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Yang Y, Yao X, Lu D, Wang Y, Gan Y, Bao X, Zhang J, Zhang Q. Improving the eHealth literacy of older adults: A scoping review. Geriatr Nurs 2024; 60:128-136. [PMID: 39244798 DOI: 10.1016/j.gerinurse.2024.07.028] [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: 04/30/2024] [Revised: 07/05/2024] [Accepted: 07/30/2024] [Indexed: 09/10/2024]
Abstract
The World Health Organization stresses eHealth literacy's importance for effective health management, particularly among older adults, whose eHealth literacy is globally low and unequal. This scoping review aims to identify strategies to enhance their eHealth literacy. A literature search was performed in eight electronic databases until February 20, 2024, found 1629 records, with 24 meeting inclusion criteria. Most studies (8 of 17, 47.1 %) employed health behavior and learning theories. Interventions materials commonly utilized existing or self-designed websites or applications, with some U.S. studies incorporating standardized training materials. Outcome measures included information, psychological motivation, and behavioral change. The eHealth literacy scale was frequently used to assess eHealth literacy. Coach education combined with classroom exercises proved effective, and online health education was pivotal during the COVID-19 pandemic. Future research should focus on enhancing study design, utilizing comprehensive but concise assessment tools, tailoring interventions to theoretical frameworks, and prioritizing privacy and security.
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Affiliation(s)
- Yuhan Yang
- School of Medicine & Nursing Sciences, Huzhou University, 759 second ring east road, Zhejiang 313000 Huzhou, PR China
| | - Xinuo Yao
- School of Medicine & Nursing Sciences, Huzhou University, 759 second ring east road, Zhejiang 313000 Huzhou, PR China
| | - Danyan Lu
- School of Medicine & Nursing Sciences, Huzhou University, 759 second ring east road, Zhejiang 313000 Huzhou, PR China
| | - Yu Wang
- School of Medicine & Nursing Sciences, Huzhou University, 759 second ring east road, Zhejiang 313000 Huzhou, PR China
| | - Yingting Gan
- School of Medicine & Nursing Sciences, Huzhou University, 759 second ring east road, Zhejiang 313000 Huzhou, PR China
| | - Xuemei Bao
- School of Medicine & Nursing Sciences, Huzhou University, 759 second ring east road, Zhejiang 313000 Huzhou, PR China
| | - Jin Zhang
- Department of Nursing, Huzhou First People's Hospital, Huzhou, PR China
| | - Qinghua Zhang
- School of Medicine & Nursing Sciences, Huzhou University, 759 second ring east road, Zhejiang 313000 Huzhou, PR China; Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou 313000, PR China.
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Moore I, Magnante C, Embry E, Mathis J, Mooney S, Haj-Hassan S, Cottingham M, Padala PR. Doctor AI? A pilot study examining responses of artificial intelligence to common questions asked by geriatric patients. Front Artif Intell 2024; 7:1438012. [PMID: 39118788 PMCID: PMC11306168 DOI: 10.3389/frai.2024.1438012] [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: 05/24/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction AI technologies have the potential to transform patient care. AI has been used to aid in differential diagnosis and treatment planning for psychiatric disorders, administer therapeutic protocols, assist with interpretation of cognitive testing, and patient treatment planning. Despite advancements, AI has notable limitations and remains understudied and further research on its strengths and limitations in patient care is required. This study explored the responses of AI (Chat-GPT 3.5) and trained clinicians to commonly asked patient questions. Methods Three clinicians and AI provided responses to five dementia/geriatric healthcare-related questions. Responses were analyzed by a fourth, blinded clinician for clarity, accuracy, relevance, depth, and ease of understanding and to determine which response was AI generated. Results AI responses were rated highest in ease of understanding and depth across all responses and tied for first for clarity, accuracy, and relevance. The rating for AI generated responses was 4.6/5 (SD = 0.26); the clinician s' responses were 4.3 (SD = 0.67), 4.2 (SD = 0.52), and 3.9 (SD = 0.59), respectively. The AI generated answers were identified in 4/5 instances. Conclusions AI responses were rated more highly and consistently on each question individually and overall than clinician answers demonstrating that AI could produce good responses to potential patient questions. However, AI responses were easily distinguishable from those of clinicians. Although AI has the potential to positively impact healthcare, concerns are raised regarding difficulties discerning AI from human generated material, the increased potential for proliferation of misinformation, data security concerns, and more.
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Affiliation(s)
- Ian Moore
- Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, United States
| | - Christopher Magnante
- Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, United States
| | - Ellie Embry
- Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, United States
| | - Jennifer Mathis
- Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, United States
| | - Scott Mooney
- Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, United States
| | - Shereen Haj-Hassan
- Tennessee Valley Veteran Affairs Healthcare System (TVHS), Nashville, TN, United States
| | - Maria Cottingham
- Tennessee Valley Veteran Affairs Healthcare System (TVHS), Nashville, TN, United States
| | - Prasad R. Padala
- Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, United States
- Department of Psychiatry, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, United States
- Baptist Health-UAMS Graduate Medical Education, Little Rock, AR, United States
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Xu RH, Tian L, Zhu L, Cao Y, Chan SKW, Dong D, Cheung WLA, Wong ELY. Age Differences in Electronic Mental Health Literacy: Qualitative Study. J Med Internet Res 2024; 26:e59131. [PMID: 39012686 PMCID: PMC11289580 DOI: 10.2196/59131] [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: 05/11/2024] [Accepted: 06/27/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Electronic mental health literacy (eMHL) is critical for accessing and effectively using digital mental health resources. However, there is a paucity of research on how eMHL varies across age groups. OBJECTIVE This study aimed to investigate differences in eMHL among young, middle-aged, and older adults; provide insights into the needs, behaviors, and attitudes of different age groups in relation to digital mental health resources; and ultimately, inform the improvement of mental health services. METHODS A qualitative investigation was conducted to examine the differences in eMHL across different age demographics in the Chinese population in 2023. The study sample comprised 3 distinct age groups: 18-34 years, 35-64 years, and 65 years and older. Participants were recruited through purposive sampling to ensure a diverse representation of the population. Data were collected through semistructured one-on-one interviews, which allowed for in-depth exploration of individual experiences and perceptions. The gathered data were subsequently subjected to rigorous thematic analysis to enable the identification and interpretation of recurring patterns and themes. RESULTS The principal outcomes derived from these interviews were synthesized into 5 distinct dimensions: emotional needs, use of digital mental health resources, assessment of digital mental health information, engagement with social media to regulate emotions, and coping strategies. These dimensions were uniformly observed across the 3 age groups. CONCLUSIONS We identified differences in knowledge, skills, and attitudes regarding the use of web-based information for managing mental health problems between the 3 age groups. The findings highlight the importance of age-specific strategies for improving eMHL.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitaion Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Lidan Tian
- Department of Rehabilitaion Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Liling Zhu
- Department of Applied Social Science, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Yuan Cao
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Sherry Kit-Wa Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dong Dong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China (Hong Kong)
| | - Wai-Ling Annie Cheung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China (Hong Kong)
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, China (Hong Kong)
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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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Jackson SR, Yu P, Armany D, Occhipinti S, Chambers S, Leslie S, Patel MI. eHealth literacy in prostate cancer: A systematic review. PATIENT EDUCATION AND COUNSELING 2024; 123:108193. [PMID: 38354430 DOI: 10.1016/j.pec.2024.108193] [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: 05/25/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE This systematic review (PROSPERO ID: CRD42022226375) aimed to identify the eHealth literacy of men with prostate cancer, and their caregivers. METHODS 8 databases (MEDLINE, SCOPUS, EMBASE, Web Of Science, PsycINFO, ERIC, CINAHL, Cochrane CENTRAL) and grey literature sources (e.g. Google Scholar) were searched from inception to December 2023. Articles were included if assessing eHealth/digital literacy of men with prostate cancer, or their carers', and health outcome associations. Formats such as case reports, and review papers were excluded. Records and full texts underwent independent screening and data extraction. Author disagreements were resolved by discussion. The Mixed Methods Appraisal Tool (MMAT) was used to appraise included literature, with narrative synthesis of results. RESULTS 21,581 records were retrieved, with 7 articles satisfying inclusion criteria. A heterogenous field was characterised with lack of modern eHealth literacy measurement tools identified. Results suggest novice eHealth literacy using web 1.0 technologies. Non-validated measures of literacy demonstrate mixed results, while health outcome effects limited in scope and reliability. CONCLUSION Prostate cancer survivors' eHealth literacy levels is likely novice, and requires further investigation. PRACTICE IMPLICATIONS Digital technologies/resources implemented as part of patient communication practices should be vetted for quality, and tailored to patients' eHealth literacy abilities and/or needs.
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Affiliation(s)
| | - Paul Yu
- Department of Urology Westmead Hospital, University of Sydney, Cnr Hawkesbury Road and, Darcy Rd, Westmead, Sydney, NSW 2145, Australia
| | - David Armany
- Department of Urology Westmead Hospital, University of Sydney, Cnr Hawkesbury Road and, Darcy Rd, Westmead, Sydney, NSW 2145, Australia
| | - Stefano Occhipinti
- School of Applied Psychology, Griffith University, Mt Gravatt, Brisbane, QLD 4122, Australia; Department of English and Communication, International Research Centre for the Advancement of Health Communication, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, 40 Edward St, North Sydney, Sydney, NSW 2060, Australia; Faculty of Health, University of Technology, 15 Broadway, Ultimo, Sydney, NSW 2007, Australia; St Vincent's Health Network, 390 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia
| | - Scott Leslie
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, 145 Missenden Rd, Camperdown, Sydney, NSW 2050, Australia; Faculty of Health and Medicine, University of Sydney, Camperdown, Sydney, NSW 2006, Australia
| | - Manish I Patel
- Department of Urology Westmead Hospital, University of Sydney, Cnr Hawkesbury Road and, Darcy Rd, Westmead, Sydney, NSW 2145, Australia
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Truong D, Pham T, Hynan LS, Neaves S, Bell KR, Juengst SB, Zhang R, Driver S, Ding K. Age-related smartphone use patterns among individuals with moderate-to-severe traumatic brain injury. Brain Inj 2024; 38:7-11. [PMID: 38117178 PMCID: PMC10922167 DOI: 10.1080/02699052.2023.2295469] [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: 09/10/2022] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE With mobile health technologies serving as an alternative means of providing healthcare, evaluating patients' abilities to navigate digital infrastructures is becoming increasingly relevant. The goal of this study is to investigate smartphone use patterns among individuals with history of moderate-to-severe traumatic brain injury (TBI). METHODS An anonymous survey was delivered via e-mail or text message to eligible participants who had a history of moderate-to-severe TBI and were prospectively followed at one of the eight participating Traumatic Brain Injury Model Systems centers for at least 1-year post-injury. The survey captured demographic data and included a questionnaire to evaluate smartphone use (calling, texting, web browsing, etc.). RESULTS A total of 2665 eligible individuals were contacted to complete the survey, 472 of which responded. 441 of them reported smartphone use. Individuals ages 45 and older were significantly less likely to use their phones for functions other than calling and texting when compared to individuals ages 18-44 (p < 0.05). CONCLUSIONS Most individuals with moderate-to-severe TBI in this cohort demonstrated intentional smartphone use, suggesting that mobile health technologies may be feasible as a cost-effective healthcare alternative. However, doing so will require additional interventions to provide further technological education especially in older individuals with TBI.
