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Xie L, Mo PKH. Prospective relationship between electronic health literacy and health-promoting lifestyle among Chinese older adults: A three-wave longitudinal study. Soc Sci Med 2025; 364:117166. [PMID: 39586136 DOI: 10.1016/j.socscimed.2024.117166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/06/2024] [Accepted: 07/26/2024] [Indexed: 11/27/2024]
Abstract
BACKGROUND Improving older people's health-promoting lifestyle (HPL) may slow the progression of health conditions and improve quality of life. Electronic health (eHealth) literacy is increasingly important for individuals managing health in the digital age. Previous cross-sectional studies have shown a positive association between eHealth literacy and HPL among older adults. However, no longitudinal studies have examined the association over time, their temporal relationship, and the potential underlying mechanisms. OBJECTIVES To examine the longitudinal association and temporal relationship between eHealth literacy and HPL among older adults, and to explore their underlying mechanisms based on the Integrated Model of eHealth Use (iMeHU). METHODS This longitudinal study was conducted among older adults in Jiangxi Province, China, from February to November 2022. Data were collected at baseline (T1) and 3-month (T2) and 6-month follow-up (T3), using online self-reported questionnaires. Older people's eHealth literacy and HPL were measured using the Digital Health Literacy Instrument and Health-Promoting Lifestyle Profile-II. Statistical analyses included Linear mixed model (LMM), cross-lagged panel model (CLPM), longitudinal mediation analysis, and multi-group analysis. RESULTS 611 participants were included at T1; 464 (75.9%) completed the follow-ups at T2 and T3. The LMM results suggested that older individuals with higher eHealth literacy levels showed better HPL over time (adjusted β = 0.31, 95%CI: 0.27-0.35, p < 0.001), after adjusting for covariates. CLPMs supported that eHealth literacy could predict older people's improved HPL subsequently, but not the reverse. Attitude towards eHealth mediated the relationship from eHealth literacy to improved HPL, with a mediated proportion of 17.2%. In addition, the prospective relationships were stronger and only significant in older patients. CONCLUSIONS From a longitudinal perspective, this study highlighted the important roles of eHealth literacy and attitude towards eHealth in improving older people's HPL, especially for the patients. The findings provide robust evidence and practical implications to develop targeted interventions.
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Affiliation(s)
- Luyao Xie
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Leviton A, Loddenkemper T. Improving the health literacy of persons with epilepsy. Epilepsy Behav 2024; 163:110237. [PMID: 39742650 DOI: 10.1016/j.yebeh.2024.110237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 12/12/2024] [Accepted: 12/22/2024] [Indexed: 01/04/2025]
Abstract
Improving health literacy can improve health. This essay reviews the resources available to help improve epilepsy health literacy, including websites, drug inserts/labels/information leaflets, patient educators, handouts, plain language, lay summaries, and other efforts to close the gaps between research and epilepsy health literacy.
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Affiliation(s)
- Alan Leviton
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Tobias Loddenkemper
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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Peimani M, Stewart AL, Ghodssi-Ghassemabadi R, Nasli-Esfahani E, Ostovar A. The moderating role of e-health literacy and patient-physician communication in the relationship between online diabetes information-seeking behavior and self-care practices among individuals with type 2 diabetes. BMC PRIMARY CARE 2024; 25:442. [PMID: 39736551 DOI: 10.1186/s12875-024-02695-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 12/17/2024] [Indexed: 01/01/2025]
Abstract
BACKGROUND This study examined the moderating role of e-health literacy (eHL) and patient-physician communication in the relationship between online diabetes information-seeking behavior (online DISB) and self-care practices. METHODS A total of 1143 individuals with type 2 diabetes mellitus completed a cross-sectional survey assessing sociodemographic characteristics, data relating to diabetes clinical history, online DISB, eHL (eHealth Literacy Scale), aspects of patient-physician communication (IPC survey), patient self-care (Self-Care Inventory-Revised), and medication adherence (measure of adherence to prescribed diabetes medications). The data were analyzed using both bivariate (correlation) and multivariate (multiple linear regression) analyses using maximum likelihood estimation procedures in Mplus. RESULTS Our results showed online DISB significantly predicted diabetes self-care (p < 0.001) and medication adherence behaviors (p = 0.005). Lower Hurried Communication (p < 0.001, p = 0.03), higher Elicited Concerns (p = 0.005, p = 0.03), higher Explained Results (p = 0.03, p = 0.008), and higher eHL (p = 0.02, p = 0.02) were significantly associated with better self-care and medication adherence. Explained Results and eHL moderated the relationship between online DISB and both self-care and medication adherence. CONCLUSIONS Findings support the role of patient eHL and patient-physician communication in amplifying the positive impact of online DISB on patients' behavioral outcomes in diabetes.
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Affiliation(s)
- Maryam Peimani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No. 10 Al-E-Ahmad and Chamran Highway Intersection, Tehran, 1411713136, Iran.
| | - Anita L Stewart
- Center for Aging in Diverse Communities, Institute for Health & Aging, University of California San Francisco, San Francisco, CA, USA
| | - Robabeh Ghodssi-Ghassemabadi
- Oncostat, CESP, Inserm U1018, University Paris-Saclay, labeled Ligue Contre le Cancer, Gustave Roussy, Villejuif, France
- Service de Biostatistique et d'Epidémiologie (SBE), Institut Gustave Roussy, Villejuif, France
| | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No. 10 Al-E-Ahmad and Chamran Highway Intersection, Tehran, 1411713136, Iran.
| | - Afshin Ostovar
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Wang X, Ge L, Yu Z, Qiao Q, Guo X, Liu S, Zhang C, Zang S. Decomposition and comparative analysis of urban-rural differences in eHealth literacy among nursing students: A multisite cross-sectional study. NURSE EDUCATION TODAY 2024; 146:106562. [PMID: 39754891 DOI: 10.1016/j.nedt.2024.106562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 10/22/2024] [Accepted: 12/24/2024] [Indexed: 01/06/2025]
Abstract
BACKGROUND Investigating the urban-rural differences in eHealth literacy among Chinese nursing students is imperative for enhancing healthcare education and practice. This study aimed to investigate the factors that contribute to urban-rural differences in eHealth literacy among Chinese nursing students and measure their respective contributions. DESIGN A multisite cross-sectional study. SETTINGS In China. PARTICIPANTS A total of 967 nursing students were involved in this study. METHODS Multivariate linear regression models were used to explore the associations between sociodemographic and health-related factors and the eHealth literacy of Chinese nursing students. Additionally, Blinder-Oaxaca decomposition was employed to scrutinize the factors attributing to the urban-rural differences in eHealth literacy among Chinese nursing students, elucidating their respective contributions. RESULTS The mean eHealth literacy score for urban nursing students (mean: 20.26, SD: 3.61) exceeded that of rural nursing students (mean: 19.53, SD: 3.56) (p < 0.001). Blinder-Oaxaca decomposition analysis indicated that 84.82 % of the urban-rural differences in eHealth literacy among nursing students can be explained. The urban-rural differences are primarily explained by family health (40.05 %). CONCLUSIONS The study emphasizes the importance of tailoring educational curricula to address urban-rural differences in eHealth literacy among nursing students in China. Specifically, incorporating content related to family health in educational programs is crucial.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Lina Ge
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhenjie Yu
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Qiao Qiao
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, China
| | - Xiaoming Guo
- Algorithm Research and Development Department, Neusoft IntelliRay Technology Co., Ltd., Shenyang, China
| | - Shiping Liu
- Algorithm Research and Development Department, Neusoft IntelliRay Technology Co., Ltd., Shenyang, China
| | - Chengcai Zhang
- Algorithm Research and Development Department, Neusoft IntelliRay Technology Co., Ltd., Shenyang, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China.
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Zhang Y, Guo X, Su Y. Spatiotemporal dynamic and regional differences of public attention to vaccination: An empirical study in China. PLoS One 2024; 19:e0312488. [PMID: 39715251 DOI: 10.1371/journal.pone.0312488] [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: 07/16/2024] [Accepted: 10/07/2024] [Indexed: 12/25/2024] Open
Abstract
BACKGROUND Internet searches offer an indicator of public attention and possible demand for certain things. Studying the spatiotemporal characteristics of the public's concern for vaccination can determine the spatiotemporal distribution of demand for vaccines in China, and capture the changes in the health awareness of the Chinese population, thus informing future vaccination strategies. METHODS Based on the collection of Baidu search indices for vaccination-related keywords in 363 cities in China, This paper seeks to explore the spatiotemporal changes and regional differences in public attention toward vaccination in China by using the seasonal index, seasonal concentration index, Herfindahl index, Moran index, and Dagum Gini coefficient. RESULTS The following findings are presented. First, there are significant seasonal fluctuations and unbalanced monthly distributions of vaccination-related public attention in China. Second, the public attention in Chinese cities shows the spatial characteristics of "leading in the east, followed by the central, western and northeastern regions". The spatial correlation of attention has been strengthened, and the high-high clusters are mainly distributed in the Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), and Greater Bay Area (GBA) urban agglomerations. Third, regional differences in overall public attention narrowed in China, with intra-regional differences narrowing in seven regions (Northwest China, Central China, and so on), and intra-regional differences increasing in East China. The dominant role in the Gini coefficient changes from transvariation intensity to inter-regional differences. CONCLUSION Major public health emergencies stimulate the public's attention to health topics. Although the short-term increase in vaccination-related public attention was not observed to translate into a long-term increase in public vaccine literacy, the seasonal and regional differences in vaccination-related public attention in China have significantly narrowed before and after COVID-19, suggesting that the imbalance between public health literacy levels has improved.
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Affiliation(s)
- Yaming Zhang
- School of Economics and Management, Yanshan University, Qinhuangdao, China
- Center for Internet Plus and Industry Development, Yanshan University, Qinhuangdao, China
| | - Xiaoyu Guo
- School of Economics and Management, Yanshan University, Qinhuangdao, China
- Center for Internet Plus and Industry Development, Yanshan University, Qinhuangdao, China
| | - Yanyuan Su
- School of Economics and Management, Yanshan University, Qinhuangdao, China
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Chen Y, Yin J, Ding Y, Wang C, Zhu J, Niu L. Evaluation of the quality of depression-related information on Chinese websites and video platforms: a cross-sectional comparative analysis. Front Psychiatry 2024; 15:1408384. [PMID: 39726915 PMCID: PMC11669601 DOI: 10.3389/fpsyt.2024.1408384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 11/27/2024] [Indexed: 12/28/2024] Open
Abstract
Objectives We aimed to assess the quality of information regarding depression on Chinese websites and popular video platforms. Methods We conducted searches on website platforms (Baidu, Bing) and video platforms (Bilibili, Douyin) using search terms "depression", "depressive disorder", "depression treatment", "depressive anxiety", "depressed patient", and "depressive symptoms". We collected the first 50 results with each search term in each platform. Each website and video included in this study was assessed using The DISCERN instrument (DISCERN), Journal of American Medical Association benchmark criteria (JAMA), Hexagonal Radar Schema (HRS), and Global Quality Scores (GQS). Results A total of 177 websites, 216 Bilibili videos, and 244 Douyin videos were included. Among all the platforms, websites had the highest median scores on DISCERN and HRS, at 33 and 2 respectively, but were still classified as "poor" and "very poor" according to the classification. Bilibili, Douyin, and websites had median scores of 3, 2, and 2 respectively in JAMA, indicating a moderate level of quality. Bilibili, Douyin, and websites all had a median score of 2 for GQS, and were of poor quality. Only the percentage score for JAMA was more than half of the weighted score, while none of the other scales reached half of the score. The median percentage scores of the websites in DISCERN, HRS, and GQS were higher than those of Bilibili and Douyin (P < 0.001). Compared to other sources, news media on websites and medical organizations on videos demonstrated higher quality (all P values < 0.05). Conclusions The findings of the study indicated an overall low quality of online depression information. Collaborative efforts between platforms and professionals are necessary to improve the comprehensiveness and quality of depression-related information available online. In addition, the platform needs to prioritize optimizing the algorithm of recommendations and present real high-quality health information to the audience.
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Affiliation(s)
| | | | | | | | | | - Lu Niu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Qian Y, Lu P. Parents' or Guardians' Knowledge, Attitudes and Practices in the Prevention and Management of Childhood Myopia. Ophthalmol Ther 2024; 13:3095-3109. [PMID: 39400672 PMCID: PMC11564600 DOI: 10.1007/s40123-024-01045-3] [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: 05/30/2024] [Accepted: 09/26/2024] [Indexed: 10/15/2024] Open
Abstract
INTRODUCTION The aim of this study was to assess the knowledge, attitude, and practices (KAP) of parents or guardians regarding the prevention and management of childhood myopia. METHODS This cross-sectional study was conducted at the Department of Ophthalmology in the First Affiliated Hospital of Soochow University (Suzhou, China) between August 2023 and November 2023. Parents or guardians who willingly volunteered to take part in the study were surveyed using a self-designed questionnaire. RESULTS A total of 571 participants returned valid questionnaires, among whom 288 respondents (50.44%) fell within the 31- to 40-year age group and 474 respondents (83.01%) were identified as myopic. The mean KAP scores for the knowledge, attitude and practices dimensions were 23.34 ± 3.05 (possible range: 0-26), 46.47 ± 4.02 (possible range: 12-60), and 40.52 ± 7.07 (possible range: 11-54), respectively. Structural equation modeling analysis indicated that education had a direct effect on knowledge (estimate = 0.41, P = 0.038), while knowledge directly influenced both attitude (estimate = 0.40, P < 0.001) and practices (estimate = 0.36, P < 0.001). Also, attitude was found to have a direct impact on practices (estimate = 0.45, P < 0.001). CONCLUSIONS Parents or guardians had adequate knowledge, a positive attitude, and proactive practices towards the prevention and management of childhood myopia, which might be affected by their educational level. This comprehensive understanding of parental perspectives highlights the potential for targeted interventions in clinical settings to further enhance pediatric eye care.
