely to report fear of missing out on the potential benefits of deprescribed medications (p = 0.003). Other items that were commonly agreed upon by both the low and high eHealth literacy groups, respectively, included desire for dose reduction (p < 0.001, p < 0.001), belief in the lack of effectiveness of some prescribed medications (p < 0.001,p < 0.001), and fear of precipitating side effects (p = 0.001,p = 0.007). Conclusions: The present study highlighted the relationship between eHealth literacy and a number of items reflecting willingness to deprescribe, and these indicators can be used to guide future deprescribing efforts among eligible patients.
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Affiliation(s)
- Rawand A Khasawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad B Nusair
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Rasha M Arabyat
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Reema Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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