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Affiliation(s)
- Dat Truong
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tri Pham
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Linda S Hynan
- Department of Population and Data Sciences & Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Stephanie Neaves
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kathleen R Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Shannon B Juengst
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rong Zhang
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Simon Driver
- Baylor Scott and White Research Institute, Dallas, Texas, USA
| | - Kan Ding
- Baylor Scott and White Research Institute, Dallas, Texas, USA
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Guo SHM, Lin JL, Hsing HC, Lee CC, Chuang SM. The Effect of Mobile eHealth Education to Improve Knowledge, Skills, Self-Care, and Mobile eHealth Literacies Among Patients With Diabetes: Development and Evaluation Study. J Med Internet Res 2023; 25:e42497. [PMID: 38055321 PMCID: PMC10733817 DOI: 10.2196/42497] [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: 09/06/2022] [Revised: 12/23/2022] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND The promotion of mobile health (mHealth) and eHealth technologies as tools for managing chronic diseases, particularly diabetes mellitus, is on the rise. Nevertheless, individuals with diabetes frequently face a literacy gap that hinders their ability to fully leverage the benefits offered by these resources. Enhancing technology literacy to facilitate the adoption of mobile eHealth services poses a significant challenge in numerous countries. OBJECTIVE This study aims to develop an educational mobile eHealth literacy (eHL) program for patients with diabetes and to evaluate its effect on patients' outcomes. METHODS This study designed a mobile eHL education program comprising 2 modules specifically tailored for individuals with type 2 diabetes (T2D). These modules focused on guiding participants through the process of effectively navigating reliable health websites and utilizing diabetes-related apps. Using a pre- and posttest experimental design, the study featured an intervention group and a control group. Participants were recruited from 3 outpatient departments in hospitals, and assessments were conducted both before and after the intervention, along with a follow-up measure at the 3-month mark. The evaluation encompassed sociodemographic characteristics, computer and internet proficiency, mobile app usage, mobile eHL, and patient outcomes such as self-care behaviors and glycated hemoglobin (HbA1c) levels. RESULTS The analysis included a total of 132 eligible participants. Significant differences were observed in the mean scores of knowledge (P<.001) and skills (P<.001) related to computers, the web, and mobile devices at the initiation of the study and after the intervention. During the 3-month follow-up, the findings indicated a significant improvement in mobile eHL (t114=3.391, P=.001) and mHealth literacy (mHL, a subconcept of mobile eHL; t114=3.801, P<.001) within the intervention group, whereas no such improvement was observed in the control group. The chi-square values from the McNemar test underscored that individuals with uncontrolled diabetes (HbA1c≥7%) in the intervention group exhibited more improvement compared with the control group. The generalized estimating equations model unveiled a significant difference in the change of general mHL in the intervention group (β=1.91, P=.047) and self-care behavior in the control group from T0 to T2 (β=-8.21, P=.015). Despite being small, the effect sizes for mobile eHL (d=0.49) and HbA1c (d=0.33) in the intervention group were greater than those in the control group (d=0.14 and d=0.16, respectively). CONCLUSIONS The implementation of a mobile eHL education intervention demonstrates a positive influence on the familiarity of patients with T2D regarding health technology, leading to favorable glycemic outcomes. While additional studies are warranted for a more comprehensive understanding, this program emerges as a promising solution for enhancing patients' uptake of digital health technology.
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Affiliation(s)
| | - Jiun-Lu Lin
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hung-Chun Hsing
- Department of Nursing, Hsinchu Cathay General Hospital, HsinChu, Taiwan
| | - Chun-Chuan Lee
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shih-Ming Chuang
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
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Değer MS, Sezerol MA, Atak M. Rational Drug and Antibiotic Use Status, E-Health Literacy in Syrian Immigrants and Related Factors: A Cross-Sectional Study. Antibiotics (Basel) 2023; 12:1531. [PMID: 37887232 PMCID: PMC10604171 DOI: 10.3390/antibiotics12101531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Rational drug use is a pivotal concept linked with morbidity and mortality. Immigration plays a significant role as a determinant affecting individuals' health-related attitudes, behaviors, and the pursuit of health services. Within this context, the study was initiated to assess the factors influencing health literacy and rational drug use among Syrian immigrants in Istanbul. A cross-sectional study was undertaken on 542 Syrian adults utilizing a three-part questionnaire encompassing sociodemographics, rational drug use, and the e-health literacy scale (eHEALS). With an average age of 39.19 ± 13.10 years, a majority of participants believed medications should solely be doctor-prescribed (97%) and opposed keeping antibiotics at home (93.7%). Yet, 62.5% thought excessive herbal medicine use was harmless. The mean eHEALS score stood at 20.57 ± 7.26, and factors like age, marital status, income, and duration of stay in Turkey influenced e-health literacy. Associations were seen between low e-health literacy and being female, being older, having a lower education level, and regular medication use. Syrian immigrants displayed proper knowledge concerning antibiotics yet exhibited gaps in their understanding of general drug usage, treatment adherence, and herbal medicines. Approximately 80.3% had limited health literacy, pointing to the need for targeted interventions for enhanced health and societal assimilation.
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Affiliation(s)
- Mehmet Sait Değer
- Department of Public Health, Medical Faculty, Hitit University, Corum 19030, Türkiye;
| | - Mehmet Akif Sezerol
- Epidemiology Program, Institute of Health Sciences, Istanbul Medipol University, Istanbul 34810, Türkiye;
- Sultanbeyli District Health Directorate, Istanbul 34935, Türkiye
- Health Management Program, Graduate Education Institute, Maltepe University, Istanbul 34857, Türkiye
- Department of Public Health, School of Medicine, Istanbul Medipol University, Istanbul 34810, Türkiye
| | - Muhammed Atak
- Department of Public Health, Istanbul Medical Faculty, Istanbul University, Istanbul 34093, Türkiye
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Milanti A, Chan DNS, Parut AA, So WKW. Determinants and outcomes of eHealth literacy in healthy adults: A systematic review. PLoS One 2023; 18:e0291229. [PMID: 37792773 PMCID: PMC10550189 DOI: 10.1371/journal.pone.0291229] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/24/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND eHealth has shown many benefits in health promotion and disease prevention. For engaging in and taking advantage of eHealth, eHealth literacy is essential. This systematic review aims to summarise and examine the existing evidence on determinants and outcomes of eHealth literacy in healthy adults. METHODS We searched the relevant peer-reviewed articles published in English in six databases: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library and ProQuest. The inclusion criteria of the review were: 1) studies examining 'eHealth literacy', which refers to the ability to search, select, judge and apply online health information to address or solve health problems and to improve wellbeing; 2) the type of study included observational and experimental studies, mixed method studies or qualitative studies; 3) the participants were healthy adults; 4) the main outcomes were the determinants (i.e. influencing or associated factors) and outcomes (i.e. benefits and disadvantages) of eHealth literacy. Articles were assessed by two reviewers using the Joanna Briggs Institute critical appraisal tool. A conceptual model to map the determinants and outcomes of eHealth literacy in healthy adults into the non-modifiable, individual, social and community networks and structural layers was developed to classify the identified determinants and outcomes. RESULTS Forty-four studies were included in this review, of which 43 studies were cross-sectional and one was qualitative. eHealth literacy determinants included age, sex, literacy factors, socioeconomic factors and language. eHealth literacy outcomes included better general health promotion behavior, COVID-19 preventive behaviors, psychological wellbeing, social support, self-rated health and health service utilisation. CONCLUSIONS Our results showed that eHealth literacy has multi-layered determinants and positive outcomes. Different strategies at different policy levels are needed to improve the eHealth literacy levels of healthy adults.
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Affiliation(s)
- Ariesta Milanti
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
| | - Dorothy Ngo Sheung Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
| | | | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
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Chan DYL, Lee SWH, Teh PL. Factors influencing technology use among low-income older adults: A systematic review. Heliyon 2023; 9:e20111. [PMID: 37809586 PMCID: PMC10559849 DOI: 10.1016/j.heliyon.2023.e20111] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
As the world's aging population increases, leveraging technology to support aging is proving advantageous. Notably, technology adoption studies among older adults have received increasing scholarly attention, but findings from these studies do not reflect the context of low-income older adults. Studies focusing on low-income older adults were relatively few and it remains unclear which factors influence this group's technology use. This systematic review aims to synthesize findings on factors influencing technology use among low-income older adults to provide directions and opportunities for future research in information systems. Observing the literature through the lens of Social Cognitive Theory, we identified avenues for future research and further integrated the framework with Maslow's hierarchy of needs to elucidate the phenomenon. Findings from this systematic review suggest that both personal and environmental factors, such as cognitions, affects, sociodemographic characteristics, technological and social environment are significant predictors of technology use among low-income older adults. Specifically, factors related to accessibility and affordability, such as income, perceived cost, and accessibility to technology are salient in a resource-limited setting. More importantly, the technology usage behavior elucidate the embeddedness of fundamental human needs which plays a central role underlying technology use among this segment. However, more research is needed to understand the interaction between person, environment and behavior determinant shaping technology use among low-income older adults from diverse economic and cultural setting. This study also sheds light on disciplinary gaps and the lack of investigations anchored on theoretical foundations, and suggests avenues for future research and implications for practice.