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Affiliation(s)
- Yifeng Qian
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China.
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Ji X, Chi J. Exploring the Relationship Between eHealth Literacy and Diabetes Knowledge, Self-Efficacy, and Self-Care Behaviors in Chinese Diabetic Patients: A Cross-Sectional Study. J Nurs Res 2024; 32:e359. [PMID: 39593226 DOI: 10.1097/jnr.0000000000000642] [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: 11/28/2024] Open
Abstract
BACKGROUND The importance of online educational resources enhancing self-management among patients is underscored by the growing prevalence of diabetes. It is crucial to comprehend how patients with diabetes in China seek diabetes-related information and use mobile applications (apps) designed for diabetes management. Although the Knowledge-Attitude-Practice theory plays an integral role in diabetes management, in-depth studies on eHealth literacy (eHL) and Knowledge-Attitude-Practice in populations with diabetes remain scarce. PURPOSE This study was developed to provide insights into the online information-seeking behaviors of and diabetes apps used by individuals living with diabetes by exploring the relationships among eHL, diabetes knowledge, self-efficacy, and self-care behaviors. METHODS A cross-sectional survey was conducted from November 2022 to June 2023 on 380 inpatients with diabetes at the Yantai Yuhuangding Hospital in Shandong Province. The participants voluntarily completed surveys covering sociodemographic characteristics, diabetes status, diabetes app usage, online diabetes information searching, eHL, diabetes knowledge, self-efficacy, and self-care behaviors. Structural equation modeling analyses were employed to assess model fitness and the interrelationships between latent constructs and observable variables. RESULTS Of the 380 participants, 57.1% (217/380) reported actively seeking diabetes information online, whereas only 3.7% (14/380) had used diabetes apps. eHL was shown to have a direct effect on diabetes knowledge (β = 0.377, p < .001) but no direct impact on self-care behaviors (β = 0.017, p = .860). However, an indirect effect on self-care behaviors was observed via diabetes knowledge and self-efficacy. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The results of this study indicate that, despite widespread online information-seeking behavior, diabetes app utilization remains limited in China. Also, the findings indicate enhancing patients' eHL contributes to more comprehensive diabetes knowledge. Furthermore, eHL was shown to influence self-care behaviors via diabetes knowledge and self-efficacy. A self-managed intervention strategy should be developed to improve eHL that utilizes internet resources to improve patients' knowledge and self-efficacy and promote better self-care behaviors.
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Affiliation(s)
- Xing Ji
- MSN, RN, School of Nursing, Binzhou Medical University, Yantai, Shandong, People's Republic of China
| | - Juntao Chi
- PhD, RN, Deputy Director, Department of Nursing, Yantai Yuhuangding Hospital, Yantai, Shandong, People's Republic of China
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Liu D, Fan S, Huang X, Gu W, Yin Y, Zhang Z, Ma B, Xia R, Lu Y, Liu J, Xin H, Cao Y, Yang S, Li R, Li H, Zhao J, Zhang J, Gao Z, Zeng Y, Ding Y, Ren Z, Guan Y, Zhang N, Li J, Ma Y, Wei P, Dong J, Zhou Y, Dong Y, Qian Y, Chen C, Zhao Y, Li Y, Zheng Y, Chen R, Li X, Han Y, Xia Y, Xu H, Wu Z, Wu M, Wu X, Hou J, Cai Y, Dai X, Li W, Nie T, Zhang C, Wang X, Li D, Yan S, Yi Z, Liu C, Zhang X, Shi L, Li H, Jiang F, Zhou X, Sun X, Wu Y. Study protocol: A national cross-sectional study on psychology and behavior investigation of Chinese residents in 2023. HEALTH CARE SCIENCE 2024; 3:475-492. [PMID: 39735279 PMCID: PMC11671216 DOI: 10.1002/hcs2.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 11/04/2024] [Accepted: 11/08/2024] [Indexed: 12/31/2024]
Abstract
Introduction This study protocol specifies the primary research line and theoretical framework of the 2023 Survey of the Psychology and Behavior of the Chinese Population. It aims to establish a consistent database of Chinese residents' psychological and behavioral surveys through multi-center and large-sample cross-sectional surveys to provide robust data support for developing research in related fields. It will track the public's physical and psychological health more comprehensively and systematically. Methods The study was conducted from June 20, 2023 to August 31, 2023, using stratified and quota sampling methods. A total of 150 cities across 800 communities/villages were surveyed, selected from China (Despite extensive coordination, we have been unable to contact our counterparts in the Taiwan region of China to obtain relevant statistical data). The questionnaires were distributed to the public one-on-one and face-to-face by trained surveyors. The questionnaires included basic information about the individual, personal health status, basic information about the family, the social environment in which the individual lives, psychological condition scales, behavioral level scales, other scales, and attitudes towards topical social issues. Supervisors conducted quality control during the distribution process and returned questionnaires, logically checked and cleaned for data analysis. Discussion Data collection has been finished, and scientific outputs based on this data will support the development of health promotion strategies in China and globally. In the aftermath of the pandemic, it will guide policymakers and healthcare organizations to improve their existing policies and services to maximize the physical and mental health of the Chinese population. Trial Registration This study was filed in the National Health Security Information Platform (Record No.: MR-37-23-017876) and officially registered in the China Clinical Trials Registry (Registration No.: ChiCTR2300072573).
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Hiito E, Ikonen R, Niela-Vilén H. Internet-based breastfeeding peer support for breastfeeding parents: An integrative review. J Adv Nurs 2024; 80:4805-4824. [PMID: 38738535 DOI: 10.1111/jan.16221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/28/2024] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
AIM To explore what Internet-based breastfeeding peer support offers to breastfeeding parents. DESIGN Integrative review. DATA SOURCES AND REVIEW METHODS A systematic literature search was conducted in March 2024 using the following electronic databases: CINAHL, The Cochrane Library, PubMed/MEDLINE and PsycINFO. Database searches yielded 717 results. Two researchers removed the duplicates (n = 256) and screened the remaining titles (n = 461), abstracts (n = 197) and full texts (n = 60) independently. Eventually, 19 studies were included in the review. The chosen studies had qualitative (n = 11), quantitative (n = 6), or mixed methods designs (n = 2) and were published between 2015 and 2024. Qualitative content analysis was conducted. RESULTS The main categories were supplying support that is responsive to the needs of parents and belonging to a breastfeeding community. The parents looked for and received breastfeeding support, advice, information, emotional support, reassurance and access to shared experiences from various online breastfeeding peer support groups. The support groups helped them in their breastfeeding decisions, thus making a difference in their breastfeeding experience. The support groups created breastfeeding communities for these parents and they were able to bond with others, feel like they belonged and share experiences. Additionally, these breastfeeding communities helped to normalize various breastfeeding practices. CONCLUSION Breastfeeding peer support groups can offer parents the support and guidance they seek and a sense that they are part of a breastfeeding community. However, it is vital these groups are efficiently moderated to ensure the advice parents receive is evidence-based and the support is encouraging. IMPACT These findings show that well-moderated online breastfeeding peer support can offer parents high-quality support. It is essential for health care professionals to be aware of the various options available in order to recommend high-quality support groups for breastfeeding parents. REPORTING METHOD PRISMA. PATIENT OR PUBLIC CONTRIBUTION This was an integrative review therefore no patient or public contribution was necessary.
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Affiliation(s)
- Elisa Hiito
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riikka Ikonen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
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Barbosa MCF, Baldiotti ALP, Resende JL, Perazzo MDF, Firmino RT, Granville-Garcia AF, Paiva SM, Ferreira FDM. Assessment of the psychometric properties of the eHealth Literacy Scale for Brazilian adolescents. PLoS One 2024; 19:e0314099. [PMID: 39585850 PMCID: PMC11588242 DOI: 10.1371/journal.pone.0314099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 11/06/2024] [Indexed: 11/27/2024] Open
Abstract
With the increase in digitalization of adolescents and health services, the population must demonstrate digital health literacy skills to be able to navigate online health information, as well as identify, evaluate, and apply relevant information. The present study aimed to investigate the psychometric properties of the adapted version of the eHealth Literacy Scale (eHEALS-BrA) for Brazilian adolescents. This study was conducted between September 2022 and May 2023, involving a total of 260 adolescents aged 13 to 19, with a mean age of 15.64 years (SD = 1.84), all of whom were enrolled in public schools in Brazil. Structural validity was evaluated by confirmatory factor analysis (CFA). The reliability of the instrument was assessed using Cronbach's alpha (α) and McDonald's omega (ω), and test-retest reliability. Questionnaires about sociodemographic aspects, health-related characteristics, and internet use were administered and used as discriminant validation measures. Convergent Validity was determined by correction with the domains of the World Health Organization Quality of Life-Bref (WHOQOL-Bref) instrument. For test-retest reliability, 67 participants completed the eHEALS-BrA a fortnight later. The average eHEALS-BrA score was 28.05 points (SD = 5.05). CFA revealed that the model with the best fit had a single factor (χ2 = 49.884 [df = 20, p = 0.0002], CFI = 0.934, TLI = 0.908, RMSEA = 0.076(CI:0.05-0.10), and SRMR = 0.045). The instrument demonstrated good reliability, with satisfactory internal consistency (α and ω = 0.71) and stability (ICC = 0.82, 95% CI:0.70-0.89). The eHEALS-BrA was correlated with the physical, psychological, and environmental domains of the WHOQOL-Bref (p = 0.001) (convergent validity). Higher scores were found among male adolescents, individuals who practiced physical activity, those with better self-rated health, those who considered the internet useful for searching for health information (discriminant validity), and those with better self-rated skills related to using the internet (convergent validity) (p < 0.05). The eHEALS-BrA demonstrated adequate psychometric properties for measuring digital health literacy in Brazilian adolescents.
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Affiliation(s)
| | - Ana Luiza Peres Baldiotti
- Department of Pediatric Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, (MG), Brazil
| | - Júlia Lara Resende
- Department of Pediatric Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, (MG), Brazil
| | | | - Ramon Targino Firmino
- Postgraduate Program in Dentistry, Federal University of Campina Grande (UFCG), Campina Grande, (PB), Brazil
| | | | - Saul Martins Paiva
- Department of Pediatric Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, (MG), Brazil
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Kang JY, Jung W, Kim HJ, An JH, Yoon H, Kim T, Chang H, Hwang SY, Park JE, Lee GT, Cha WC, Heo S, Lee SU. Temporary Telemedicine Policy and Chronic Disease Management in South Korea: Retrospective Analysis Using National Claims Data. JMIR Public Health Surveill 2024; 10:e59138. [PMID: 39566066 PMCID: PMC11618008 DOI: 10.2196/59138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 09/30/2024] [Accepted: 10/06/2024] [Indexed: 11/22/2024] Open
Abstract
BACKGROUND Since its introduction, telemedicine for patients with chronic diseases has been studied in various clinical settings. However, there is limited evidence of the effectiveness and medical safety of the nationwide adoption of telemedicine. OBJECTIVE This study aimed to analyze the effects of telemedicine on chronic diseases during the COVID-19 pandemic under a temporary telemedicine policy in South Korea using national claims data. METHODS Health insurance claims data were extracted over 2 years: 1 year before (from February 24, 2019, to February 23, 2020) and 1 year after the policy was implemented (from February 24, 2020, to February 23, 2021). We included all patients who used telemedicine at least once in the first year after the policy was implemented and compared them with a control group of patients who never used telemedicine. The comparison focused on health care use; the medication possession ratio (MPR); and admission rates to general wards (GWs), emergency departments (EDs), and intensive care units (ICUs) using difference-in-differences analysis. A total of 4 chronic diseases were targeted: hypertension, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and common mental disorders. RESULTS A total of 1,773,454 patients with hypertension; 795,869 patients with DM; 37,460 patients with COPD; and 167,084 patients with common mental disorders were analyzed in this study. Patients diagnosed with hypertension or DM showed increased MPRs without an increase in GW, ED, or ICU admission rates during the policy year. Moreover, patients in the DM group who did not use telemedicine had higher rates of ED, GW, and ICU admissions, and patients in the hypertension group had higher rates of GW or ICU admissions after 1 year of policy implementation. This trend was not evident in COPD and common mental disorders. CONCLUSIONS The temporary telemedicine policy was effective in increasing medication adherence and reducing admission rates for patients with hypertension and DM; however, the efficacy of the policy was limited for patients with COPD and common mental disorders. Future studies are required to demonstrate the long-term effects of telemedicine policies with various outcome measures reflecting disease characteristics.
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Affiliation(s)
- Ji Ye Kang
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Weon Jung
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyun Ji Kim
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Ji Hyun An
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hee Yoon
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Taerim Kim
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hansol Chang
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sung Yeon Hwang
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jong Eun Park
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Gun Tak Lee
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Won Chul Cha
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sejin Heo
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Se Uk Lee
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Ünlü G, Altındiş S. The Cross-Sectional Association of Health Literacy With Healthy Lifestyle Behaviors in the Turkish Population: A Systematic Review and Meta-Analysis. Am J Health Promot 2024:8901171241300190. [PMID: 39535425 DOI: 10.1177/08901171241300190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
OBJECTIVE To meta-analytically investigate the cross-sectional association between health literacy (HL) and healthy lifestyle behaviors (HLBs) in the Turkish population. DATA SOURCE Web of Science, PubMed, Scopus, EBSCO, DergiPark, TRDizin, and Türkiye Council of Higher Education Thesis Center. EXCLUSION CRITERIA Not accessible in Turkish or English in full text; not on the Turkish population; addressed e-HL, digital HL, mobile HL or corporate HL; addressed HL in a specific context; did not seek any association between HL and HLBs. INCLUSION CRITERIA Cross-sectional studies that reported a correlation coefficient or any convertible equal statistical measure for the association between HL and HLBs. DATA EXTRACTION Two reviewers independently screened the articles, extracted the data from the included studies into a structured form and assessed their methodological quality. DATA SYNTHESIS We conducted meta-analyses and reported the characteristics, outcomes, and quality assessment of studies. RESULTS Of 3833 records accessed we included 52 that fulfilled the eligibility criteria. Our primary findings demonstrated positive low-to-moderate associations between HL and health-promoting behaviors (r = .32 [CI:.30-.35; I2 = .00]), HL and physical activity (r = .23 [CI:.18-.27; I2 = .12]), and HL and vaccination (r = .12 [CI:.07-.17; I2 = .00]). In contrast, HL was not significantly associated with non-smoking (r = .02 [CI:-.02-.36; I2 = .09]), healthy diet (r = .02 [CI:-.01-.06; I2 = .00]), and screening (r = .07 [CI:.04-.11; I2 = .07]). However, our sensitivity and meta-regression analysis results suggested that the association of HL with healthy diet seems to increase with age. On the other hand, we failed to find any convincing evidence of any of the included variables affecting the association between HL and all types of HLBs (r = .17, I2 = 95.81%). CONCLUSION HL has the potential to improve the HLBs of Turkish individuals, however, there is a need for better understanding of the possible underlying determinants of the association between them.
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Affiliation(s)
- Gazi Ünlü
- Graduate School of Business, Sakarya University, Sakarya, Turkey
| | - Selma Altındiş
- Department of Health Management, Sakarya University, Sakarya, Turkey
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Ekenberg M, Landin F, Wettermark B. A Cross-Sectional Study Identifying Medication Adherence Technologies (MATech) in Sweden Using Behavior Change Techniques. Patient Prefer Adherence 2024; 18:2281-2293. [PMID: 39559483 PMCID: PMC11571989 DOI: 10.2147/ppa.s481152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 10/10/2024] [Indexed: 11/20/2024] Open
Abstract
Background Poor medication adherence is a well-recognized problem, and behavior change techniques (BCTs) have shown promise in improving patient adherence to prescribed drug treatment. Through the utilization of medication adherence technologies (MATech), these BCT interventions could be delivered effectively in a person-centered way. MATech can be defined as systems, services or physical devices (hardware), with a digital component, used to support patients in their drug utilization. However, there is a lack of knowledge regarding their availability and to what extent they apply evidence-based BCTs. Purpose This study aimed to identify and describe MATech with BCT interventions available in the Swedish language. Methods A cross-sectional survey study was conducted in 2023. After identifying potential MATech developers by contacting umbrella organizations in the private sector, public agencies and regions, and conducting an app search, a survey was distributed to 381 potential MATech developers. Included MATech were in Swedish, used by patients, incorporated a BCT intervention, and had survey response from the developer. The survey was based on the BCT taxonomy and the framework of attributes from the COST ENABLE project, and included questions regarding BCT features. Following correspondence with 189 potential developers, 32 with products of interest responded to the survey, and 21 MATech were identified (12 standalone software and nine hardware solutions). Results Among the 21 MATech identified, nine were hardware and ten were specifically designed for a particular disease or medication. The majority of technologies incorporated BCTs of reminding the patient to take the medication (81%), information about the treatment (71%) and providing feedback on the monitoring of medication adherence or clinical outcomes (76%). Conclusion Swedish-language MATech employing BCTs are available, encompassing both hardware and software solutions. There is a need to enhance the visibility of these technologies, enabling patients to discover and utilize the support they provide.
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Affiliation(s)
- Marie Ekenberg
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Fanny Landin
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
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Jiang X, Wang L, Leng Y, Xie R, Li C, Nie Z, Liu D, Wang G. The level of electronic health literacy among older adults: a systematic review and meta-analysis. Arch Public Health 2024; 82:204. [PMID: 39511667 PMCID: PMC11542313 DOI: 10.1186/s13690-024-01428-9] [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: 07/30/2024] [Accepted: 10/17/2024] [Indexed: 11/15/2024] Open
Abstract
BACKGROUND In the context of deeper integration of the internet and healthcare services, eHealth literacy levels have become an important predictor of public health outcomes and health-promoting behaviors. However, there is a lack of comprehensive understanding of eHealth literacy levels among older adults. OBJECTIVE To systematically assess the level of eHealth literacy among older adults. METHODS We conducted searches in MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, China National Knowledge Infrastructure Database (CNKI), Wanfang Database, Weipu Database (VIP), and Chinese Biomedical Database (Sinomed) to collect survey studies on the eHealth literacy levels of the older adults, with a search timeframe from the establishment of the database to May 2024. The quality of the included literature was assessed using the Agency for Healthcare Research and Quality (AHRQ) and the Newcastle-Ottawa Scale (NOS). Additionally, subgroup analysis and meta-regression were conducted to detect sources of heterogeneity. Funnel plots and Egger's test were used to assess publication bias. RESULTS A total of 48 relevant studies were included, including 45 cross-sectional, 2 cohort studies and 1 longitudinal study, comprising 33,919 older adults. The quality of the studies was all above moderate, with 10 high-quality publications. Meta-integration results showed that the eHealth literacy score of older adults was 21.45 (95% CI:19.81-23.08). Subgroup analysis showed that among the elderly population, females had lower eHealth literacy at 19.13 (95% CI:15.83-22.42), those aged 80 years and older had lower eHealth literacy at 16.55 (95% CI:11.73-21.38), and elderly individuals without a spouse and living alone had even lower eHealth literacy at 18.88 (95% CI:15.71-22.04) and 16.03 (95% CI:16.51-21.79). Based on region, eHealth literacy was lower among older adults in developing countries at 20.71 (95% CI:18.95-22.48). Meta-regression results indicate that sample size and region can significantly impact heterogeneity. CONCLUSION Our results found that the average eHealth literacy score of the elderly was 21.45, which was much lower than the passing level (≥ 32), suggesting that more attention should be paid to the eHealth literacy aspect of the elderly. Meanwhile, due to the limitation of the literature sources, the global representativeness of the results of this study still needs to be supported by more research data from other countries.
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Affiliation(s)
- Xin Jiang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Lushan Wang
- The Traditional Chinese Medicine Hospital of Longquanyi, Chengdu, 610100, China
| | - Yingjie Leng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Ruonan Xie
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Chengxiang Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Zhuomiao Nie
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Daiqing Liu
- Medical College of University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Guorong Wang
- West China School of Public Health and West China Fourth Hospital, West China Nursing School, Sichuan University, Chengdu, 610041, China.
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Jiang S, Ng JYY, Choi SM, Ha AS. Relationships Among eHealth Literacy, Physical Literacy, and Physical Activity in Chinese University Students: Cross-Sectional Study. J Med Internet Res 2024; 26:e56386. [PMID: 39496161 PMCID: PMC11574492 DOI: 10.2196/56386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 08/09/2024] [Accepted: 09/23/2024] [Indexed: 11/06/2024] Open
Abstract
BACKGROUND eHealth literacy is critical for evaluating abilities in locating, accessing, and applying digital health information to enhance one's understanding, skills, and attitudes toward a healthy lifestyle. Prior research indicates that enhancing eHealth literacy can improve health behaviors such as physical activity (PA). Physical literacy (PL) refers to the ability to develop sustainable PA habits, taking into account various aspects of an individual. Notably, university students have shown a decline in PA and possess low PL levels. However, the connection between eHealth literacy and PL in this demographic has not been extensively studied, and it remains uncertain whether PA acts as a mediator between eHealth literacy and PL. OBJECTIVE This study examines the extent to which PA mediates the link between eHealth literacy and PL in Chinese university students and explores gender differences in these variables. METHODS In February 2022, a cross-sectional survey was administered to 1210 students across 3 universities in China. The instruments used were the Perceived PL Instrument, the International Physical Activity Questionnaire, and the Chinese version of the eHealth Literacy Scale. Correlations between eHealth literacy, PA, and PL were analyzed using Pearson product-moment correlation and multiple linear regression, while mediation models helped elucidate the interactions among the 3 variables. RESULTS The response rate for the study was 92.9% (1124/1210). In the mediation analysis, eHealth literacy showed a significant direct effect on PL, with a coefficient of 0.78 (β .75, SE 0.02; P<.001). Moderate to vigorous physical activity (MVPA) accounted for 2.16% of the total effect, suggesting that MVPA partially mediates the relationship between eHealth literacy and PL. Additionally, male students outperformed female students in terms of MVPA (t636=4.94; P<.001) and PL (t636=3.18; P<.001), but no significant differences were found in eHealth literacy (t636=1.23; P=.22). CONCLUSIONS The findings indicate that MVPA serves as a mediator in the link between eHealth literacy and PL among university students. Students with low eHealth literacy or limited PA are less likely to be physically literate. Thus, eHealth literacy plays a crucial role in enhancing PL and PA, especially when interventions targeting PL are implemented. Our results also suggest a need for targeted health education interventions aimed at improving MVPA and PL among female students, while also recognizing that eHealth literacy is comparable across genders at universities.
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Affiliation(s)
- Shan Jiang
- Department of Sport Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Johan Y Y Ng
- Department of Sport Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Siu Ming Choi
- Faculty of Education, University of Macau, Macau, China
| | - Amy S Ha
- Department of Sport Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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Li S, Cui G, Zhang X, Zhang S, Yin Y. Associations between Digital Skill, eHealth Literacy, and Frailty among Older Adults: Evidence from China. J Am Med Dir Assoc 2024; 25:105275. [PMID: 39307173 DOI: 10.1016/j.jamda.2024.105275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 08/20/2024] [Accepted: 08/20/2024] [Indexed: 10/20/2024]
Abstract
OBJECTIVES Frailty is a common geriatric syndrome in older adults; however, its relationship with digital factors is underexplored. This study aimed to examine the association between digital skills, eHealth literacy, and frailty to provide insights for developing frailty interventions in the digital age. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Data were collected from a cross-sectional survey of older adults aged ≥60 years in China. METHODS We used a digital skills questionnaire, the eHealth Literacy Scale, and the Tilburg Frailty Indicator to measure digital skill, eHealth literacy, and frailty, respectively. Linear regression and logistic models were established to explore the association between digital skill, eHealth literacy, and frailty. Finally, we used a structural equation model and the Karlson-Holm-Breen method to test the mediation. RESULTS A total of 2144 older adults were included in this study. The rates of adequate digital skill, adequate eHealth literacy, and frailty were 4.1%, 11.9%, and 38.3%, respectively. Digital skill (β = -0.108; 95% CI, -0.151 to -0.065) and eHealth literacy (β = -0.153; 95% CI, -0.195 to -0.112) were negatively associated with frailty score (P < .05), and adequate digital skill (odds ratio, 0.367; 95% CI, 0.170-0.793) and adequate eHealth literacy (odds ratio, 0.455; 95% CI, 0.298-0.694) were associated with a lower prevalence of frailty. eHealth literacy had a mediating effect on the association between digital skills and frailty. CONCLUSIONS AND IMPLICATIONS Better digital skill and eHealth literacy are associated with a lower prevalence of frailty among older adults. The association between digital skill and frailty was found to be completely mediated by eHealth literacy.
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Affiliation(s)
- Shaojie Li
- Shandong University of Traditional Chinese Medicine, Jinan, China; School of Public Health, Peking University, Beijing, China
| | - Guanghui Cui
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Xiaochen Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shengkai Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yongtian Yin
- Shandong University of Traditional Chinese Medicine, Jinan, China.
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Athanasopoulou K, Mentis M, Vathi-Sarava P, Nikolaou G, Panagiotopoulos E. Health literacy of older adults with musculoskeletal problems: A systematic review. Int J Orthop Trauma Nurs 2024; 55:101127. [PMID: 39217800 DOI: 10.1016/j.ijotn.2024.101127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/16/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION People with poor Health Literacy (HL) find it difficult to understand medical information in their daily lives, participate in health-related decision making and comply with medical instructions. The physical effects of ageing on the musculoskeletal system have a direct impact on skills related to the management of health problems. Many older adults have limited HL, which impacts their ability to fully engage in their care and their health status. The aim of this study is to conduct a systematic review of the published research regarding the prevalence of low HL and its impact on health outcomes of older adults with musculoskeletal problems. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English, with specific pre-selected eligibility criteria. RESULTS The combined searches yielded 1617 records of which 19 articles were eligible for inclusion. The percentage of low HL varied across the studies of this review, ranging from 14% to 67%. In most studies, however, patients with limited HL were about 1/3 of the participants. Patients of lower educational level, male gender, older age, lower income, unemployment and different country of origin had lower HL level. Low HL was also associated with worse health outcomes, especially adherence to treatment, pain, functionality and health status. DISCUSSION It is of major importance to conduct educational interventions aimed at enhancing HL in this patient group, as these will contribute to the empowerment and the promotion of appropriate health behaviors of these patients.
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Affiliation(s)
- Katerina Athanasopoulou
- Educationalist, PhD Student, Department of Educational Sciences and Social Work, University of Patras, Greece.
| | - Manolis Mentis
- Assistant Professor, Department of Educational Sciences and Social Work, University of Patras, Greece.
| | | | - Georgios Nikolaou
- Professor, Department of Educational Sciences and Social Work, University of Patras, Greece.
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Keles E, Kaya L, Yakşi N, Kaya Z, Kumru P. Effects of eHealth literacy on maternal and neonatal outcomes. Women Health 2024; 64:829-838. [PMID: 39450436 DOI: 10.1080/03630242.2024.2420211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 10/15/2024] [Accepted: 10/18/2024] [Indexed: 10/26/2024]
Abstract
eHealth literacy plays a crucial role during pregnancy, as maternal health behavior can influence health outcomes for both mother and child. This study assessed the impact of eHealth literacy on maternal-fetal health outcomes through a cross-sectional analysis of 1,265 pregnant women admitted to a tertiary maternity hospital in Turkey between April and July 2022. Data on sociodemographic information, obstetric variables, birth outcomes, Internet usage, and eHealth Literacy Scale (eHEALS) were collected. Kolmogorov-Smirnov, Mann - Whitney U, Kruskal-Wallis, and Spearman correlation were used for data analysis. The median age of women was 28 years, and the mean gestational age was 38.6 weeks. Median eHealth literacy score was 21 (range:8-40). Pregnant women who had planned pregnancies, received spousal support, attended 9-12 antenatal care visits, received vaccinations, adhered to iron and folic acid supplementation, engaged in regular physical activity, and maintained regular sleep patterns exhibited higher eHealth scores (all p < .001). eHEALS scores were higher in women who experienced normal vaginal deliveries (p < .001), while lower eHEALS scores were noted in those with comorbidities (p = .001). The study suggested that higher eHealth literacy among pregnant women was associated with improved health-promoting behaviors, more favorable health perceptions, increased utilization of health services, and better maternal and fetal outcomes.