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Affiliation(s)
- Diana Yian Lian Chan
- School of Business, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
- Gerontechnology Laboratory, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Pei-Lee Teh
- School of Business, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
- Gerontechnology Laboratory, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
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Verweel L, Newman A, Michaelchuk W, Packham T, Goldstein R, Brooks D. The effect of digital interventions on related health literacy and skills for individuals living with chronic diseases: A systematic review and meta-analysis. Int J Med Inform 2023; 177:105114. [PMID: 37329765 DOI: 10.1016/j.ijmedinf.2023.105114] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Chronic diseases are a leading cause of death and disease burden globally. Digital interventions could be an approach to improve patients' ability to find, evaluate, and use health information. OBJECTIVES The main objective was to conduct a systematic review to determine the effect of digital interventions on digital health literacy for patients living with chronic disease. Secondary objectives were to provide an overviewof the design and delivery characteristics of interventions that impact digital health literacy in people with chronic disease. METHODS Randomized controlled trials examining digital health literacy (and related components) for individuals with cardiovascular disease, chronic lung disease, osteoarthritis, diabetes, chronic kidney disease, and HIV were identified. This review was conducted following the PRIMSA guidelines. Certainty was assessed using GRADE and the Cochrane risk of bias tool. Meta-analyses were conducted using Review Manager 5.1. The protocol was registered on PROSPERO (CRD42022375967). RESULTS 9386 articles were identified and 17 articles representing 16 unique trials were included. Studies evaluated 5138 individuals with one or more chronic conditions (50% women, ages 42 ± 7-71 ± 12 years). The most targeted conditions were cancer, diabetes, cardiovascular disease, and HIV. Interventions included: skills training, websites, electronic personal health records, remote patient monitoring, and education. The effects of the interventions were related to: (i) digital health literacy, (ii) health literacy, (iii) health information skills, (iv) technology skills and access, and (v) self-management and participation in care. A meta-analysis of three studies identified the effect of digital interventions was better than usual care for eHealth literacy (1.22 [CI 0.55, 1.89], p < 0.001). CONCLUSIONS The evidence of the effects of digital interventions on related health literacy is limited. Existing studies reflect the heterogeneity in study design, population, and outcome measures. There is a need for further studies on the effects of digital interventions on related health literacy for individuals with chronic conditions.
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Affiliation(s)
- L Verweel
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada.
| | - A Newman
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada
| | - W Michaelchuk
- West Park Healthcare Centre, Toronto, Canada; Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - T Packham
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - R Goldstein
- West Park Healthcare Centre, Toronto, Canada; Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - D Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada
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Cheng Q, Lin Y. Multilevel Classification of Users' Needs in Chinese Online Medical and Health Communities: Model Development and Evaluation Based on Graph Convolutional Network. JMIR Form Res 2023; 7:e42297. [PMID: 37079346 PMCID: PMC10160934 DOI: 10.2196/42297] [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: 08/30/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Online medical and health communities provide a platform for internet users to share experiences and ask questions about medical and health issues. However, there are problems in these communities, such as the low accuracy of the classification of users' questions and the uneven health literacy of users, which affect the accuracy of user retrieval and the professionalism of the medical personnel answering the question. In this context, it is essential to study more effective classification methods of users' information needs. OBJECTIVE Most online medical and health communities tend to provide only disease-type labels, which do not give a comprehensive summary of users' needs. The study aims to construct a multilevel classification framework based on the graph convolutional network (GCN) model for users' needs in online medical and health communities so that users can perform more targeted information retrieval. METHODS Using the Chinese online medical and health community "Qiuyi" as an example, we crawled questions posted by users in the "Cardiovascular Disease" section as the data source. First, the disease types involved in the problem data were segmented by manual coding to generate the first-level label. Second, the needs were identified by K-means clustering to generate the users' information needs label as the second-level label. Finally, by constructing a GCN model, users' questions were automatically classified, thus realizing the multilevel classification of users' needs. RESULTS Based on the empirical research of questions posted by users in the "Cardiovascular Disease" section of Qiuyi, the hierarchical classification of users' questions (data) was realized. The classification models designed in the study achieved accuracy, precision, recall, and F1-score of 0.6265, 0.6328, 0.5788, and 0.5912, respectively. Compared with the traditional machine learning method naïve Bayes and the deep learning method hierarchical text classification convolutional neural network, our classification model showed better performance. At the same time, we also performed a single-level classification experiment on users' needs, which in comparison with the multilevel classification model exhibited a great improvement. CONCLUSIONS A multilevel classification framework has been designed based on the GCN model. The results demonstrated that the method is effective in classifying users' information needs in online medical and health communities. At the same time, users with different diseases have different directions for information needs, which plays an important role in providing diversified and targeted services to the online medical and health community. Our method is also applicable to other similar disease classifications.
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Affiliation(s)
- Quan Cheng
- School of Economics and Management, Fuzhou University, Fuzhou, China
| | - Yingru Lin
- School of Economics and Management, Fuzhou University, Fuzhou, China
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Lyles CR, Nguyen OK, Khoong EC, Aguilera A, Sarkar U. Multilevel Determinants of Digital Health Equity: A Literature Synthesis to Advance the Field. Annu Rev Public Health 2023; 44:383-405. [PMID: 36525960 PMCID: PMC10329412 DOI: 10.1146/annurev-publhealth-071521-023913] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Current digital health approaches have not engaged diverse end users or reduced health or health care inequities, despite their promise to deliver more tailored and personalized support to individuals at the right time and the right place. To achieve digital health equity, we must refocus our attention on the current state of digital health uptake and use across the policy, system, community, individual, and intervention levels. We focus here on (a) outlining a multilevel framework underlying digital health equity; (b) summarizingfive types of interventions/programs (with example studies) that hold promise for advancing digital health equity; and (c) recommending future steps for improving policy, practice, and research in this space.
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Affiliation(s)
- Courtney R Lyles
- Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California-San Francisco, San Francisco, California, USA;
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
- School of Public Health, University of California-Berkeley, Berkeley, California, USA
| | - Oanh Kieu Nguyen
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
- Department of Medicine, Division of Hospital Medicine at Zuckerberg San Francisco General Hospital, University of California-San Francisco, San Francisco, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Elaine C Khoong
- Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California-San Francisco, San Francisco, California, USA;
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
| | - Adrian Aguilera
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
- School of Social Welfare, University of California-Berkeley, Berkeley, California, USA
- Department of Psychiatry, University of California-San Francisco, San Francisco, California, USA
| | - Urmimala Sarkar
- Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California-San Francisco, San Francisco, California, USA;
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
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He Y, Guo L, Zauszniewski JA, Wei M, Zhang G, Lei X, Liu Y. A reliability and validity study of the electronic health literacy scale among stroke patients in China. Top Stroke Rehabil 2023; 30:272-280. [PMID: 34927574 DOI: 10.1080/10749357.2021.2016100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patients with stroke usually use smartphones to obtain online information to maintain their health. But their ability to identify, evaluate and apply this information is still unknown. AIM This study was designed to examine the reliability and validity of the electronic Health Literacy Scale among patients with stroke in China. DESIGN This is a cross-sectional survey. METHODS A demographic questionnaire, the electronic Health Literacy Scale (e-HLS) and the eHealth Literacy Scale (eHEALS) were administered to a sample of 648 patients with ischemic stroke recruited from December 2020 to March 2021 in a tertiary hospital. RESULTS The Cronbach'α coefficient on the e-HLS-CHI was 0.907. Kappa consistency coefficient of test-retest reliability was 0.691 (p < .05). Three factors were extracted by Exploratory Factor Analysis (EFA), accounting for 90.84% of the total variance. Confirmatory Factory Analysis (CFA) revealed that three factors of e-HLS-CHI fit well (NFI = 0.979, RFI = 0.955, IFI = 0.987, TLI = 0.972, CFI = 0.987, RMSEA = 0.070, CMIN/DF = 2.586). Good simultaneous validity was suggested by the positive correlation of 0.94 (p < .001) between the e-HLS-CHI and eHEALS. When using eHEALS as the standard, the area under the ROC curve of e-HLS-CHI was 0.896 (95% CI: 0.831-0.960, p < .001). The sensitivity and specificity were 97.8% and 70.4% respectively. CONCLUSIONS The e-HLS can be used to evaluate electronic health literacy of patients with stroke in China after translation and cultural adaption.
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Affiliation(s)
- Yu He
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Lina Guo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | | | - Miao Wei
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Gege Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiaoyu Lei
- College of Nursing, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yanjin Liu
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Huang YQ, Liu L, Goodarzi Z, Watt JA. Diagnostic accuracy of eHealth literacy measurement tools in older adults: a systematic review. BMC Geriatr 2023; 23:181. [PMID: 36978033 PMCID: PMC10049781 DOI: 10.1186/s12877-023-03899-x] [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: 07/03/2022] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND In Canada, virtual health care rapidly expanded during the COVID-19 pandemic. There is substantial variability between older adults in terms of digital literacy skills, which precludes equitable participation of some older adults in virtual care. Little is known about how to measure older adults' electronic health (eHealth) literacy, which could help healthcare providers to support older adults in accessing virtual care. Our study objective was to examine the diagnostic accuracy of eHealth literacy tools in older adults. METHODS We completed a systematic review examining the validity of eHealth literacy tools compared to a reference standard or another tool. We searched MEDLINE, EMBASE, CENTRAL/CDSR, PsycINFO and grey literature for articles published from inception until January 13, 2021. We included studies where the mean population age was at least 60 years old. Two reviewers independently completed article screening, data abstraction, and risk of bias assessment using the Quality Assessment for Diagnostic Accuracy Studies-2 tool. We implemented the PROGRESS-Plus framework to describe the reporting of social determinants of health. RESULTS We identified 14,940 citations and included two studies. Included studies described three methods for assessing eHealth literacy: computer simulation, eHealth Literacy Scale (eHEALS), and Transactional Model of eHealth Literacy (TMeHL). eHEALS correlated moderately with participants' computer simulation performance (r = 0.34) and TMeHL correlated moderately to highly with eHEALS (r = 0.47-0.66). Using the PROGRESS-Plus framework, we identified shortcomings in the reporting of study participants' social determinants of health, including social capital and time-dependent relationships. CONCLUSIONS We found two tools to support clinicians in identifying older adults' eHealth literacy. However, given the shortcomings highlighted in the validation of eHealth literacy tools in older adults, future primary research describing the diagnostic accuracy of tools for measuring eHealth literacy in this population and how social determinants of health impact the assessment of eHealth literacy is needed to strengthen tool implementation in clinical practice. PROTOCOL REGISTRATION We registered our systematic review of the literature a priori with PROSPERO (CRD42021238365).
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Affiliation(s)
- Yu Qing Huang
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, 190 Elizabeth Street, R. Fraser Elliott Building, 3-805, Toronto, ON, M5G 2C4, Canada
| | - Laura Liu
- Temerty Faculty of Medicine, University of Toronto, 6 Queen's Park Crescent West, Third Floor, Toronto, ON, M5S 3H2, Canada
| | - Zahra Goodarzi
- Department of Medicine, University of Calgary, Foothills Medical Centre - North Tower, 9Th Floor, 1403 - 29th Street NW, Calgary, AB, T2N 2T9, Canada
- Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
- O'Brien Institute of Public Health, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
| | - Jennifer A Watt
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, 190 Elizabeth Street, R. Fraser Elliott Building, 3-805, Toronto, ON, M5G 2C4, Canada.
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
- St. Michael's Hospital, 36 Queen St East, Toronto, ON, M5B 1W8, Canada.
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Vazquez CE, Xie B, Shiroma K, Charness N. Individualistic Versus Collaborative Learning in an eHealth Literacy Intervention for Older Adults: Quasi-Experimental Study. JMIR Aging 2023; 6:e41809. [PMID: 36757773 PMCID: PMC9951071 DOI: 10.2196/41809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/23/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Older adults tend to have insufficient health literacy, which includes eHealth literacy-the ability to access, assess, and use digital health information. Interventions using methods such as collaborative learning (CL) and individualistic learning (IL) may be effective in addressing older adults' low eHealth literacy, but little is known about the short- and long-term effects of CL versus IL on older adults' eHealth literacy. OBJECTIVE The objective of this study was to use a 3 × 2 × 3 mixed factorial design to examine older adults' learning with CL versus IL for eHealth literacy. METHODS Older adults (N=466; mean age 70.5, SD 7.2; range 60-96 years) from diverse racial and ethnic groups were randomly assigned to either the CL or IL group (233/466, 50% in each). The intervention consisted of 4 weeks of training in 2-hour sessions held twice a week. Using ANOVA and multiple regression, we focused on the main effects of learning condition and interaction between learning condition and previous computer experience. Learning method (CL or IL) and previous computer experience (experienced, new, or mixed) were between-subject variables, and time of measurement (pretest measurement, posttest measurement, and 6-month follow-up) was the within-subject variable. Primary outcome variables were eHealth literacy efficacy, computer and web knowledge, basic computer and web operation skills, information-seeking skills, and website evaluation skills. Control variables were age, sex, education, health status, race and ethnicity, income, primary language, and previous health literacy. RESULTS eHealth literacy efficacy, computer and web knowledge, basic computer and web operation skills, information-seeking skills, and website evaluation skills improved significantly (P<.001 in all cases) from before to after the intervention. From postintervention measurement to 6-month follow-up, there was a significant interaction between learning condition and previous computer experience based on 1 outcome measure, computer and web operation skills (F2,55=3.69; P=.03). To maintain computer and web operation skills 6 months after the intervention, it was more effective for people with little to no previous computer experience to learn individually, whereas for people with more previous computer experience, it was more effective to learn collaboratively. From postintervention measurement to 6-month follow-up, statistically significant decreases were found in 3 of the 5 outcome measures: eHealth literacy efficacy, computer and web knowledge, and basic computer and web operation skills (P<.001 for all 3 cases). CONCLUSIONS Older adults' eHealth literacy can be improved through effective intervention, and the IL or CL condition may have little effect on short-term outcomes. However, to maintain long-term benefits, it may be best to learn collaboratively with others who have similar previous computer experience. eHealth literacy is multidimensional, with some components retained better over time. Findings suggest a need for resources to provide continuous training or periodic boosting to maintain intervention gains.
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Affiliation(s)
| | - Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Kristina Shiroma
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Neil Charness
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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Magallón-Botaya R, Méndez-López F, Oliván-Blázquez B, Carlos Silva-Aycaguer L, Lerma-Irureta D, Bartolomé-Moreno C. Effectiveness of health literacy interventions on anxious and depressive symptomatology in primary health care: A systematic review and meta-analysis. Front Public Health 2023; 11:1007238. [PMID: 36844856 PMCID: PMC9948257 DOI: 10.3389/fpubh.2023.1007238] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Background Affective disorders are a debilitating and very prevalent problem throughout the world. Often these are associated with the onset of comorbidities or a consequence of chronic diseases. Anxiety and depression are associated with poor social and personal relationships, compromised health. We aimed to synthesize evidence from studies measuring the impact of a health literacy (HL) intervention on the improvement of affective disorders. Methods For this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, Web of Science, Ibecs, Cuiden, Scielo, Science Direct and Dialnet for exclusively randomized controlled trial studies (RCTs) published between 1 Jan 2011, and 31 May 2022. The search terms employed were "health literacy," "health knowledge," "anxiety," "anxiety disorder," "depression," "depressive disorder," and "adult." The risk of bias assessment was performed using the Cochrane Collaboration Revised Risk of Bias tool (RoB2). We conducted random-effects meta-analyses and explored heterogeneity using meta-regression and a stratified survey. Results Of 2,863 citations found through the initial screening, 350 records were screened by the title and abstract for their themes and relevance. Finally, nine studies complied with the inclusion criteria for the meta-analysis. 66.66% of studies (n = 6) were rated as having a low risk of bias and 33.33% (n = 3) were judged to raise some concerns. The health literacy interventions were associated with -1.378 reduction in depression and anxiety questionnaires scores [95% CI (-1.850, -0.906)]. Low mood disorder scores are associated with better mental health and wellbeing. Conclusion Our findings demonstrate that an HL intervention in relation to the symptoms associated with affective disorders improves the emotional state of patients in PHC, with a moderately positive effect in reducing depression and anxiety.
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Affiliation(s)
- Rosa Magallón-Botaya
- Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
| | - Fátima Méndez-López
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | | | - David Lerma-Irureta
- Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Cruz Bartolomé-Moreno
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
- Aragonese Healthcare Service (SALUD), Zaragoza, Spain
- Department of Family and Community Care Teaching - Sector I, Aragonese Healthcare Service, Zaragoza, Spain
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Mavragani A, Miranda A, Garcia M, Carvalho ACD, Costa P, Correia-Neves M, Santos NC. Promoting Digital Proficiency and Health Literacy in Middle-aged and Older Adults Through Mobile Devices With the Workshops for Online Technological Inclusion (OITO) Project: Experimental Study. JMIR Form Res 2023; 7:e41873. [PMID: 36753331 PMCID: PMC9947750 DOI: 10.2196/41873] [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: 08/12/2022] [Revised: 10/16/2022] [Accepted: 10/24/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Digital inclusion and literacy facilitate access to health information and can contribute to self-care behaviors and informed decision-making. However, digital literacy is not an innate skill, but rather requires knowledge acquisition. OBJECTIVE The present study aimed to develop, conduct, and measure the impact, on digital and health literacy, of a digital inclusion program aimed at community dwellers. METHODS The program targeted the recruitment of people aged 55 and older that owned mobile devices with an internet connection in 3 cities in northern Portugal (Paredes de Coura, Guimarães, and Barcelos). The program was titled the Workshops for Online Technological Inclusion (OITO) project and, in each city, was promoted by the coordinator of municipal projects and organized as an in-person 8-workshop program, using mobile devices, smartphones, or tablets. A quasi-experimental design was used with a nonrandomized allocation of participants in each set of 8 workshops. Sociodemographic, health status, and mobile use information were collected at baseline. Digital and health literacy were measured via the Mobile Device Proficiency Questionnaire and the Health Literacy Scale questionnaires, respectively, at baseline (T1), program completion (T2), and a 1-month follow-up (T3). A self-reported measure of autonomy was evaluated at T1 and T2 using a visual scale. RESULTS Most participants were women with primary schooling (up to 4 years) aged between 65 and 74 years and retired. The intervention had an 81% (97/120) recruitment rate, 53% (43/81) adherence, and 94% (67/71) satisfaction rate, with 81 participants completing the entire 8-workshop program. Most participants had owned their mobile device for more than one year (64/81, 79%), were frequent daily users (70/81, 86%), and had received their mobile device from someone else (33/64, 52%). Over 80% (71/81) of the participants who completed the intervention used Android smartphones. At baseline, participants had low baseline scores in digital literacy, but medium-high baseline scores in health literacy. They showed significant improvement in digital literacy at T2 and T3 compared to T1, but without a significant difference between T2 and T3, regardless of sex, age, or schooling. A significant improvement in self-reported autonomy was observed at T3 compared with baseline. Regarding health literacy, no significant differences were found at T2 or T3 compared to the baseline. CONCLUSIONS The feasibility indicators showed that the OITO project methodology had a substantial rate of recruitment and satisfaction. Program participants had significant improvement in digital literacy after 8 workshops and maintained their score 1 month after completing the intervention. There was no significant change in health literacy during the project period.
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Affiliation(s)
| | - André Miranda
- Associação Centro de Medicina P5, School of Medicine, University of Minho, Braga, Portugal
| | - Miguel Garcia
- Office of Infrastructure and Operations in Information Technology, University of Southern of Santa Catarina, Tubarão, Brazil
| | | | - Patrício Costa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
| | - Margarida Correia-Neves
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Associação Centro de Medicina P5, School of Medicine, University of Minho, Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Associação Centro de Medicina P5, School of Medicine, University of Minho, Braga, Portugal
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Refahi H, Klein M, Feigerlova E. e-Health Literacy Skills in People with Chronic Diseases and What Do the Measurements Tell Us: A Scoping Review. Telemed J E Health 2023; 29:198-208. [PMID: 35671526 DOI: 10.1089/tmj.2022.0115] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Use of electronic health (e-Health) technologies has increased in the past decade and inadequate e-Health literacy may lead to health-related social inequality. This is especially true for patients living with chronic diseases who are often involved in self-care. However, the measurement of e-Health literacy represents several challenges. Among available instruments, the e-Health Literacy Scale (eHEALS) is the only instrument with available psychometric properties. Aim: To identify studies measuring e-Health literacy in adults living with chronic disease and its relationship to health-related behaviors and other perceptions such as quality of life, self-efficacy, or specific disease biomarkers, and studies analyzing the impact of educational intervention on e-Health literacy. Methods: The authors searched MEDLINE, the Cochrane Library, and Web of Science databases to identify studies published in English language until April 2022. Results: Seventeen studies involving 4,877 participants were included. A majority of the studies were cross-sectional with a lack of appropriate controls. Five of the included studies were experimental, involving 758 participants. All of them reported positive effects of educational interventions on the improvements in self-reported e-Health literacy skills. However, most studies were at risk of bias. Conclusion: Despite these limitations, the findings of this review indicate the positive relationship between e-Health literacy and various health care processes in adults with chronic diseases and highlights a need for prospective controlled studies. Promoting e-Health literacy might give better opportunities for the active involvement of people with chronic diseases in self-care and for the implementation of online interventions into existing system of care.