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Affiliation(s)
- Esra Keles
- Department of Gynecologic Oncology, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
- Department of Public Health, University of Health Sciences, Hamidiye Faculty of Medicine, Istanbul, Turkey
| | - Leyla Kaya
- Department of Midwifery, Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey
| | - Neşe Yakşi
- Department of Public Health, Amasya University School of Medicine, Amasya, Turkey
| | - Zahide Kaya
- Department of Internal Medicine, Uskudar State Hospital, Istanbul, Turkey
| | - Pınar Kumru
- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Disease Training and Research Hospital, Istanbul, Turkey
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Liu D, Yang S, Cheng CY, Cai L, Su J. Online Health Information Seeking, eHealth Literacy, and Health Behaviors Among Chinese Internet Users: Cross-Sectional Survey Study. J Med Internet Res 2024; 26:e54135. [PMID: 39423374 PMCID: PMC11530723 DOI: 10.2196/54135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/05/2024] [Accepted: 08/30/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND The internet has become an increasingly vital platform for health-related information, especially in upper-middle-income countries such as China. While previous research has suggested that online health information seeking (OHIS) can significantly impact individuals' engagement in health behaviors, most research focused on patient-centered health communication. OBJECTIVE This study aims to examine how OHIS influences health behavior engagement among Chinese internet users, focusing on the role of eHealth literacy and perceived information quality in influencing relationships. METHODS An online cross-sectional survey was conducted in November 2021 among 10,000 Chinese internet users, using quota sampling based on sex, age, and urban and rural residence, in line with the 48th Statistical Report on Internet Development of China. Nonparametric tests were used to examine the differences in eHealth literacy across sociodemographic groups. Partial correlation analysis and stepwise linear regression were conducted to test the associations between key variables. Confirmatory factor analysis and structural equation modeling were conducted to test the hypotheses. RESULTS Our study identified significant disparities in functional and critical eHealth literacy between urban and rural residents across age groups, income levels, education backgrounds, and health conditions (all P<.001). In terms of sex and regional differences, we found higher functional literacy among female users than male users, and critical literacy varied significantly across different regions. The proposed structural model showed excellent fit (χ2404=4183.6, χ2404=10.4,P<.001; root mean square error of approximation value of 0.031, 95% CI 0.030-.031; standardized root mean square residual value of 0.029; and comparative fit index value of 0.955), highlighting reciprocal associations between 2 types of eHealth literacy and OHIS. Participants' functional eHealth literacy, critical eHealth literacy, and OHIS have positive impacts on their health behavioral engagement. Perceived information quality was found to mediate the influence of OHIS on health behavior (b=0.003, 95% CI 0.002-0.003; P<.001). CONCLUSIONS The study revealed the pathways linking sociodemographic factors, eHealth literacy, OHIS, and perceived information quality and how they together influenced health outcomes. The findings underscore the significance of enhancing eHealth literacy and improving information quality to promote better health outcomes among Chinese internet users.
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Affiliation(s)
- Diyi Liu
- Oxford Internet Institute, University of Oxford, Oxford, United Kingdom
| | - Shuhang Yang
- Chinese Academy of Cyberspace Studies, Beijing, China
| | | | - Lin Cai
- Chinese Academy of Cyberspace Studies, Beijing, China
| | - Jing Su
- School of Humanities, Tsinghua University, Beijing, China
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Wei Y, Zhou Y. The mediating impact of exercise frequency and duration on the relationship between digital health literacy and health among older adults: A cross-sectional study. Medicine (Baltimore) 2024; 103:e39877. [PMID: 39432656 PMCID: PMC11495726 DOI: 10.1097/md.0000000000039877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 09/09/2024] [Indexed: 10/23/2024] Open
Abstract
Although several studies have discussed the relationships among digital health literacy, health, and exercise behavior, few have integrated these 3 factors into a single model. This study aims to address this research gap. This article aims to analyze the impact of digital health literacy on the health of older adults, as well as the mediating mechanisms related to exercise frequency and duration. A cross-sectional survey was conducted in Luoyang and Zhengzhou urban areas from December 2023 to January 2024. Utilizing random sampling methods, data were collected from 661 older adults through the "digital health literacy scale," "health scale," and "count of exercise duration and frequency" questionnaires. The data were processed by employing SPSS 20 and Process, v3.0, and analyzed through independent samples t test, 1-way ANOVA (F-test), and mediation testing methods. The results indicate that no statistical significance (P > .05) is observed in terms of the 3 dimensions of digital health literacy, exercise behavior, and health status among older adults with different genders, living conditions, educational backgrounds, and economic status. In contrast, statistical significance (P < .05) is observed in terms of exercise frequency and health status among older adults with varying levels of smoking and drinking. The 3 dimensions of digital health literacy among older adults statistically impact (P < .05) their exercise duration, frequency, and health. The dimension of access and assessment exerts the most significant influence on exercise duration (β = 0.415) and a considerable impact on health (β = 0.214). Furthermore, the impact of exercise duration and frequency on health status is statistically significant (P < .05). In terms of the interactive capability dimension, exercise frequency exerts the most significant influence (β = 0.199). Digital health literacy has a significant impact on the health of older adults. The duration and frequency of exercise play a partial mediating role between older adults' digital health literacy and their physical health status. Digital health literacy can encourage older adults to increase the duration and frequency of exercise, which, in turn, promotes their physical health.
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Affiliation(s)
- Ye Wei
- School of Physical Education, Henan University of Science and Technology, Luoyang, China
| | - Yinting Zhou
- School of Physical Education, Henan University of Science and Technology, Luoyang, China
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Liu L, Fu M, Wu J, Wang H, Zhao J, Chen P, Cao J, Zhang W, Lin Q, Li L. Digital health literacy among undergraduate nursing students in China: associations with health lifestyles and psychological resilience. BMC MEDICAL EDUCATION 2024; 24:1139. [PMID: 39402500 PMCID: PMC11476067 DOI: 10.1186/s12909-024-06075-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 09/23/2024] [Indexed: 10/19/2024]
Abstract
BACKGROUND Digital health literacy (DHL) is pivotal for individuals to access trustworthy health information and make informed decisions, closely intertwined with health behaviors and psychological resilience-these factors collectively shape an individual's approach to health management. Despite extensive research on digital health literacy in broader populations, the specific dynamics of digital health literacy in relation to health behaviors and psychological resilience among undergraduate nursing students in China remain understudied, highlighting a gap that this research endeavors to address. This study aims to assess the levels of digital health literacy among undergraduate nursing students in China, and to explore its association with health lifestyles and psychological resilience, which are considered influential factors. METHODS Employing a descriptive cross-sectional research design, eligible Chinese nursing undergraduates were surveyed from June to October 2023. This study recruited a total of 418 undergraduate nursing students. After excluding 11 students on leave, 407 students participated in questionnaire completion and submission. The College Students' Digital Health Literacy Scale, Healthy Lifestyle Assessment Scale and The Psychological Resilience Scale were used in this study. RESULTS The mean scores for digital health literacy, health lifestyles, and psychological resilience were 74.78 ± 8.44, 127.14 ± 11.22, and 79.21 ± 11.02, respectively. Pearson correlation analysis results indicated that the correlations between digital health literacy and both health lifestyles (r = 0.707, P < 0.01) and psychological resilience (r = 0.638, P < 0.01) were statistically significant and positive. The multiple linear regression analysis revealed that volunteer activity experience, academic performance, physical fitness, psychological traits, health lifestyle, and psychological resilience significantly predicted digital health literacy (F = 58.091, P < 0.001, R² = 0.678, adjusted R² = 0.666). Specifically, excellent academic performance (β = 0.210, P < 0.001) and good physical fitness (β = 0.188, P = 0.002) were the strongest predictors of higher digital health literacy. CONCLUSIONS There is a correlation between the digital health literacy of nursing undergraduates and their health lifestyles and psychological resilience. Future research should consider interventions in digital health literacy for undergraduate nursing students in China from the perspectives of health lifestyles and psychological resilience.
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Affiliation(s)
- Linfeng Liu
- Department of Discipline Research, Sichuan Nursing Vocational College, Chengdu, 610100, China
| | - Mengxue Fu
- Department of Rehabilitation, People's Hospital of Jianyang, Jianyang, 641400, China
| | - Jijun Wu
- Department of Cardiology, People's Hospital of Deyang, Deyang, 618099, China
| | - Hongyan Wang
- Department of Discipline Research, Sichuan Nursing Vocational College, Chengdu, 610100, China
| | - Jiaorong Zhao
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China
| | - Pei Chen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China
| | - Jun Cao
- Department of Discipline Research, Sichuan Nursing Vocational College, Chengdu, 610100, China
| | - Wen Zhang
- Department of Discipline Research, Sichuan Nursing Vocational College, Chengdu, 610100, China
| | - Qin Lin
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China.
| | - Ling Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China.
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Thomassen EEK, Berg IJ, Kristianslund EK, Tveter AT, Bakland G, Gossec L, Hakim S, Macfarlane GJ, de Thurah A, Østerås N. Patients with axial spondyloarthritis reported willingness to use remote care and showed high adherence to electronic patient-reported outcome measures: an 18-month observational study. Rheumatol Int 2024; 44:2089-2098. [PMID: 39164589 PMCID: PMC11393250 DOI: 10.1007/s00296-024-05673-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/27/2024] [Indexed: 08/22/2024]
Abstract
Remote monitoring using electronic patient reported outcomes (ePROs) in axial spondyloarthritis (axSpA) may improve self-management and reduce the need for consultations. However, knowledge regarding patients' willingness to use remote care and adherence to reporting ePROs is scarce. The objective of this study was to assess axSpA patients' willingness to use remote care and adherence to reporting of ePROs. The study was part of a three-armed randomized controlled trial testing digital follow-up strategies (The ReMonit study, NCT: 05031767). AxSpA patients in low disease activity were randomized to usual care, remote monitoring, or patient-initiated care. Demographics, clinical data, and patients' willingness to use remote care were collected at baseline. EPROs were reported either monthly or quarterly by the remote monitoring- and patient-initiated care group over 18 months, respectively. Adherence to reporting was calculated as number of ePROs completed divided by the total number requested. Mixed model logistic regression was utilized to assess factors associated with adherence to reporting of ePROs. In total 242 patients (median age 43 years, 75% males) were included. The majority (96%) reported high willingness to use remote care. Adherence to reporting ePROs remained high over 18 months by remote monitoring and patient-initiated care groups [median (IQR): 88% (77-100) vs. 83% (66-100)]. No patient characteristics were significantly associated with adherence to reporting of ePROs. The high degree of willingness and adherence to reporting ePROs over time indicates that the majority of axSpA patients with low disease activity are motivated to use remote care.
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Affiliation(s)
- Emil Eirik Kvernberg Thomassen
- Centre for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
- Faculty of Medicine, University of Oslo (UiO), Oslo, Norway.
| | - Inger Jorid Berg
- Centre for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Eirik Klami Kristianslund
- Centre for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Anne Therese Tveter
- Centre for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Gunnstein Bakland
- Department of Rheumatology, University Hospital of North Norway, Tromsø, Norway
- Institute of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Tromsø, Tromsø, Norway
| | - Laure Gossec
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- Rheumatology Department Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Sarah Hakim
- Centre for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Gary John Macfarlane
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK
| | - Annette de Thurah
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nina Østerås
- Centre for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo (UiO), Oslo, Norway
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Yavari B, Kolbehdari N, Gann L, Portillo M, Rumschlag A, Aldridge M, Mellon W, Alcaraz GM, Richker H, Sarkissian M, Compton ZT, Aktipis A, Maley C, Baciu C. The Digital Health Revolution: Exploring the Impact of Online Cancer Information on Self-Reported Preventive Behaviors. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.20.24307517. [PMID: 38826228 PMCID: PMC11142276 DOI: 10.1101/2024.05.20.24307517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Cancer, one of the leading causes of death worldwide, is a disease characterized by uncontrolled cell growth within the body. While there have been many improvements in the treatment of cancer clinically, there is now an urgent need to improve cancer-related communication. This study explores the impact of online health information, specifically cancer-related information and prevention, among members of the general public. Through a randomized survey, we examined what information leads people to take action to minimize their cancer risk and communicate with their providers. Through evaluation of the various modes of communication, we were able to provide insight into which are more effective and better received by members of the general public. Through this, ways of bettering these avenues of communication and strengthening the bond between them will be highlighted and more easily elaborated on by future studies. The results of our study indicated that 60% of participants asserted that they are motivated by online preventive information to take steps to limit their cancer risk, while only roughly 44% of participants overall agreed that their doctor has communicated with them about when proper cancer screenings should be scheduled for the future. Although patients may be turning to the Internet now more than ever due to various reasons, when comparing self-reported rates of comprehension among the study participants, 35% agreed that the cancer-related information they can access online is confusing, while fewer than 22% of participants agreed that the cancer-related information they receive directly from their doctor is confusing. This is indicative of the limitations the Internet may have when undertaking the role of being a medical resource, especially when acting as a replacement for in-person medical appointments where patients can communicate directly with their physicians. Ultimately, these results provide a unique perspective into how people receive, evaluate, and implement cancer-preventive steps and general health-related information in a post-COVID-19 world, where the Internet is now strongly embedded in healthcare.
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Affiliation(s)
- Bryan Yavari
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Nilofar Kolbehdari
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Lindsay Gann
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Mercedes Portillo
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | | | - Melanie Aldridge
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Walker Mellon
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | | | - Harley Richker
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | | | - Zachary T Compton
- Arizona Cancer Evolution Center
- University of Arizona Cancer Center
- University of Arizona College of Medicine
| | - Athena Aktipis
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Carlo Maley
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Cristina Baciu
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
- W.P. Carey School of Business, Arizona State University
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25
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Chung Y, Kim JS. Association between health-related behaviors and obstructive sleep apnea among Korean adults. Sci Rep 2024; 14:21244. [PMID: 39261636 PMCID: PMC11390712 DOI: 10.1038/s41598-024-72401-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 09/06/2024] [Indexed: 09/13/2024] Open
Abstract
We aimed to investigate the association between health-related behaviors and obstructive sleep apnea (OSA) among Korean adults. A cross-sectional design using national open data was employed. Data from 8,096 adults aged 40 years and above who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2021 were analyzed. The participants' OSA risk level was assessed using the STOP-Bang questionnaire. A logistic regression analysis was performed to investigate the association between health-related behaviors and high risk for OSA. The association between health-related behaviors and OSA risk remained significant for former smokers (OR = 1.643) and high-risk drinking (OR = 1.365), after adjusting for variables that showed significant differences in general and metabolic characteristics. Implementing lifestyle modifications is crucial for mitigating the health and societal impact of OSA. Understanding and addressing modifiable risk factors, including high-risk drinking and smoking, should be prioritized in nursing intervention. Nursing interventions are critical for preventing and managing OSA among Korean adults. Prioritizing high-risk behaviors through cessation programs and education is essential. Vulnerability of individuals living alone must be addressed through community outreach and support services. Emphasizing routine screenings for pre-hypertension and pre-diabetes, promoting balanced nutrition, and encouraging physical activity are crucial.
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Affiliation(s)
- Yoongi Chung
- Department of Nursing, Chung-Ang University, 84, Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea
| | - Ji-Su Kim
- Department of Nursing, Chung-Ang University, 84, Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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26
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Salim MM, Yang LT, Park JH. Lightweight Authentication Scheme for IoT Based E-Healthcare Service Communication. IEEE J Biomed Health Inform 2024; 28:5025-5032. [PMID: 38048233 DOI: 10.1109/jbhi.2023.3338851] [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: 12/06/2023]
Abstract
Remote Patient Monitoring (RPM) using Electronic Healthcare (E-health) is a growing phenomenon enabling doctors predict patient health such as possible cardiac arrests from identified abnormal arrythmia. Remote Patient Monitoring enables healthcare staff to notify patients with preventive measures to avoid a medical emergency reducing patient stress. However weak authentication security protocols in IoT wearables such as pacemakers, enable cyberattacks to transmit corrupt data, preventing patients from receiving medical care. In this paper we focus on the security of wearable devices for reliable healthcare services and propose a Lightweight Key Agreement (LKA) based authentication scheme for securing Device-to-Device (D2D) communication. A Network Key Manager on the edge builds keys for each device for device validation. Device authentication requests are verified using certificates, reducing network communication costs. E-health empowered mobile devices are store authentication certificates for future seamless device validation. The LKA scheme is evaluated and compared with existing studies and exhibits reduced operation time for key generation operation costs and lower communication costs incurred during the execution of the device authentication protocol compared with other studies. The LKA scheme further exhibits reduced latency when compared with the three existing schemes due to reduced communication costs.
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27
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Peng RX, Shen F. Why fall for misinformation? Role of information processing strategies, health consciousness, and overconfidence in health literacy. J Health Psychol 2024:13591053241273647. [PMID: 39175178 DOI: 10.1177/13591053241273647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Health misinformation, defined as false or misleading claims lacking scientific evidence, poses a significant threat to public health. This paper investigates factors associated with the failure to discern misinformation, including health consciousness, information processing strategies, and inaccurate self-assessments of health literacy. Through an online experiment involving 707 English-speaking U.S. participants (mean age = 43 years, 56.2% female), we found that misinformation beliefs about nutrition, vaccination, vaping, and cancer were significantly correlated, implying susceptibility across health topics. Greater susceptibility was associated with higher health consciousness, lower objective health literacy, more elaboration, and more selective scanning. Results provided evidence for the Dunning-Kruger effect and metacognitive monitoring errors, whereby confident individuals were unaware of inadequate health literacy and showed poor misinformation identification. Findings suggest that promoting both health literacy education and cognitive reflection skills among the general adult population could empower them to more critically evaluate online health information.
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28
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Gallo AM, Laranjeira C, Araújo JP, Marques FRDM, Baccon WC, Salci MA, Carreira L. The experiences of daily smartphone use among older adults in Brazil: A grounded theory analysis. Heliyon 2024; 10:e35120. [PMID: 39161834 PMCID: PMC11332897 DOI: 10.1016/j.heliyon.2024.e35120] [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: 04/15/2024] [Revised: 07/21/2024] [Accepted: 07/23/2024] [Indexed: 08/21/2024] Open
Abstract
Background Digital inclusion of older people is an important agenda for the future and well-being of the older population, as it represents a form of social inclusion with significant gains for healthy aging. The present study aimed to understand the experiences of Brazilian older adults who use smartphones and the implications in their daily lives. Method A qualitative study was developed using a constructivist grounded approach. Older people (≥60 years) with prior access to a smartphone were invited to participate in the study. Participation took place through semi-structured, audio-recorded interviews. Data collection and analysis occurred simultaneously using a constant comparative approach. Data management and analysis used the Atlas.ti® software. Results Overall, 37 older people participated, with an average age of 70.60 ± 6.95 years, predominantly female (n = 33), white (n = 25), married (n = 26) and retired (n = 27). The first sample group included 27 older people with family support and the second group included 10 older people without family support (who lived alone in their homes). A core category emerged from the data analysis-"Expanding the personal and social development of older adults through smartphone communication"-around which three main categories emerged: 1) The smartphone as "a window to the world"; 2) The problem of misinformation and fake news on virtual networks; 3) Technological paradoxes in the use of smartphones. Conclusions The digital transition associated with smartphone use brings unimaginable benefits to older adults who adopt positive habits to improve their well-being and expand their social connections, following efforts proposed by the Decade of Healthy Aging. However, older adults still face disparities and experience a significant digital divide, which represents a major challenge. Barriers to access are further aggravated in developing countries. We hope this study contributes to public health policies on digital inclusion and healthy aging.
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Affiliation(s)
- Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, Brazil
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto Do Vieiro, Apartado 4137, 2411-901, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua Das Olhalvas, 2414-016 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000- 801 Évora, Portugal
| | - Juliane Pagliari Araújo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid, PR-445, Km 380 - Campus Universitário, Londrina 86057-970, Brazil
| | | | - Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, Brazil
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, Brazil
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, Brazil
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Zhao J, Nie L, Pan L, Pang M, Wang J, Zhou Y, Chen R, Liu H, Xu X, Zhou C, Li S, Kong F. Association between social capital, mental health, and digital health literacy among the university students in China: a multigroup analysis based on major difference. BMC Public Health 2024; 24:2193. [PMID: 39138431 PMCID: PMC11321090 DOI: 10.1186/s12889-024-19672-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 08/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND This study aimed to clarify medical-nonmedical difference on the relationship between social capital, mental health and digital health literacy of university students in China, and furtherly provide evidence-based suggestions on the improvement of the digital health literacy for the university students. METHODS The snowball sampling method was used to collect data from the university students (including medical students and nonmedical students) through online questionnaires, and finally 1472 university students were included for the data analysis, of whom, 665 (45.18%) were medical students, 807 (54.82%) were nonmedical students; 462 (31.39%) were male, 1010 (68.61%) were female. Mean value of the age was 21.34 ± 2.33 for medical students vs. 20.96 ± 2.16 for nonmedical students. Descriptive analysis, chi-square test analysis, one-way Analysis of Variance (conducted by SPSS) and structural equation modeling (conducted by AMOS) were employed to explore the difference on the relationship between social capital, mental health and digital health literacy between the medical students and nonmedical students. RESULTS The mean value of the digital health literacy was 36.27 (37.33 for medical students vs. 35.39 for nonmedical students). The SEM analysis showed that there was a statistically positive correlation between social capital and digital health literacy (stronger among the nonmedical students (0.317) than medical students (0.184)). Mental health had a statistically positive impact on the digital health literacy among medical students (0.242), but statistically significant correlation was not observed in nonmedical students (0.017). Social capital was negatively correlated with the mental health for both medical students and NMS (stronger among the nonmedical students (0.366) than medical students (0.255)). And the fitness indices of SEM were same between medical students and nonmedical students (GFI = 0.911, AGFI = 0.859, CFI = 0.922, RMSEA = 0.074). CONCLUSION The digital health literacy of the university student was relatively high. Both social capital and mental health could exert a positive effect on digital health literacy, while social capital was found to be positively associated with mental health. Statistical difference was found between medical students and nonmedical students on the above correlations. Implications were given on the improvement of the digital health literacy among university students in China.
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Affiliation(s)
- Jiajia Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Limei Nie
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Lutong Pan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Yue Zhou
- Department of Mathematics, College of Art and Science, New York University, New York, 10003, USA
| | - Rui Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Hui Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Xixing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China.
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Li J. The relationship between peer support and sleep quality among Chinese college students: the mediating role of physical exercise atmosphere and the moderating effect of eHealth literacy. Front Psychol 2024; 15:1422026. [PMID: 39144583 PMCID: PMC11322897 DOI: 10.3389/fpsyg.2024.1422026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024] Open
Abstract
Background Poor sleep quality has emerged as a prevalent health issue among college students. This study aims to explore the mechanism of sleep quality among college students by constructing a moderated mediation model. Methods The Peer Support Scale, Physical Exercise Atmosphere Scale, eHealth Literacy Scale and Pittsburgh Sleep Quality Index were used to conduct a survey and analysis on 1,085 questionnaires, which were distributed among students from four universities in the northwest, northeast and central regions of China. Results (1) A significant pairwise correlation exists between peer support, physical exercise atmosphere, eHealth literacy and sleep quality (P < 0.001); (2) Physical exercise atmosphere plays a mediating role between peer support and sleep quality, with a mediating effect accounting for 28.08%; (3) eHealth literacy can significantly moderate the strength of the relationships between peer support and exercise atmosphere, between peer support and sleep quality, and between physical exercise atmosphere and sleep quality. This study revealed the relationship between peer support and sleep quality among college students and its influencing mechanism, and provided theoretical and practical basis for improving college students' sleep quality from the perspectives of peer support, physical exercise atmosphere, and eHealth literacy.
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Affiliation(s)
- Jin Li
- Department of Physical Education, Beijing Union University, Beijing, China
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31
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Press VG. Real-World Use of Inhaled COPD Medications: the Good, the Bad, the Ugly. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2024; 11:331-340. [PMID: 39054287 PMCID: PMC11363969 DOI: 10.15326/jcopdf.2024.0546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/12/2024] [Indexed: 07/27/2024]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) rely primarily on inhaled medications to control and treat symptoms. Although the medications delivered by inhaler devices are often quite efficacious when delivered to the lung, the real-world effectiveness of these inhaler devices often falls short. Barriers to effective inhaler use include inhaler misuse and cost-related nonadherence. Inhaler misuse can be reduced with appropriate education which leads to improved outcomes. Education can be provided in multiple settings by a wide array of clinicians and clinical team members including pharmacists, respiratory therapists, nurses, physicians, advanced practice nurses, physician assistants, and community health workers, among others. However, despite decades of research and existing effective strategies across settings and types of educators, overall not much progress has been made with respect to effective inhaler technique among populations of patients with COPD in nearly half a century. Similarly, cost-related nonadherence is a long-standing and critical barrier to effective control of COPD, with limited improvements, especially until very recently. This perspective reviews the current promising directions for inhaler-based therapies, ongoing challenges, and critical issues requiring urgent attention.
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Affiliation(s)
- Valerie G. Press
- Department of Medicine, University of Chicago, Chicago, Illinois, United States
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Miao Y, Luo Y, Zhao Y, Liu M, Wang H, Wu Y. Effectiveness of eHealth Interventions in Improving Medication Adherence Among Patients With Cardiovascular Disease: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e58013. [PMID: 39008845 PMCID: PMC11287104 DOI: 10.2196/58013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/02/2024] [Accepted: 05/30/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Nonadherence to medication among patients with cardiovascular diseases undermines the desired therapeutic outcomes. eHealth interventions emerge as promising strategies to effectively tackle this issue. OBJECTIVE The aim of this study was to conduct a network meta-analysis (NMA) to compare and rank the efficacy of various eHealth interventions in improving medication adherence among patients with cardiovascular diseases (CVDs). METHODS A systematic search strategy was conducted in PubMed, Embase, Web of Science, Cochrane, China National Knowledge Infrastructure Library (CNKI), China Science and Technology Journal Database (Weipu), and WanFang databases to search for randomized controlled trials (RCTs) published from their inception on January 15, 2024. We carried out a frequentist NMA to compare the efficacy of various eHealth interventions. The quality of the literature was assessed using the risk of bias tool from the Cochrane Handbook (version 2.0), and extracted data were analyzed using Stata16.0 (StataCorp LLC) and RevMan5.4 software (Cochrane Collaboration). The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. RESULTS A total of 21 RCTs involving 3904 patients were enrolled. The NMA revealed that combined interventions (standardized mean difference [SMD] 0.89, 95% CI 0.22-1.57), telephone support (SMD 0.68, 95% CI 0.02-1.33), telemonitoring interventions (SMD 0.70, 95% CI 0.02-1.39), and mobile phone app interventions (SMD 0.65, 95% CI 0.01-1.30) were statistically superior to usual care. However, SMS compared to usual care showed no statistical difference. Notably, the combined intervention, with a surface under the cumulative ranking curve of 79.3%, appeared to be the most effective option for patients with CVDs. Regarding systolic blood pressure and diastolic blood pressure outcomes, the combined intervention also had the highest probability of being the best intervention. CONCLUSIONS The research indicates that the combined intervention (SMS text messaging and telephone support) has the greatest likelihood of being the most effective eHealth intervention to improve medication adherence in patients with CVDs, followed by telemonitoring, telephone support, and app interventions. The results of these network meta-analyses can provide crucial evidence-based support for health care providers to enhance patients' medication adherence. Given the differences in the design and implementation of eHealth interventions, further large-scale, well-designed multicenter trials are needed. TRIAL REGISTRATION INPLASY 2023120063; https://inplasy.com/inplasy-2023-12-0063/.