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Affiliation(s)
- Hélène Refahi
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France
| | - Marc Klein
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France
| | - Eva Feigerlova
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France.,INSERM UMR_S 1116-DCAC, Université de Lorraine, Nancy, France.,Centre Universitaire d'Enseignement par SIMulation (CUESim), Hôpital Virtuel de Lorraine (HVL), Medical Faculty, Université de Lorraine, Nancy, France
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Roh M, Won Y. Impact of Online-Delivered eHealth Literacy Intervention on eHealth Literacy and Health Behavior Outcomes among Female College Students during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2044. [PMID: 36767409 PMCID: PMC9915326 DOI: 10.3390/ijerph20032044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
This study examined the effects of a novel online-delivered eHealth literacy intervention to improve eHealth literacy and positive health behaviors among female college students during COVID-19. Female college students taking a physical education class were allocated to either an online-based eHealth literacy intervention group (n = 62) or a physical education class (n = 58). Weekly two-hour sessions were implemented through Zoom videoconferencing over six weeks. We measured eHealth literacy, exercise self-schemata, and health behavior outcomes (eating, sleep, and exercise) before and after the intervention. A two-way repeated measures ANOVA was conducted to examine within- and between-group differences in all outcomes. The ANOVA (2 × 2) for the interaction effect of group and time showed a statistical significance in eHealth literacy and cognitive-emotional exercise self-schemata. There was a marginally significant interaction effect for exercise but none for eating and sleep. This was the first trial to examine the impact of the online eHealth literacy intervention on eHealth literacy and health behavior outcomes for college students during COVID-19. Preliminary findings indicated that the intervention showed promising effectiveness for improving eHealth literacy and promoting health behaviors among female college students.
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Affiliation(s)
- Miyoung Roh
- College of General Education, Kookmin University, 77, Jeongneung-ro, Seongbuk-gu, Seoul 02707, Republic of Korea
| | - Yoonkyung Won
- Department of Physical Education, Yonsei University, Seoul 03722, Republic of Korea
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21
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Eysenbach G, Leung T, Plourde KV, Gadio S, Elf M, Jones CA, Meijering L, Giguère A, Légaré F. Canadian Older Adults' Intention to Use an Electronic Decision Aid for Housing Decisions: Cross-sectional Web-Based Survey. JMIR Aging 2023; 6:e43106. [PMID: 36566499 PMCID: PMC9947828 DOI: 10.2196/43106] [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: 09/29/2022] [Revised: 12/05/2022] [Accepted: 12/25/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Older adults with disabilities such as loss of autonomy face the decision of whether to stay at home or move to a health care facility such as a nursing home. Therefore, they may need support for this difficult decision. OBJECTIVE We assessed the intention of Canadian older adults to use an electronic decision aid (eDA) to make housing decisions and identified the factors that influenced their intention. METHODS We conducted a cross-sectional study using a web-based survey targeting older adults across 10 Canadian provinces and 3 territories. We included respondents from a web-based panel who were aged ≥65 years, understood English or French, had access to an electronic device with an internet connection, and had made a housing decision over the past few months or were planning to make a decision in the coming year. We based the web-based survey on the Unified Theory of Acceptance and Use of Technology (UTAUT). We adapted 17 UTAUT items to measure respondents' intention to use the eDA for housing decisions, as well as items measuring 4 intention constructs (performance expectancy, effort expectancy, social influence, and facilitating conditions). We also assessed eHealth literacy using both subjective and objective scales. We used descriptive statistics and multivariable linear regression analyses to identify the factors influencing the intention to use the eDA. RESULTS Of the 11,972 invited panelists, 1176 (9.82%) met the eligibility criteria, and 1000 (85.03%) respondents completed the survey. The mean age was 72.5 (SD 5.59) years. Most respondents were male (548/1000, 54.8%), White (906/1000, 90.6%), English speakers (629/1000, 62.9%), and lived in Ontario or Quebec (628/1000, 62.8%) and in urban areas (850/1000, 85%). The mean scores were 27.8 (SD 5.88) out of 40 for subjective eHealth literacy and 3.00 (SD 0.97) out of 5 for objective eHealth literacy. In our sample, the intention score was 4.74 (SD 1.7) out of 7. The mean scores of intention constructs out of 7 were 5.63 (SD 1.28) for facilitating conditions, 4.94 (SD 1.48) for performance expectancy, 5.61 (SD 1.35) for effort expectancy, and 4.76 (SD 1.59) for social influence. In the final model, the factors associated with intention included mother tongue (β=.30; P<.001), objective eHealth literacy (β=-.06; P=.03), performance expectancy (β=.55; P<.001), social influence (β=.37; P<.001), and facilitating conditions (β=.15; P<.001). CONCLUSIONS Findings from this pan-Canadian web-based survey on Canadian older adults suggest that their intention to use the eDA to make housing decisions is similar to the findings in other studies using UTAUT. The factors identified as influencing intention were mother tongue, objective eHealth literacy, performance expectancy, social influence, and facilitating conditions. These will guide future strategies for the implementation of the eDA.
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Affiliation(s)
| | | | - Karine V Plourde
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Souleymane Gadio
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Dalarna, Sweden
| | - C Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmondon, AB, Canada
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
| | - Anik Giguère
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
| | - France Légaré
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
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22
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Bäuerle A, Marsall M, Jahre LM, Rammos C, Mallien C, Skoda EM, Rassaf T, Lortz J, Teufel M. Psychometric properties of the German revised version of the eHealth literacy scale in individuals with cardiac diseases: Validation and test of measurement invariance. Digit Health 2023; 9:20552076231194915. [PMID: 37588160 PMCID: PMC10426311 DOI: 10.1177/20552076231194915] [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: 01/17/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023] Open
Abstract
Background The internet is most people's primary source of (health) information. However, no validated instrument exists to assess eHealth literacy in the group of patient with cardiac diseases. Objective The objective of this study was the evaluation of the psychometric properties of the German revised version of the eHealth literacy scale (GR-eHEALS) in individuals with coronary artery disease (CAD) and congestive heart failure (CHF). Methods A cross-sectional study was conducted. N = 455 were included in the statistical analyses. The assessment compromised the GR-eHEALS, medical history, sociodemographic data, and technology-related data. Confirmatory factor analyses, correlational analyses, and tests of measurement invariance were performed. Results The two-factorial model reached a good model fit. The sub-scales information seeking and information appraisal, as well as the eHealth literacy total score, reached high reliability coefficients. Construct and criterion validity was fully confirmed For the two-factorial model, measurement invariance up to the scalar level could be confirmed regarding the sociodemographic characteristics sex, age, and educational level. Conclusions This study confirmed the two-factor structure, construct, and criterion validity as well as measurement invariance at the scalar level for sex, age, and educational level of the GR-eHEALS scale in a sample of individuals with CAD and CHF.
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Affiliation(s)
- Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen 45147, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen 45147, Germany
| | - Matthias Marsall
- Institute for Patient Safety (IfPS), University Hospital Bonn, Bonn, Germany
| | - Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen 45147, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen 45147, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen 45147, Germany
| | - Charlotta Mallien
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen 45147, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen 45147, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen 45147, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen 45147, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen 45147, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen 45147, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Essen 45147, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen 45147, Germany
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23
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Emamekhoo H, Chandereng T, Sesto ME, Luoh R, Bergeson EM, Barbosa Carroll C, Tevaarwerk AJ. Patterns of Health Portal Use by Regular Portal Users Among Patients With Cancer: Results From the UWCCC Survivorship Program. JCO Clin Cancer Inform 2023; 7:e2200119. [PMID: 36638325 PMCID: PMC10166448 DOI: 10.1200/cci.22.00119] [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: 08/08/2022] [Revised: 10/21/2022] [Accepted: 12/06/2022] [Indexed: 01/14/2023] Open
Abstract
PURPOSE We sought to evaluate the patterns of portal usage among patients with cancer who regularly log in to the portal. These data will inform approaches to facilitate portal use among patients with cancer. PATIENTS AND METHODS We conducted a retrospective analysis of patient portal usage by patients with cancer at the University of Wisconsin Carbone Cancer Center. Our analysis focuses on patterns of portal use by regular users (≥ 2 portal logins/year, > 3 months) receiving ongoing oncology care between January 1, 2017, and December 31, 2019. Demographics, cancer characteristics, number of oncology visits per month, and portal usage data were extracted. Regular portal users were grouped and compared on the basis of their frequency of use. A linear mixed-effects model was used to determine if the frequency of oncology visits influenced the number of logins. RESULTS We identified 2076 regular portal users. The median number of portal logins/year was 72 for the entire cohort. Age and race were associated with frequency of portal logins. There was no difference in frequency of portal login on the basis of cancer type or stage. Each additional oncology office visit in a month increased the frequency of portal logins by 3.05 ± 0.11 (SE) within the same month. Messages and test result functionalities were used by 98.7% and 98.9% of the regular users, respectively. Regular users who logged in to portal more frequently used all five studied portal functionalities. CONCLUSION Patients with cancer who use portals regularly use it more in proximity to an oncology office visit and use multiple available portal functionalities. These findings can direct strategic planning to facilitate portal utilization among those not engaged with this tool.