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Affiliation(s)
- Yiqun Miao
- School of Nursing, Capital Medical University, Beijing, China
| | - Yuan Luo
- School of Nursing, Capital Medical University, Beijing, China
| | - Yuhan Zhao
- School of Nursing, Capital Medical University, Beijing, China
| | - Mingxuan Liu
- School of Nursing, Capital Medical University, Beijing, China
| | - Huiying Wang
- School of Nursing, Capital Medical University, Beijing, China
| | - Ying Wu
- School of Nursing, Capital Medical University, Beijing, China
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Liu J, Liu S, Yu S, Du X, Hao J, Hui R, Buh A, Chen W, Chen J. Willingness to receive mpox vaccine among men who have sex with men: a systematic review and meta-analysis. BMC Public Health 2024; 24:1878. [PMID: 39010029 PMCID: PMC11247826 DOI: 10.1186/s12889-024-19260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Since May 2022, mpox outbreaks have been occurring in non-mpox endemic areas, with the main population affected being men who have sex with men (MSM). Outbreak prevention and control depend not only on the effectiveness of vaccines but also on people's willingness to receive these vaccines. Currently, there is lack of synthesis on the overall rates and influence factors of MSMs' willingness to vaccinate against mpox. Therefore, we systematically reviewed studies that assessed the willingness of MSM to receive mpox vaccine. METHODS Studies reporting mpox vaccination intentions among MSM were included by searching five databases (PubMed, Web of Science, EMBASE, CINAHL, and SCOPUS) from inception to May 12, 2024. The quality of the included literature was assessed using Joanna Briggs Institute's critical appraisal tool. The data analysis software is Stata17. The systematic review has been registered with Prospero (registration ID: CRD42023452357). RESULTS Twenty cross-sectional studies were included in the review. Meta-analysis results showed that the pooled willingness rate of vaccinate against mpox was 77.0% (95% CI: 73-81%, I2 = 99.4%). According to subgroup analysis, study countries (P = 0.002), research sample size (P = 0.001), and whether participants were infected with HIV (P = 0.002) may be sources of heterogeneity. The results of the meta-analysis of influencing factors showed that more number of sexual partners (OR: 2.24, 95%CI: 1.86-2.69), pre-exposure prophylaxis use (OR: 6.04, 95%CI: 4.80-7.61), history of sexually transmitted infections (OR: 2.96, 95%CI: 2.33-3.76), confidence in the vaccine's effectiveness (OR: 2.79, 95%CI: 2.04-3.80) and safety (OR: 10.89, 95%CI: 5.22-22.72), fear of mpox infection (OR: 2.47, 95%CI: 2.11-2.89) and epidemics (OR: 2.87, 95%CI: 2.22-3.70), high mpox knowledge (OR: 2.35, 95%CI: 1.51-3.66), and the belief that people at high risk should be prioritized for vaccination (OR: 3.09, 95%CI: 1.40-6.84) were the facilitators of vaccine willingness. In addition, as a secondary outcome, meta-analysis results showed a pooled unwillingness rate of 16% (95% CI: 13-20%, I2 = 98.1%, 9 studies). CONCLUSION Willingness to vaccinate mpox was high among MSM, but some participants still had negative attitudes towards vaccination. Therefore, the Ministry of Public Health should develop targeted and effective strategies against those influencing factors to prevent and manage mpox outbreaks.
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Affiliation(s)
- Jiajia Liu
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Siying Liu
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Simin Yu
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Xiaoyu Du
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Jiaqi Hao
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Ruixue Hui
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Amos Buh
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Wenjun Chen
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan, China.
| | - Jia Chen
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan, China.
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Le Brun M, Godard D, Camps L, Gomes de Pinho Q, Benyamine A, Granel B. [Health literacy: Definition, assessment tools, state of the art in Europe, health consequences and ways to improve it]. Rev Med Interne 2024:S0248-8663(24)00673-8. [PMID: 38991855 DOI: 10.1016/j.revmed.2024.06.014] [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: 04/18/2024] [Revised: 06/16/2024] [Accepted: 06/22/2024] [Indexed: 07/13/2024]
Abstract
The term "littératie" is derived from the English word "literacy", which refers to knowledge and skills in the fields of reading, writing, speech (or other means of communication) and calculation that allow people to be efficient and integrated into society. Health literacy is a recent concept that relies on the ability to find, understand, evaluate and communicate information in ways that promote, maintain and improve the health of the individual in various settings over the course of life. The objectives of this review are first of all to realize an overview on the health literacy of populations in Europe. Then, we propose to study the link between health literacy and health status (risk behaviors, chronic diseases, morbi-mortality, adherence to care and medical monitoring) and to study its medico-economic impact. We also analyzed the association between personalized therapeutic education and health literacy. Finally, we propose a review of the means put in place in the care system to improve the health literacy of the patients we manage.
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Affiliation(s)
- Magali Le Brun
- Service de médecine interne, hôpital Nord, Aix-Marseille université (AMU), Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Dominique Godard
- Association des sclérodermiques de France (ASF), 45130 Baccon, France
| | - Lila Camps
- Association des sclérodermiques de France (ASF), 45130 Baccon, France
| | - Quentin Gomes de Pinho
- Service de médecine interne, hôpital Nord, Aix-Marseille université (AMU), Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Audrey Benyamine
- Service de médecine interne, hôpital Nord, Aix-Marseille université (AMU), Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Brigitte Granel
- Service de médecine interne, hôpital Nord, Aix-Marseille université (AMU), Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France.
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Qiu Z, Jia X, Li Y, Fu Y, Xiao Y. Screen time in the development of type 2 diabetes mellitus (T2DM) : a two-sample Mendelian randomization study. Endocrine 2024; 85:158-167. [PMID: 38347339 DOI: 10.1007/s12020-024-03723-5] [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: 11/08/2023] [Accepted: 01/30/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE This study aimed to investigate the potential causal relationship between screen time and the risk of developing type 2 diabetes mellitus (T2DM) using Mendelian randomization. METHODS Two-sample Mendelian randomization was conducted, utilizing genetic variants associated with different types of screen time as instrumental variables. Single nucleotide polymorphisms (SNPs) were used to assess the primary outcome, which was the risk of developing T2DM. RESULTS The analysis revealed a significant positive causal association between television viewing time and the risk of T2DM. Specifically, excessive television viewing time was found to increase the risk of developing T2DM (OR: 2.39, 95% CI: 1.90 to 3.00, P < 0.01). However, no significant causal relationship was observed between computer usage time and the risk of T2DM. Additionally, mobile phone use time showed a positive correlation with the risk of T2DM (OR: 1.31, 95% CI: 1.04 to 1.64, P = 0.02), albeit to a lesser extent than television viewing time. CONCLUSION The findings of this study indicate a significant causal association between certain types of screen time, specifically television viewing and mobile phone use, and an increased risk of T2DM.
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Affiliation(s)
- Zhengqi Qiu
- Faculty of Medicine, Macau University of Science and Technology, Est. Seak Pai Van Praia Park, Rés-Do-Chão R, Coloane, Macao, 999078, China
| | - Xueyuan Jia
- Faculty of Medicine, Macau University of Science and Technology, Est. Seak Pai Van Praia Park, Rés-Do-Chão R, Coloane, Macao, 999078, China
| | - Yufei Li
- Faculty of Medicine, Macau University of Science and Technology, Est. Seak Pai Van Praia Park, Rés-Do-Chão R, Coloane, Macao, 999078, China
| | - Yancheng Fu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Health Science Center, Shenzhen University, Shenzhen, 518060, China
| | - Ying Xiao
- Faculty of Medicine, Macau University of Science and Technology, Est. Seak Pai Van Praia Park, Rés-Do-Chão R, Coloane, Macao, 999078, China.
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Yuan X, Lu L, Jiang R, Yu Y, Zhou J, Wang L, Du Y. Human papilloma virus (HPV)-related information acquisition and seeking behavior among infected women: A single center cross-sectional survey in Shanghai, China. Glob Health Med 2024; 6:212-217. [PMID: 38947411 PMCID: PMC11197161 DOI: 10.35772/ghm.2023.01100] [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: 09/15/2023] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 07/02/2024]
Abstract
Lacking of adequate knowledge is an obstacle to effective prevention of cervical cancer, yet factors that affect the information acquisition and seeking behavior as well as the information communication process are not well studied. We assessed information acquisition and seeking behavior, as well as perceived barriers of doctor-patient communication regarding human papilloma virus (HPV)-related information of infected women. Among 437 participants, 405 (93%) expressed demands for HPV-related information, while only a small proportion (100/437, 22.9%) actively sought information and felt obstacles comprehending. Web-based channels were most frequently utilized and medical personnel were the most trusted information source. Patients' satisfaction was significantly correlated with doctor's patience (r = 0.581, p < 0.001) and emotional caring (r = 0.555, p < 0.001). Compared to patients not actively seeking information, those actively seeking information were more likely to be single (p = 0.005), had higher education (p = 0.009) and monthly individual-level income (p = 0.023), and was more likely to undergo regular cervical cancer screening (p = 0.003), and were already or willing to be vaccinated (p = 0.008). The actively seeking information group also achieved higher scores in HPV knowledge test (p = 0.007). Public health interventions targeting HPV-infected women using specifically designed educational materials may influence information seeking behavior, increase HPV literacy and knowledge, which could potentially increase HPV vaccine uptake and cervical cancer screening rate.
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Affiliation(s)
- Xiehua Yuan
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Linlin Lu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Ruhe Jiang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yue Yu
- Eight-year Clinical Medicine Program, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jing Zhou
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Ling Wang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Yan Du
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
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Cai W, Liang W, Liu H, Zhou R, Zhang J, Zhou L, Su N, Zhu H, Yang Y. Electronic Health Literacy Scale-Web3.0 for Older Adults with Noncommunicable Diseases: Validation Study. J Med Internet Res 2024; 26:e52457. [PMID: 38830207 PMCID: PMC11184271 DOI: 10.2196/52457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/11/2023] [Accepted: 04/19/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND In the current digital era, eHealth literacy plays an indispensable role in health care and self-management among older adults with noncommunicable diseases (NCDs). Measuring eHealth literacy appropriately and accurately ensures the successful implementation and evaluation of pertinent research and interventions. However, existing eHealth literacy measures focus mainly on individuals' abilities of accessing and comprehending eHealth information (Web1.0), whereas the capabilities for web-based interaction (Web2.0) and using eHealth information (Web3.0) have not been adequately evaluated. OBJECTIVE This study aimed to examine the reliability, validity, and measurement invariance of the eHealth Literacy Scale-Web3.0 (eHLS-Web3.0) among older adults with NCDs. METHODS A total of 642 Chinese older adults with NCDs (mean age 65.78, SD 3.91 years; 55.8% female) were recruited in the baseline assessment, of whom 134 (mean age 65.63, SD 3.99 years; 58.2% female) completed the 1-month follow-up assessment. Baseline measures included the Chinese version of the 24-item 3D eHLS-Web3.0, the Chinese version of the 8-item unidimensional eHealth Literacy Scale (eHEALS), and demographic information. Follow-up measures included the 24-item eHLS-Web3.0 and accelerometer-measured physical activity and sedentary behavior. A series of statistical analyses, for example, Cronbach α, composite reliability coefficient (CR), confirmatory factor analysis (CFA), and multigroup CFA, were performed to examine the internal consistency and test-retest reliabilities, as well as the construct, concurrent, convergent, discriminant, and predictive validities, and the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence. RESULTS Cronbach α and CR were within acceptable ranges of 0.89-0.94 and 0.90-0.97, respectively, indicating adequate internal consistency of the eHLS-Web3.0 and its subscales. The eHLS-Web3.0 also demonstrated cross-time stability, with baseline and follow-up measures showing a significant intraclass correlation of 0.81-0.91. The construct validity of the 3D structure model of the eHLS-Web3.0 was supported by confirmatory factor analyses. The eHLS-Web3.0 exhibited convergent validity with an average variance extracted value of 0.58 and a CR value of 0.97. Discriminant validity was supported by CFA results for a proposed 4-factor model integrating the 3 eHLS-Web3.0 subscales and eHEALS. The predictive validity of the eHLS-Web3.0 for health behaviors was supported by significant associations of the eHLS-Web3.0 with light physical activity (β=.36, P=.004), moderate to vigorous physical activity (β=.49, P<.001), and sedentary behavior (β=-.26, P=.002). Finally, the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence was supported by the establishment of configural, metric, strong, and strict invariances. CONCLUSIONS The present study provides timely empirical evidence on the reliability, validity, and measurement invariance of the eHLS-Web3.0, suggesting that the 24-item 3D eHLS-Web3.0 is an appropriate and valid tool for measuring eHealth literacy among older adults with NCDs within the Web3.0 sphere.
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Affiliation(s)
- Wenfei Cai
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Wei Liang
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Huaxuan Liu
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Rundong Zhou
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Jie Zhang
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Lin Zhou
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
| | - Ning Su
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Hanxiao Zhu
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Yide Yang
- School of Medicine, Hunan Normal University, Changsha, China
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Elgamal R. Meta-analysis: eHealth literacy and attitudes towards internet/computer technology. PATIENT EDUCATION AND COUNSELING 2024; 123:108196. [PMID: 38364573 DOI: 10.1016/j.pec.2024.108196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE To explore the relationship between eHealth literacy and attitudes towards internet/computer (I/C) technology use in healthcare. METHODS Analysis of data from 16 cross-sectional studies, involving literature search from databases like PubMed, EBSCO, JMIR, up to April 2023. Studies were selected based on a quantitative cross-sectional design, with no restrictions on participant characteristics. RESULTS A significant positive correlation (0.36; 95% CI 0.37-0.38, p < 0.05) was found between eHealth literacy and positive attitudes towards I/C technology use. Age and regional differences, especially in participants over 50 and from Asian and Middle Eastern countries, were notable. CONCLUSION Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions.