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Affiliation(s)
- Hamid Emamekhoo
- University of Wisconsin School of Medicine and Public Health, Madison, WI
- University of Wisconsin Carbone Cancer Center, Madison, WI
| | | | - Mary E. Sesto
- University of Wisconsin School of Medicine and Public Health, Madison, WI
- University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Rebecca Luoh
- University of Wisconsin School of Medicine and Public Health, Madison, WI
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24
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Rokohl AC, Pine NS, Adler W, Bartenschlager LAK, Wawer Matos PA, Trester M, Pine KR, Pförtner TK, Heindl LM. Health Literacy in Patients Wearing Prosthetic Eyes: A Prospective Cross-Sectional Study. Curr Eye Res 2023; 48:11-17. [PMID: 36305786 DOI: 10.1080/02713683.2022.2141783] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To investigate general and electronic health literacy (HL) levels in prosthetic eye wearing patients, to define factors associated with reduced HL, and to identify a potential healthcare gap. METHODS In this prospective cross-sectional study 148 prosthetic eye wearers were screened using the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the 8-item electronic Health Literacy Scale (eHEALS). HLS-EU-16 and eHEALS scores were correlated to health levels, vision functioning, and sociodemographic factors. RESULTS A total of 85 patients (57%) had adequate, 38 (26%) problematic, and 9 (6%) inadequate general HL, while 16 (11%) had no valid HLS-EU-Q16 score. General HL was positively correlated with physical health (p = 0.009) and negatively with a migration background (p = 0.023). There was a positive correlation between electronic HL and educational level (p < 0.001), social status (p = 0.048), and mental health (p = 0.013). Higher age was associated with lower electronic HL (p < 0.001). CONCLUSIONS More than 30% of the prosthetic eye wearers had problematic or even inadequate general HL, suggesting a significant health care gap. To identify patients with reduced HL, a standardized screening tool should be implemented as part of routine clinical care. Within integrated care, patients with insufficient HL should be offered barrier-free advisory services and information brochures in various languages.
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Affiliation(s)
- Alexander C Rokohl
- Department of Ophthalmology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.,Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Dusseldorf, Cologne, Germany
| | - Nicola S Pine
- Auckland District Health Board, Auckland, New Zealand.,School of Psychology, Massey University, Wellington, New Zealand
| | - Werner Adler
- Department of Medical Informatics, Biometry, and Epidemiology, Friedrich-Alexander- University Erlangen-Nürnberg, Erlangen, Germany
| | - Lisa A K Bartenschlager
- Department of Ophthalmology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Philomena A Wawer Matos
- Department of Ophthalmology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.,Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Dusseldorf, Cologne, Germany
| | - Marc Trester
- Trester Institute for Ocular Prosthetics and Artificial Eyes, Cologne, Germany
| | - Keith R Pine
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Timo-Kolja Pförtner
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Ludwig M Heindl
- Department of Ophthalmology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.,Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Dusseldorf, Cologne, Germany
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25
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Root EZ, Caskie GIL. The Associations between eMental Health Literacy, Barriers to Mental Health Services, and Psychological Distress in Older Adults. J Appl Gerontol 2022; 42:951-961. [PMID: 36541275 DOI: 10.1177/07334648221146775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Building on eHealth literacy and mental health literacy, this cross-sectional survey study examined associations between eMental health literacy (the degree to which individuals obtain, process, and understand basic mental health information online to inform mental health-related decisions), perceived barriers to mental healthcare, and psychological distress. Data were collected online for 247 older adults in the United States. Higher eMental health literacy was associated with fewer perceived barriers to mental healthcare, in models conceptualizing psychological distress as an outcome of eMental health literacy and barriers to care (intrinsic, β = −0.36, p < .001; extrinsic, β = −0.24, p = .002) and as a covariate of eMental health literacy (intrinsic, β = −0.33, p = .001; extrinsic, β = −0.24, p = .003). Continued research and replication of findings are needed to better understand the potential role of eMental health literacy in reducing barriers to mental health services in later life.
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Chang SJ, Lee KE, Yang E, Ryu H. Evaluating a theory-based intervention for improving eHealth literacy in older adults: a single group, pretest-posttest design. BMC Geriatr 2022; 22:918. [PMID: 36451127 PMCID: PMC9710125 DOI: 10.1186/s12877-022-03545-y] [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: 05/23/2022] [Revised: 10/08/2022] [Accepted: 10/19/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The Internet is considered an important channel for providing health information to older adults. We developed an intervention to improve eHealth literacy in older adults according to the information-motivation-behavioral skills (IMB) theory and Intervention Mapping. This study aimed to analyze the effect of a developed intervention on information, motivation, behavioral skills, and behaviors related to eHealth information in older adults. METHODS Forty-six older adults over the age of 65 were recruited from two senior welfare centers in a city in South Korea. We divided the participants into four groups and conducted one intervention per group from March to December 2019. One intervention consisted of 5 sessions and was performed once a week (2 h/1 time) for 5 weeks, culminating in a total lecture time of 10 h. One lecture instructor and two assistant instructors supported the participants in the computer practices. RESULTS Participants' computer/web knowledge, perceived ease of use, perceived enjoyment, and attitude toward eHealth information showed statistically significant increases. The eHealth literacy efficacy score, searching performance score, and understanding score were also significantly increased. However, there was no significant difference in perceived usefulness. CONCLUSION The application of the current theory-based methodology can improve the quality of research in eHealth literacy. Additionally, various interventions should be developed and continuously applied to improve eHealth literacy among older adults.
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Affiliation(s)
- Sun Ju Chang
- grid.31501.360000 0004 0470 5905College of Nursing & Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Kyoung-eun Lee
- grid.412859.30000 0004 0533 4202Department of Nursing, Sunmoon University, Asan, Republic of Korea
| | - Eunjin Yang
- grid.15444.300000 0004 0470 5454Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Hyunju Ryu
- grid.31501.360000 0004 0470 5905College of Nursing, Seoul National University, Seoul, Republic of Korea
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Délétroz C, Allen MC, Sasseville M, Rouquette A, Bodenmann P, Gagnon MP. eHealth literacy measurement tools: a systematic review protocol. Syst Rev 2022; 11:205. [PMID: 36151577 PMCID: PMC9508732 DOI: 10.1186/s13643-022-02076-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 09/18/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Improving eHealth literacy (eHL) is one of the biggest challenges currently facing the global healthcare community. Indeed the use of digital services has the potential to engage patients in care as well as improve the effectiveness of chronic disease self-management, it remains highly dependent on a patient's specific skills and experiences in the health care systems. Although eHealth literacy has gained momentum in the past decade, it remains an underresearched area, particularly eHealth literacy measurement. The aim of the review is to identify patient-reported outcome measures (PROMs) of eHealth literacy for adult populations and to summarize the evidence on their psychometric properties. METHODS We will conduct a systematic literature review of the tools used to measure eHealth literacy for adult population. The search strategy aims to find published studies. A three-step search strategy will be used in this review. Published studies will be searched in CINAHL, PubMed, PsycINFO, and Web of Science from inception until end. Grey literature will be searched to find theses. Database search strategies will be formulated and tested with the assistance of an expert Health Sciences Librarian. The selection of studies will be done by two independent reviewers. Disagreements will be resolved through consensus, and a third reviewer will solve discrepancies. Furthermore, two reviewers will independently evaluate the methodological rigor of the instruments development and testing and assign a grade using the standardized Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Disagreements will be discussed with a third reviewer, expert in psychometrics. Extracted data will be aggregated and analyzed to produce a set of synthesized findings that will be used to develop evidence-informed recommendations in regard of eHL instruments. We will present a synthesis of all instruments, their psychometric properties, and make recommendations for eHL instrument selection in practice. Reporting will be informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and a PRISMA flow diagram. DISCUSSION This systematic review will summarize the evidence on the psychometric properties of PROMs instruments used to measure eHL and will help clinicians, managers, and policy-makers to select an appropriate instrument. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021232765.
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Affiliation(s)
- Carole Délétroz
- Faculty of Nursing Sciences, Laval University, 2325 Rue de l'Université, Québec, QC, G1V 0A6, Canada. .,School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011, Lausanne, Switzerland.
| | - Marina Canepa Allen
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011, Lausanne, Switzerland
| | - Maxime Sasseville
- Faculty of Nursing Sciences, Laval University, 2325 Rue de l'Université, Québec, QC, G1V 0A6, Canada
| | - Alexandra Rouquette
- Paris-Saclay University, Inserm, UVSQ, CESP, DevPsy, Paris, France.,Public Health and Epidemiology Department, AP-HP Paris-Sarclay, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Unisanté, Lausanne, Switzerland.,Faculty of Biology and Medicine, Vice-Dean Teaching and Diversity, University of Lausanne, Rue du Bugnon 44, 1011, Lausanne, Switzerland
| | - Marie-Pierre Gagnon
- Faculty of Nursing Sciences, Laval University, 2325 Rue de l'Université, Québec, QC, G1V 0A6, Canada
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28
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Seale DE, LeRouge CM, Kolotylo-Kulkarni M. Professional Organizers’ Description of Personal Health Information Management Work with a Spotlight on the Practices of Older Adults: A Qualitative e-Delphi Study (Preprint). J Med Internet Res 2022; 25:e42330. [PMID: 37000478 PMCID: PMC10131782 DOI: 10.2196/42330] [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: 08/31/2022] [Revised: 01/03/2023] [Accepted: 01/18/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Personal health information (PHI) is created on behalf of and by health care consumers to support their care and wellness. Available tools designed to support PHI management (PHIM) remain insufficient. A comprehensive understanding of PHIM work is required, particularly for older adults, to offer more effective PHIM tools and support. OBJECTIVE The primary objective of this study was to use the Patient Work System model to provide a holistic description of PHIM work from the perspective of professional organizers with experience assisting health care consumers, including older adults, in managing their PHI. A secondary objective was to examine how factors associated with 4 Patient Work System components (person, tasks, tools and technologies, and context) interact to support or compromise PHIM work performance. METHODS A modified e-Delphi methodology was used to complete 3 web-based rounds of open-ended questions and obtain consensus among a panel of 16 experts in professional organizing. Data were collected between April and December 2017. The Patient Work System model was used as a coding schema and guided the interpretation of findings during the analysis. RESULTS The PHIM work of adults who sought assistance focused on the tasks of acquiring, organizing, and storing 3 classifications of PHI (medical, financial, and reference) and then processing, reconciling, and storing the medical and financial classifications to tend to their health, health care, and health finances. We also found that the complexities of PHI and PHIM-related work often exceeded the abilities and willingness of those who sought assistance. A total of 6 factors contributed to the complexity of PHIM work. The misalignment of these factors was found to increase the PHIM workload, particularly for older adults. The life changes that often accompanied aging, coupled with obscure and fragmented health care provider- and insurer-generated PHI, created the need for much PHIM work. Acquiring and integrating obscure and fragmented PHI, detecting and reconciling PHI discrepancies, and protecting PHI held by health care consumers were among the most burdensome tasks, especially for older adults. Consequently, personal stakeholders (paid and unpaid) were called upon or voluntarily stepped in to assist with PHIM work. CONCLUSIONS Streamlining and automating 2 of the most common and burdensome PHIM undertakings could drastically reduce health care consumers' PHIM workload: developing and maintaining accurate current and past health summaries and tracking medical bills and insurance claims to reconcile discrepancies. Other improvements that hold promise are the simplification and standardization of commonly used financial and medical PHI; standardization and automation of commonly used PHI acquisition interfaces; and provision of secure, Health Insurance Portability and Accountability Act (HIPAA)-certified PHI tools and technologies that control multiperson access for PHI stored by health care consumers in electronic and paper formats.