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Affiliation(s)
- Raghad Elgamal
- DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada.
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Eto M, Yamatsu K. Associations of eHealth Literacy with Social Activity among Community-Dwelling Older Adults: A Cross-Sectional Study. Eur J Investig Health Psychol Educ 2024; 14:1279-1294. [PMID: 38785582 PMCID: PMC11120453 DOI: 10.3390/ejihpe14050084] [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: 03/25/2024] [Revised: 04/26/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Older adults who use digital technology are desired to adapt to digitalization and literacy. One required aspect is eHealth literacy, measured with the eHealth Literacy Scale (eHEALS). Many studies on eHealth literacy have used the eHEALS to examine the health behaviors of college students, relatively younger adults, and Internet users. However, the relevance of eHealth literacy to social activity has not yet been studied in older adults. The purposes of this study were to examine the relationship between eHealth literacy and health behaviors and social activities (community, cultural, and sports activities) and to investigate the factors associated with eHEALS scores among community-dwelling older adults. The mean eHEALS score was 12.4 points (SD 8.2), with the majority (73.3%) having the lowest score (the lowest score is 8 points). Males (17.6, SD 10.5) scored significantly higher than females (11.8, SD 7.7). The eHEALS score had a significant relationship with both cultural and community activity. Five factors significantly associated with having the lowest eHEALS score were cultural activity at least once a week, no cultural activity, no community activity, total IADL score, and intellectual activity. These results suggest that eHealth literacy is associated with community activity and cultural activity among older adults.
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Affiliation(s)
- Mamiko Eto
- Graduate School of Medical Science, Saga University, Saga 849-8502, Japan;
| | - Koji Yamatsu
- Graduate School of Medical Science, Saga University, Saga 849-8502, Japan;
- Graduate School of Advanced Health Sciences, Saga University, Saga 849-8502, Japan
- Faculty of Education, Saga University, Saga 840-8502, Japan
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Patel S, Sreelal B, Kalyani S, Joy SG, Pravalika T, Ramya T, Khan S, Archana V, Gandhi AP. Digital health literacy among the ageing population: A comparative cross-sectional study between rural and urban Telangana, India. Med J Armed Forces India 2024; 80:313-319. [PMID: 38799990 PMCID: PMC11117001 DOI: 10.1016/j.mjafi.2023.09.006] [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: 05/08/2023] [Accepted: 09/07/2023] [Indexed: 05/29/2024] Open
Abstract
Background Digital health literacy (DHL) is the confluence where health literacy meets digital literacy. DHL has been labelled as one of the digital determinants of health by the World Health Organization. The present study estimated and compared the DHL between Telangana's urban and rural ageing adults, and their potential determinants. Methods A cross-sectional study was undertaken among 318 of the ageing individuals (≥45 years) of Hyderabad, visiting the primary health centres in the rural and urban field practice during March 2023. A Telugu version of the eHealth literacy scale (eHEALS) and health literacy scale tools were administered by the interviewers. Adjusted analysis was conducted by multiple linear regression method. Results Overall, 20.4% of the study participants had good DHL, with a similar proportion between rural and urban areas (rural-20.1% and urban-20.8%, p value-0.889). The median eHealth literacy score among the study participants was 8. While 36.5% and 45.9% had smartphones and standard analogue phones, respectively in urban areas, only 19.5% and 38.4% had smartphones and standard analogue phones, respectively in rural areas. Computer usage in the past month, higher educational qualification, and ownership of mobile phones were significant determinants of DHL. A mild but significant correlation between DHL and health literacy screening scores was found. Conclusion Considering the low DHL among the ageing population, enabling environment with enhanced access to mobile phones/smartphones and familiarity with information and communication technology gadgets must be established to improve their DHL.
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Affiliation(s)
- Sunil Patel
- Intern (Community Medicine), ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
| | - B.S. Sreelal
- Intern (Community Medicine), ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
| | - Sriramoju Kalyani
- Intern (Community Medicine), ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
| | - Sona G. Joy
- Intern (Community Medicine), ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
| | | | - Thatikonda Ramya
- Intern (Community Medicine), ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
| | - Somiya Khan
- Intern (Community Medicine), ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
| | - Vadithya Archana
- Intern (Community Medicine), ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
| | - Aravind P. Gandhi
- Assistant Professor (Community Medicine), ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
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Zhang L, Ye JF, Zhao X. "I Saw it Incidentally but Frequently": Exploring the Effects of Online Health Information Scanning on Lung Cancer Screening Behaviors Among Chinese Smokers. HEALTH COMMUNICATION 2024:1-12. [PMID: 38683113 DOI: 10.1080/10410236.2024.2345948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
In China, lung cancer is the most common cancer with high mortality. While prior research suggests that health information scanning influences cancer screening within the general population, a deeper exploration of the underlying mechanisms is imperative. This study specifically targets smokers, aiming to investigate whether online health information scanning can effectively encourage lung cancer screening and elucidate the mechanisms driving this association. Data were extracted from a Chinese national survey conducted between January and September 2023, exclusively involving current smokers (N = 992). A moderated mediation model was employed to examine a cognitive-affective sequential chain of mediation through risk perceptions and cancer worry. Results showed that 99.1% of Chinese smokers reported online health information scanning, which possessed significant influence. Online health information scanning was positively associated with effective lung cancer screening among smokers directly (OR = 1.927, p < .01) and indirectly (OR = .065, p < .001). The perceived threat of smoking and cancer worry served as the cognitive and affective mediating mechanisms. Furthermore, a moderating effect of eHealth literacy was observed (OR = 6.292, p < .05). Smokers with higher eHealth literacy are more inclined to undergo effective lung cancer screening. Based on these findings, public health sectors should leverage online platforms to disseminate tailored cancer screening education and implement initiatives to enhance public eHealth literacy.
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Affiliation(s)
- Luxi Zhang
- Department of Communication/Institute of Collaborative Innovation, University of Macau
| | - Jizhou Francis Ye
- Department of Communication/Institute of Collaborative Innovation, University of Macau
| | - Xinshu Zhao
- Department of Communication/Institute of Collaborative Innovation/Center for Research in Greater Bay Area, University of Macau
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Marsall M, Dinse H, Schröder J, Skoda EM, Teufel M, Bäuerle A. Assessing Electronic Health Literacy in Individuals With the Post-COVID-19 Condition Using the German Revised eHealth Literacy Scale: Validation Study. JMIR Form Res 2024; 8:e52189. [PMID: 38662429 PMCID: PMC11082733 DOI: 10.2196/52189] [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: 08/28/2023] [Revised: 01/12/2024] [Accepted: 02/05/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND The eHealth Literacy Scale (eHEALS) is a widely used instrument for measuring eHealth literacy (eHL). However, little is known so far about whether the instrument is valid for the assessment of eHL in persons who are affected by the post-COVID-19 condition. This is particularly important as people with the post-COVID-19 condition are frequently affected by false information from the internet. OBJECTIVE The objective of our study was to evaluate the validity and reliability of the German Revised eHealth Literacy Scale (GR-eHEALS) in individuals with the post-COVID-19 condition. METHODS A cross-sectional study was conducted from January to May 2022. The self-assessment survey consisted of the GR-eHEALS, health status- and internet use-related variables, sociodemographic data, and (post)-COVID-19-related medical data. Confirmatory factor analysis (CFA), correlational analyses, and tests of measurement invariance were deployed. RESULTS In total, 330 participants were included in the statistical analyses. CFA revealed that the 2-factor model reached an excellent model fit (comparative fit index=1.00, Tucker-Lewis index=0.99, root mean square error of approximation=0.036, standardized root mean square residual=0.038). Convergent validity was confirmed by significant positive correlations between eHL and knowledge of internet-based health promotion programs, experience in using these programs, and the duration of private internet use. In addition, a significantly negative relationship of eHL with internet anxiety supported convergent validity. Further, significant relationships of eHL with mental health status and internal health locus of control confirmed the criterion validity of the instrument. However, relationships of eHL with physical health status and quality of life could not be confirmed. The 2-factor model was fully measurement invariant regarding gender. Regarding age and educational level, partial measurement invariance was confirmed. The subscales as well as the overall GR-eHEALS reached good-to-excellent reliability (Cronbach α≥.86). CONCLUSIONS The GR-eHEALS is a reliable and largely valid instrument for assessing eHL in individuals with the post-COVID-19 condition. Measurement invariance regarding gender was fully confirmed and allows the interpretation of group differences. Regarding age and educational level, group differences should be interpreted with caution. Given the high likelihood that individuals with the post-COVID-19 condition will be confronted with misinformation on the Internet, eHL is a core competency that is highly relevant in this context, in both research and clinical practice. Therefore, future research should also explore alternative instruments to capture eHL to overcome shortcomings in the validity of the GR-eHEALS.
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Affiliation(s)
- Matthias Marsall
- Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
| | - Hannah Dinse
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Julia Schröder
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
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Ji H, Dong J, Pan W, Yu Y. Associations between digital literacy, health literacy, and digital health behaviors among rural residents: evidence from Zhejiang, China. Int J Equity Health 2024; 23:68. [PMID: 38594723 PMCID: PMC11003150 DOI: 10.1186/s12939-024-02150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024] Open
Abstract
OBJECTIVE Within the digital society, the limited proficiency in digital health behaviors among rural residents has emerged as a significant factor intensifying health disparities between urban and rural areas. Addressing this issue, enhancing the digital literacy and health literacy of rural residents stands out as a crucial strategy. This study aims to investigate the relationship between digital literacy, health literacy, and the digital health behaviors of rural residents. METHODS Initially, we developed measurement instruments aimed at assessing the levels of digital literacy and health literacy among rural residents. Subsequently, leveraging micro survey data, we conducted assessments on the digital literacy and health literacy of 968 residents in five administrative villages in Zhejiang Province, China. Building upon this foundation, we employed Probit and Poisson models to empirically scrutinize the influence of digital literacy, health literacy, and their interaction on the manifestation of digital health behaviors within the rural population. This analysis was conducted from a dual perspective, evaluating the participation of digital health behaviors among rural residents and the diversity to which they participate in such behaviors. RESULTS Digital literacy exhibited a notably positive influence on both the participation and diversity of digital health behaviors among rural residents. While health literacy did not emerge as a predictor for the occurrence of digital health behavior, it exerted a substantial positive impact on the diversity of digital health behaviors in the rural population. There were significant interaction effects between digital literacy and health literacy concerning the participation and diversity of digital health behaviors among rural residents. These findings remained robust even after implementing the instrumental variable method to address endogeneity issues. Furthermore, the outcomes of robust analysis and heterogeneity analysis further fortify the steadfastness of the aforementioned conclusions. CONCLUSION The findings suggest that policymakers should implement targeted measures aimed at enhancing digital literacy and health literacy among rural residents. This approach is crucial for improving rural residents' access to digital health services, thereby mitigating urban-rural health inequality.
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Affiliation(s)
- Hao Ji
- Zhejiang A&F University, College of Economics and Management, Hangzhou, People's Republic of China
- Hangzhou Medical College, Center for Medical Intelligence and Health Policy Research, Hangzhou, People's Republic of China
| | - Junqiang Dong
- Zhejiang A&F University, Mental Health Education Center, Hangzhou, People's Republic of China
| | - Weiguang Pan
- Research Academy for Rural Revitalization of Zhejiang Province, Zhejiang A & F University, Hangzhou, People's Republic of China.
| | - Yingying Yu
- Hangzhou Medical College, Center for Medical Intelligence and Health Policy Research, Hangzhou, People's Republic of China.
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Jiang Y, Gao J, Sun P, Nan J, Zou X, Sun M, Song X. Factors Associated with the e-Health Literacy Among Older Adults with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study. Telemed J E Health 2024; 30:e1138-e1147. [PMID: 37851981 DOI: 10.1089/tmj.2023.0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
Background: The telemanagement model in chronic diseases needs older patients to have a certain level of e-Health literacy. According to Electronic Health Literacy model, factors associated with the e-Health literacy among older patients could be comprehensively investigated from individual, situational, and environmental aspects. Objectives: To investigate the e-Health literacy levels among older patients with chronic obstructive pulmonary disease (COPD) and explore associated factors. Methods: A cross-sectional study was conducted among older patients with COPD. The e-Health Literacy Scale was used to measure individuals' e-Health literacy. The multiple linear regression was applied to identify factors associated with e-Health literacy. Results: A total of 230 responses were included in the final analysis. The average score of e-Health literacy for older COPD patients was 24.66 (6.86). After adjusting the model, the results of multiple linear regression demonstrated that aging attitudes (B = 0.067, p < 0.001), technophobia (B = -0.285, p < 0.001), and self-efficacy (B = 0.431, p < 0.001) accounted for 68.3% (p < 0.001) of the total variation in e-Health literacy. Conclusion: This study identifies significant correlations of technophobia, aging attitudes, and self-efficacy, respectively, with e-Health literacy, and self-efficacy and technophobia may be constant predictive factors of e-Health literacy. In the future, intervention research on e-Health literacy should be conducted from a social psychology perspective, with particular emphasis on addressing negative aging attitudes and technophobia. That will promote the tele-management model of chronic diseases. Trial Registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR1900028563; http://apps.who.int/trialsearch/default.aspx.