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Affiliation(s)
- Deborah E Seale
- Department of Public Health, College of Health Sciences, Des Moines University, Des Moines, IA, United States
| | - Cynthia M LeRouge
- Department of Information Systems & Business Analytics, College of Business, Florida International University, Miami, FL, United States
| | - Malgorzata Kolotylo-Kulkarni
- Department of Information Management & Business Analytics, Zimpleman College of Business, Drake University, Des Moines, IA, United States
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Gentizon J, Fleury M, Pilet E, Büla C, Mabire C. Conceptualization and content validation of the MEDication literacy assessment of geriatric patients and informal caregivers (MED-fLAG). J Patient Rep Outcomes 2022; 6:87. [PMID: 35984575 PMCID: PMC9389474 DOI: 10.1186/s41687-022-00495-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background The assessment of patients’ medication literacy skills (i.e., abilities to access, comprehend and interact with medication-related information) is an important step in assisting clinicians to plan for appropriate care. Despite several attempts by researchers to develop measures of medication literacy, an instrument tailored to the specific needs of older adults remains a significant shortfall. Therefore, an interprofessional team that included a citizen co-researcher conceptualized a new standardised measure of medication literacy—the MEDedication Literacy Assessment of Geriatric patients and informal caregivers (MED-fLAG). MED-fLAG was designed as a three-dimensional self-reported measure of functional, interactive and critical skills. This study describes the conceptualization process and provides the results of an evaluation of MED-fLAG’s content validity, acceptability, and feasibility during a hospital stay. Methods MED-fLAG was developed in accordance with the guidance on scale development and standards for good content validity, by using the following steps: (I) conceptualization of a provisional version of MED-fLAG; (II) iterative qualitative evaluation of its content validity by older adults, informal caregivers and healthcare professionals. Results The qualitative assessment of the initial 54-item MED-fLAG was conducted in 36 participants, namely 13 home-dwelling older adults and/or informal caregivers and 23 healthcare professionals. Six rounds of revisions were performed to achieve content validity and to propose a 56-item revised MED-fLAG. Participants reported benefits of using a standardized assessment of medication literacy during a hospital stay but warned about certain limitations and prerequisites. The extent to which MED-fLAG could be integrated into discharge planning needs to be further investigated. Conclusions MED-fLAG is the first medication literacy measure tailored to the specific needs of older patients and informal caregivers. A unique feature of this measure is that it includes prescribed and non-prescribed medications, irrespective of the galenic form. Additional studies are required to evaluate the other measurement properties of MED-fLAG, and to reduce the number of items before considering its clinical application. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00495-2. On the basis of what has been written about medication literacy and the experiences of experts, we developed a new questionnaire to measure medication literacy (MED-fLAG) in older adults and/or informal caregivers. MED-fLAG was then submitted to older adults, informal caregivers and healthcare professionals to retrieve their feedback concerning the relevance, comprehensibility and exhaustiveness of the proposed items. In future, MED-fLAG will allow health professionals to evaluate medication literacy skills in older patients during hospitalization and/or in their informal caregivers when they are responsible for preparing or administering the medications, and then propose individualised support.
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De Main AS, Xie B, Shiroma K, Yeh T, Davis N, Han X. Assessing the Effects of eHealth Tutorials on Older Adults' eHealth Literacy. J Appl Gerontol 2022; 41:1675-1685. [PMID: 35466732 DOI: 10.1177/07334648221088281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
eHealth literacy is the ability to access, assess, and use digital health information. This study compared the effects of a multimedia tutorial versus a paper-based control in improving older adults' eHealth literacy from pre- to posttest. A total of 99 community-dwelling older adults (63-90 years old; mean = 73.09) participated from July 2019 to February 2020. Overall, knowledge about computer/Internet terms, eHealth literacy efficacy, knowledge about the quality of health information websites, and procedural skills in computer/Internet use improved significantly from pre- to posttest. No interaction effect was found between time and group. Participants in both groups had an overwhelmingly positive attitude toward training. Their attitudes toward training approached a statistically significant difference between the two conditions: F (1, 89) = 3.75, p = .056, partial η2 = .040, with the multimedia condition showing more positive attitudes. These findings have implications for designing effective eHealth literacy interventions for older adults.
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Affiliation(s)
- Atami S De Main
- 12330The University of Texas at Austin School of Nursing, Austin, TX, USA
| | - Bo Xie
- 12330The University of Texas at Austin School of Nursing, Austin, TX, USA.,12330The University of Texas at Austin School of Information, Austin, TX, USA
| | - Kristina Shiroma
- 12330The University of Texas at Austin School of Information, Austin, TX, USA
| | - Tom Yeh
- Department of Computer Science, 1877The University of Colorado Boulder, Boulder, CO, USA
| | - Nathan Davis
- 12330The University of Texas at Austin School of Information, Austin, TX, USA
| | - Xu Han
- Department of Computer Science, 1877The University of Colorado Boulder, Boulder, CO, USA
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Chen M, Chan KL. Effectiveness of Digital Health Interventions on Unintentional Injury, Violence, and Suicide: Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2022; 23:605-619. [PMID: 33094703 DOI: 10.1177/1524838020967346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Digital technologies are increasingly used in health-care delivery and are being introduced into work to prevent unintentional injury, violence, and suicide to reduce mortality. To understand the potential of digital health interventions (DHIs) to prevent and reduce these problems, we conduct a meta-analysis and provide an overview of their effectiveness and characteristics related to the effects. We searched electronic databases and reference lists of relevant reviews to identify randomized controlled trials (RCTs) published in or before March 2020 evaluating DHIs on injury, violence, or suicide reduction. Based on the 34 RCT studies included in the meta-analysis, the overall random effect size was 0.21, and the effect sizes for reducing suicidal ideation, interpersonal violence, and unintentional injury were 0.17, 0.24, and 0.31, respectively, which can be regarded as comparable to the effect sizes of traditional face-to-face interventions. However, there was considerable heterogeneity between the studies. In conclusion, DHIs have great potential to reduce unintentional injury, violence, and suicide. Future research should explore DHIs' successful components to facilitate future implementation and wider access.
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Affiliation(s)
- Mengtong Chen
- Department of Social Work, 26679Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ko Ling Chan
- Department of Applied Social Sciences, 26680The Hong Kong Polytechnic University, Hunghom, Hong Kong
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Makowsky MJ, Davachi S, Jones CA. eHealth Literacy in a Sample of South Asian Adults in Edmonton, Alberta, Canada: Subanalysis of a 2014 Community-Based Survey. JMIR Form Res 2022; 6:e29955. [PMID: 35353044 PMCID: PMC9008520 DOI: 10.2196/29955] [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: 04/27/2021] [Revised: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Digital health interventions are efficient and flexible methods for enhancing the prevention and management of cardiovascular disease and type 2 diabetes. However, little is known about the characteristics associated with eHealth literacy in the Canadian South Asian population. OBJECTIVE The aim of this study is to describe perceived eHealth literacy and explore the extent to which it is associated with sociodemographic, health status, and technology use variables in a subset of South Asian Canadians. METHODS We analyzed data from the e-Patient Project survey, a mixed-mode cross-sectional survey that occurred in 2014. The eHealth Literacy Scale (eHEALS) was used to measure eHealth literacy in a convenience sample of 511 English- or Punjabi-speaking South Asian adults recruited from a community pharmacy, a family physician office, and community events in Edmonton, Alberta. Multivariable quantile regression was used to explore variables associated with eHealth literacy. RESULTS The analysis was restricted to 301 internet users (mean age 39.9, SD 14.8 years; 166/301, 55.1% female) who provided responses to all 8 eHEALS questions and complete demographic information. The mean overall eHEALS score was 29.3 (SD 6.8) out of 40, and 71.4% (215/301) agreed to at least 5 out of the 8 eHEALS items. The eHEALS item with the lowest level of agreement was "I can tell high-quality health resources from low-quality health resources on the internet" (182/301, 60.5%). Although there were statistically significant differences in eHEALS scores according to age, educational achievement, language preference, and the presence of chronic medical conditions, multivariable regression analysis indicated that language preference was the only variable independently associated with eHealth literacy (coefficient -6.0, 95% CI -9.61 to -2.39). CONCLUSIONS In our sample of South Asian Canadian internet users, preference for written health information in languages other than English was associated with lower eHealth literacy. Opportunities exist to improve eHealth literacy using culturally and linguistically tailored interventions.