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Affiliation(s)
- Yuyu Jiang
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jing Gao
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Pingping Sun
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jiang Nan
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xueqiong Zou
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Manyao Sun
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xianjing Song
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
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Korkmaz Aslan G, Kılınç İşleyen E, Kartal A, Koştu N. The relation between eHealth literacy and healthy lifestyle behaviours in pregnant women. Health Promot Int 2024; 39:daae022. [PMID: 38501310 DOI: 10.1093/heapro/daae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
The aim of this study was to determine the relationship between eHealth literacy and healthy lifestyle behaviours among pregnant women. This cross-sectional study was conducted in five family health centres in a city in the western part of Turkey. The study sample consisted of 201 pregnant women who were admitted to the five family health centres between September and December 2022. A socio-demographic questionnaire, the eHealth Literacy Scale and the Healthy Lifestyle Behaviours in Pregnancy Scale were used to collect data. Multiple linear regression analysis was used to explore predictors of health-promoting behaviours. The mean score of the eHealth Literacy Scale was 29.37 ± 6.20. The mean score of the Healthy Lifestyle Behaviours Scale was 119.69 ± 13.58. Multiple linear regression showed that predictors of healthy lifestyle behaviours among pregnant women were eHealth literacy, using internet to access health information and gestational age. eHealth literacy was found to be an important factor affecting the healthy lifestyle behaviours of pregnant women. This study highlights the importance of considering pregnant women's eHealth literacy in interventions aimed at improving healthy lifestyle behaviours.
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Affiliation(s)
- Gülbahar Korkmaz Aslan
- Faculty of Health Sciences, Public Health Nursing Department, Pamukkale University, Kınıklı Campus, Pamukkale, Denizli, Türkiye
| | - Eda Kılınç İşleyen
- Faculty of Health Sciences, Public Health Nursing Department, Uşak University, 1 Eylül Campus, Uşak, Türkiye
| | - Asiye Kartal
- Faculty of Health Sciences, Public Health Nursing Department, Pamukkale University, Kınıklı Campus, Pamukkale, Denizli, Türkiye
| | - Nazan Koştu
- Faculty of Health Sciences, Public Health Nursing Department, Pamukkale University, Kınıklı Campus, Pamukkale, Denizli, Türkiye
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Şenoymak MC, Erbatur NH, Şenoymak İ, Fırat SN. The Role of Artificial Intelligence in Endocrine Management: Assessing ChatGPT's Responses to Prolactinoma Queries. J Pers Med 2024; 14:330. [PMID: 38672957 PMCID: PMC11051052 DOI: 10.3390/jpm14040330] [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: 02/21/2024] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
This research investigates the utility of Chat Generative Pre-trained Transformer (ChatGPT) in addressing patient inquiries related to hyperprolactinemia and prolactinoma. A set of 46 commonly asked questions from patients with prolactinoma were presented to ChatGPT and responses were evaluated for accuracy with a 6-point Likert scale (1: completely inaccurate to 6: completely accurate) and adequacy with a 5-point Likert scale (1: completely inadequate to 5: completely adequate). Two independent endocrinologists assessed the responses, based on international guidelines. Questions were categorized into groups including general information, diagnostic process, treatment process, follow-up, and pregnancy period. The median accuracy score was 6.0 (IQR, 5.4-6.0), and the adequacy score was 4.5 (IQR, 3.5-5.0). The lowest accuracy and adequacy score assigned by both evaluators was two. Significant agreement was observed between the evaluators, demonstrated by a weighted κ of 0.68 (p = 0.08) for accuracy and a κ of 0.66 (p = 0.04) for adequacy. The Kruskal-Wallis tests revealed statistically significant differences among the groups for accuracy (p = 0.005) and adequacy (p = 0.023). The pregnancy period group had the lowest accuracy score and both pregnancy period and follow-up groups had the lowest adequacy score. In conclusion, ChatGPT demonstrated commendable responses in addressing prolactinoma queries; however, certain limitations were observed, particularly in providing accurate information related to the pregnancy period, emphasizing the need for refining its capabilities in medical contexts.
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Affiliation(s)
- Mustafa Can Şenoymak
- Department of Endocrinology and Metabolism, University of Health Sciences Sultan, Abdulhamid Han Training and Research Hospital, Istanbul 34668, Turkey
| | - Nuriye Hale Erbatur
- Department of Endocrinology and Metabolism, University of Health Sciences Sultan, Abdulhamid Han Training and Research Hospital, Istanbul 34668, Turkey
| | - İrem Şenoymak
- Family Medicine Department, Usküdar State Hospital, Istanbul 34662, Turkey
| | - Sevde Nur Fırat
- Department of Endocrinology and Metabolism, University of Health Sciences, Ankara Training and Research Hospital, Ankara 06230, Turkey
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Park KW, Mirian MS, McKeown MJ. Artificial intelligence-based video monitoring of movement disorders in the elderly: a review on current and future landscapes. Singapore Med J 2024; 65:141-149. [PMID: 38527298 PMCID: PMC11060643 DOI: 10.4103/singaporemedj.smj-2023-189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/19/2023] [Indexed: 03/27/2024]
Abstract
ABSTRACT Due to global ageing, the burden of chronic movement and neurological disorders (Parkinson's disease and essential tremor) is rapidly increasing. Current diagnosis and monitoring of these disorders rely largely on face-to-face assessments utilising clinical rating scales, which are semi-subjective and time-consuming. To address these challenges, the utilisation of artificial intelligence (AI) has emerged. This review explores the advantages and challenges associated with using AI-driven video monitoring to care for elderly patients with movement disorders. The AI-based video monitoring systems offer improved efficiency and objectivity in remote patient monitoring, enabling real-time analysis of data, more uniform outcomes and augmented support for clinical trials. However, challenges, such as video quality, privacy compliance and noisy training labels, during development need to be addressed. Ultimately, the advancement of video monitoring for movement disorders is expected to evolve towards discreet, home-based evaluations during routine daily activities. This progression must incorporate data security, ethical considerations and adherence to regulatory standards.
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Affiliation(s)
- Kye Won Park
- Pacific Parkinson Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maryam S Mirian
- Pacific Parkinson Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin J McKeown
- Pacific Parkinson Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
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Murakami K, Shinozaki N, Okuhara T, McCaffrey TA, Livingstone MBE. Prevalence and Correlates of Dietary and Nutrition Information Seeking Through Various Web-Based and Offline Media Sources Among Japanese Adults: Web-Based Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e54805. [PMID: 38354021 PMCID: PMC10902774 DOI: 10.2196/54805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The advent of the internet has changed the landscape of available nutrition information. However, little is known about people's information-seeking behavior toward healthy eating and its potential consequences. OBJECTIVE We aimed to examine the prevalence and correlates of nutrition information seeking from various web-based and offline media sources. METHODS This cross-sectional study included 5998 Japanese adults aged 20 to 79 years participating in a web-based questionnaire survey (February and March 2023). The dependent variable was the regular use of web-based and offline media as a reliable source of nutrition information. The main independent variables included health literacy, food literacy, and diet quality, which were assessed using validated tools, as well as sociodemographic factors (sex, age, education level, and nutrition- and health-related occupations). RESULTS The top source of nutrition information was television (1973/5998, 32.89%), followed by web searches (1333/5998, 22.22%), websites of government and medical manufacturers (997/5998, 16.62%), newspapers (901/5998, 15.02%), books and magazines (697/5998, 11.62%), and video sites (eg, YouTube; 634/5998, 10.57%). Multivariable logistic regression showed that higher health literacy was associated with higher odds of using all the individual sources examined; odds ratios (ORs) for 1-point score increase ranged from 1.27 (95% CI 1.09-1.49) to 1.81 (95% CI 1.57-2.09). By contrast, food literacy was inversely associated with the use of television (OR 0.65, 95% CI 0.55-0.77), whereas it was positively associated with the use of websites of government and medical manufacturers (OR 1.98, 95% CI 1.62-2.44), books and magazines (OR 2.09, 95% CI 1.64-2.66), and video sites (OR 1.53, 95% CI 1.19-1.96). Furthermore, diet quality was positively associated with the use of newspapers (OR 1.02, 95% CI 1.01-1.03) and books and magazines (OR 1.03, 95% CI 1.02-1.04). Being female was associated with using television and books and magazines, whereas being male was associated with using websites of government and medical manufacturers, newspapers, and video sites. Age was positively associated with using newspapers and inversely associated with using websites of government and medical manufacturers and video sites. People with higher education were more likely to refer to websites of government and medical manufacturers and newspapers but less likely to use television and video sites. Dietitians were more likely to use websites of government and medical manufacturers and books and magazines than the general public but less likely to use television and video sites. CONCLUSIONS We identified various web-based and offline media sources regularly used by Japanese adults when seeking nutrition information, and their correlates varied widely. A lack of positive associations between the use of the top 2 major sources (television and web searches) and food literacy or diet quality is highlighted. These findings provide useful insights into the potential for developing and disseminating evidence-based health promotion materials.
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Affiliation(s)
- Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Nana Shinozaki
- Department of Nutritional Epidemiology and Behavioural Nutrition, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - M Barbara E Livingstone
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
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Salahshouri A, Raisi-Philabadi P, Ghanbari S, Stein L, Araban M. Using the health beliefs model to implement mobile puberty health education in Iranian adolescent boys: a randomized controlled trial. Front Public Health 2024; 12:1175262. [PMID: 38389945 PMCID: PMC10882100 DOI: 10.3389/fpubh.2024.1175262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 01/10/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction Given boys' low health knowledge and their unhealthy behavior during puberty, which can cause many physical, mental, and psychological problems, it is important to prevent these complications. This study was therefore aimed to determine the efficacy of a mobile health educational intervention based on the Health Beliefs Model (HBM) on Iranian adolescent boys. Materials and methods This randomized controlled trial involved junior high school boys (n = 148) in Iran studying during the 2020-2021 school year. Educational content concerning healthy behaviors during puberty (e.g., the importance of bathing) was developed based on HBM and sent to the intervention group via mobile phone. HBM addresses multiple factors (e.g., perceived disease risk) that explain health behaviors. The intervention was delivered in five sessions over four weeks using real-time Internet communication and texting. The control group did not receive any intervention. One school was randomly selected from each of the four districts of the study site. The schools were then randomized into intervention and control groups. The boys were then randomly selected from each school to participate in the study. Data collected at baseline and 2-month follow-up assessments included demographic information, health knowledge (e.g., physical changes during puberty), health behaviors (e.g., bathing), and HBM constructs (e.g., self-efficacy to perform healthy behaviors). Data analysis was done using the chi-square, independent and paired t-tests, and analysis of covariance (ANCOVA). Results The two groups did not differ in terms of demographic characteristics. Before the intervention, the two groups were slightly different in terms of knowledge, health behavior, and HBM constructs. Following the intervention, the scores of the intervention group improved significantly (p < 0.05). After adjusting for pre-intervention knowledge, HBM, and health behavior scores, the intervention group remained superior to the control group in terms of improvement of knowledge, HBM constructs, and healthy behaviors (p < 0.05). Effect sizes ranged from medium to large (0.25-0.86). Conclusion Mobile phone education based on the HBM is efficacious in encouraging healthy behavior in boys during puberty. Organizations interested in encouraging healthy behaviors in boys should consider the use of such a program.
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Affiliation(s)
- Arash Salahshouri
- Department of Health Education and Promotion, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvaneh Raisi-Philabadi
- Department of Health Education and Promotion, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Ghanbari
- Department of Epidemiology and Biostatistics, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Lar Stein
- Department of Psychology, University of Rhode Island, South Kingstown, RI, United States
- Adjunct Research Faculty, Social and Behavioral Sciences, Brown University, Providence, RI, United States
- Department of Behavioral Healthcare, Developmental Disabilities & Hospitals, Cranston, RI, United States
| | - Marzieh Araban
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Li S, Hu M, An R, Yin Y. Relationship Between eHealth Literacy and Healthy Aging in Older Chinese People: The Mediating Effect of Health Behaviors. J Am Med Dir Assoc 2024; 25:237-242.e1. [PMID: 37527794 DOI: 10.1016/j.jamda.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES Healthy aging is an important means of promoting the well-being of older individuals. However, no studies have examined the relationship between eHealth literacy and healthy aging or its mechanism. Therefore, this study aimed to examine the relationship between eHealth literacy and healthy aging and the mediating effect of health behaviors in older Chinese individuals. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS We recruited 2144 older individuals from Jinan, Shandong Province, China. METHODS We used the eHealth Literacy Scale to assess eHealth literacy. Healthy aging was evaluated based on multimorbidity, functional limitations, mild cognitive impairment, depressive symptoms, and social isolation. Moreover, health behaviors were assessed using the Health-Promoting Lifestyle Profile. Logistic and linear regression models were used to analyze the relationships between eHealth literacy, healthy aging, and its components. Finally, a structural equation model was used to analyze the mediation. RESULTS High eHealth literacy was associated with all healthy aging components (P < .05), including the absence of multimorbidity [odds ratio (OR), 1.014; 95% CI, 1.002-1.025], no functional limitation (OR, 1.035; 95% CI, 1.022-1.047), no mild cognitive impairment (OR, 1.042; 95% CI, 1.024-1.061), no depressive symptoms (OR, 1.049; 95% CI, 1.027-1.072), and no social isolation (OR, 1.033; 95% CI, 1.018-1.048). In the adjusted model, eHealth literacy (β = 0.174; 95% CI, 0.132-0.217) was positively correlated with healthy aging. Health behaviors had a partial mediating effect on the relationship between eHealth literacy and healthy aging. CONCLUSIONS AND IMPLICATIONS Higher eHealth literacy was associated with better healthy aging in older Chinese individuals, and health behaviors mediated this relationship. Improving eHealth literacy may be an effective intervention for achieving healthy aging.
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Affiliation(s)
- Shaojie Li
- Shandong University of Traditional Chinese Medicine, Jinan, China; School of Public Health, Peking University, Beijing, China
| | - Mingzheng Hu
- School of Public Health, Peking University, Beijing, China
| | - Ran An
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yongtian Yin
- Shandong University of Traditional Chinese Medicine, Jinan, China.
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