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Affiliation(s)
- Mark J Makowsky
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Shahnaz Davachi
- Primary Health Care, Alberta Health Services, Calgary, AB, Canada
| | - Charlotte A Jones
- Faculty of Medicine, Southern Medical Program, University of British Columbia Okanagan Campus, Kelowna, BC, Canada
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Truong M, Fenton SH. Understanding the Current Landscape of Direct-to-Consumer Health Literacy Interventions. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2022; 19:1e. [PMID: 35692847 PMCID: PMC9123524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Mehnert-Theuerkauf A, Esser P. [Survivorship care plans for cancer patients: the importance of risk stratification, self-management and health literacy in the age of digital care]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:412-419. [PMID: 35275217 PMCID: PMC8979897 DOI: 10.1007/s00103-022-03514-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/24/2022] [Indexed: 11/25/2022]
Abstract
In Deutschland wie allen anderen Industrieländern weltweit nimmt mit einer älter werdenden Bevölkerung und einer verbesserten Krebsfrüherkennung, Diagnostik und onkologischen Behandlung die Zahl der Patienten, die geheilt werden oder lange Zeit mit der Erkrankung leben, deutlich zu (Cancer Survivors). Ein Leben mit und nach einer Krebserkrankung bedeutet für viele Patienten ein Leben mit körperlichen und psychosozialen krankheits- und behandlungsbedingten Langzeit- und Spätfolgen. Angesichts des demografischen Wandels, der steigenden Krebsprävalenz sowie des medizinischen Fortschritts ist eine der dringenden Fragen, wie eine qualitativ hochwertige individualisierte und gleichzeitig finanzierbare Krebsversorgung für älter werdende, häufig multimorbide Patienten sichergestellt werden kann. Diese Entwicklungen erfordern neben einer Stärkung der Krebsprävention die Erforschung und Umsetzung einer individualisierten Nachsorge im Rahmen von Survivorship-Care-Programmen (SCP). Übergreifende Zielsetzung von SCP ist es, den körperlichen wie psychosozialen Langzeit- und Spätfolgen vorzubeugen bzw. diese zu minimieren, die Mortalität zu senken sowie die Lebensqualität von Patienten zu verbessern. Die Evidenz zur Wirksamkeit von SCP hinsichtlich der Verbesserung patientenberichteter Endpunkte ist bislang nicht eindeutig. Die Bereitstellung von maßgeschneiderten Informationen sowie von risikomodifizierenden und bedarfsorientierten Angeboten auf der Basis einer Risikostratifizierung wird als zentraler Bestandteil bei der Implementierung von SCP angesehen. Dabei nimmt die Förderung von Selbstmanagement- und Gesundheitskompetenzen der Patienten, insbesondere vor dem Hintergrund der Zunahme von digitalen Gesundheitsanwendungen, einen hohen Stellenwert ein.
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Affiliation(s)
- Anja Mehnert-Theuerkauf
- Abteilung für Medizinische Psychologie und Medizinische Soziologie Universitätsklinikum Leipzig, Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland.
| | - Peter Esser
- Abteilung für Medizinische Psychologie und Medizinische Soziologie Universitätsklinikum Leipzig, Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
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Jung SO, Son YH, Choi E. E-health literacy in older adults: an evolutionary concept analysis. BMC Med Inform Decis Mak 2022; 22:28. [PMID: 35101005 PMCID: PMC8805227 DOI: 10.1186/s12911-022-01761-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/20/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Internet technologies have become important for older adults to not only seek, understand, and evaluate information on health management but also apply and share acquired knowledge. Despite the disparity in e-health literacy among older adults, which affects health outcomes, its conceptual definition has not been distinctly clarified in previous studies. This study aimed to analyse the concept of e-health literacy among older adults and to identify its contexts in the nursing field. METHODS We identified concepts, attributes, antecedents, and consequences of e-health literacy in older adults using Rodgers' evolutionary approach to various fields of study, time, and cultural differences. A literature search was conducted using the National Assembly Library, Research Information Sharing Service, National Digital Science Library, DataBase Periodical Information Academic, PubMed, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica database, and Cochrane. RESULTS A total of 28 studies were included, and we categorised the following three attributes: active information seeking, two-way interactive communication, and information utilization/sharing. The antecedents included personal factors, health status, socioeconomic factors, cultural factors, and attitudes toward the Internet while the consequences included increased health interest, health behaviour promotion, and active decision-making. CONCLUSIONS As e-health literacy in older adults affects their health and quality of life, this study clarifies the concept and provides a conceptual framework for nursing practice and research. Further studies are needed to identify and expand the constantly evolving concept of e-health literacy in older adults.
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Affiliation(s)
- Sun Ok Jung
- College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760 Republic of Korea
| | - Yoon Hee Son
- College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760 Republic of Korea
| | - Eunju Choi
- College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760 Republic of Korea
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Wray C, Tang J, Byers A, Keyhani S. Digital Health Skillsets and Digital Preparedness: Comparison of Veterans Health Administration Users and Other Veterans Nationally. JMIR Form Res 2022; 6:e32764. [PMID: 35089147 PMCID: PMC8838565 DOI: 10.2196/32764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/03/2021] [Accepted: 12/13/2021] [Indexed: 02/06/2023] Open
Abstract
Background As health care systems shift to greater use of telemedicine and digital tools, an individual’s digital health literacy has become an important skillset. The Veterans Health Administration (VA) has invested resources in providing digital health care; however, to date, no study has compared the digital health skills and preparedness of veterans receiving care in the VA to veterans receiving care outside the VA. Objective The goal of the research was to describe digital health skills and preparedness among veterans who receive care within and outside the VA health care system and examine whether receiving care in the VA is associated with digital preparedness (reporting more than 2 digital health skills) after accounting for demographic and social risk factors. Methods We used cross-sectional data from the 2016-2018 National Health Interview Survey to identify veterans (aged over 18 years) who obtain health care either within or outside the VA health care system. We used multivariable logistic regression models to examine the association of sociodemographic (age, sex, race, ethnicity), social risk factors (economic instability, disadvantaged neighborhood, low educational attainment, and social isolation), and health care delivery location (VA and non-VA) with digital preparedness. Results Those who received health care within the VA health care system (n=3188) were younger (age 18-49 years: 33.3% [95% CI 30.7-36.0] vs 24.2% [95% CI 21.9-26.5], P<.01), were more often female (34.7% [95% CI 32.0-37.3] vs 6.6% [95% CI 5.5-7.6], P<.01) and identified as Black (13.1% [95% CI 11.2-15.0] vs 10.2% [95% CI 8.7-11.8], P<.01), and reported greater economic instability (8.3% [95% CI 6.9-9.8] vs 5.5% [95% CI 4.6-6.5], P<.01) and social isolation (42.6% [95% CI 40.3-44.9] vs 35.4% [95% CI 33.4-37.5], P<.01) compared to veterans who received care outside the VA (n=3393). Veterans who obtained care within the VA reported more digital health skills than those who obtained care outside the VA, endorsing greater rates of looking up health information on the internet (51.8% [95% CI 49.2-54.4] vs 45.0% [95% CI 42.6-47.3], P<.01), filling a prescription using the internet (16.2% [95% CI 14.5-18.0] vs 11.3% [95% CI 9.6-13.0], P<.01), scheduling a health care appointment on the internet (14.1% [95% CI 12.4-15.8] vs 11.6% [95% CI 10.1-13.1], P=.02), and communicating with a health care provider by email (18.0% [95% CI 16.1-19.8] vs 13.3% [95% CI 11.6-14.9], P<.01). Following adjustment for sociodemographic and social risk factors, receiving health care from the VA was the only characteristic associated with higher odds (adjusted odds ratio [aOR] 1.36, 95% CI 1.12-1.65) of being digitally prepared. Conclusions Despite these demographic disadvantages to digital uptake, veterans who receive care in the VA reported more digital health skills and appear more digitally prepared than veterans who do not receive care within the VA, suggesting a positive, system-level influence on this cohort.
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Affiliation(s)
- Charlie Wray
- Section of Hospital Medicine, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Janet Tang
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Amy Byers
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States.,Division of Mental Health Services, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA, United States.,Department of Psychiatry and Behavioral Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Salomeh Keyhani
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Versluis A, Schnoor K, Chavannes NH, Talboom-Kamp EP. Direct Access for Patients to Diagnostic Testing and Results Using eHealth: Systematic Review on eHealth and Diagnostics. J Med Internet Res 2022; 24:e29303. [PMID: 35019848 PMCID: PMC8792777 DOI: 10.2196/29303] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/14/2021] [Accepted: 12/01/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The number of people with chronic diseases and the subsequent pressure on health care is increasing. eHealth technology for diagnostic testing can contribute to more efficient health care and lower workload. OBJECTIVE This systematic review examines the available methods for direct web-based access for patients to diagnostic testing and results in the absence of a health care professional in primary care. METHODS We searched the PubMed, Embase, Web of Sciences, Cochrane Library, Emcare, and Academic Search Premier databases in August 2019 and updated in July 2021. The included studies focused on direct patient access to web-based triage leading to diagnostic testing, self-sampling or testing, or web-based communication of test results. A total of 45 studies were included. The quality was assessed using the Mixed Methods Appraisal Tool. RESULTS Most studies had a quantitative descriptive design and discussed a combination of services. Diagnostic test services mainly focused on sexually transmitted infections. Overall, the use was high for web-based triage (3046/5000, >50%, who used a triage booked a test), for self-sampling or self-testing kits (83%), and the result service (85%). The acceptability of the test services was high, with 81% preferring home-based testing over clinic-based testing. There was a high rate of follow-up testing or treatment after a positive test (93%). CONCLUSIONS The results show that direct access to testing and result services had high use rates, was positively evaluated, and led to high rates of follow-up treatment. More research on cost-effectiveness is needed to determine the potential for other diseases. Direct access to diagnostic testing can lower the threshold for testing in users, potentially increase efficiency, and lower the workload in primary care.
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Affiliation(s)
- Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Kyma Schnoor
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Saltro Diagnostic Center, Utrecht, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Esther Pwa Talboom-Kamp
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Saltro Diagnostic Center, Utrecht, Netherlands
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Bardus M, Keriabian A, Elbejjani M, Al-Hajj S. Assessing eHealth literacy among internet users in Lebanon: A cross-sectional study. Digit Health 2022; 8:20552076221119336. [PMID: 35968030 PMCID: PMC9373133 DOI: 10.1177/20552076221119336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/25/2022] [Indexed: 12/31/2022] Open
Abstract
Objective Assessing the level of eHealth literacy in a population is essential to
designing appropriate public health interventions. This study aimed to
assess eHealth literacy among adult internet users in Lebanon, recruited
through social media and printed materials. The study examined the
relationship between internet use, perceived eHealth literacy, and
sociodemographic characteristics. Methods A cross-sectional study based on a web-based questionnaire was conducted
between January and May 2020. The survey assessed internet use and eHealth
literacy using the homonymous scale (eHEALS) in English and Arabic.
Cronbach's alpha and factor analyses were used to evaluate eHEALS’
psychometric properties. A generalized linear model was used to identify
factors predicting the eHEALS. Results A total of 2715 respondents were recruited mostly through Facebook (78%) and
printed materials (17%). Most respondents completed the survey in English
(82%), were aged 30 ± 11 years, female (60%), Lebanese (84%), unmarried
(62%), employed (54%), and with a graduate-level education (53%). Those who
completed the eHEALS questionnaire (n = 2336) had a
moderate eHealth literacy (M = 28.7,
SD = 5.5). eHEALS was significantly higher among older
females with a high education level, recruited from Facebook, Instagram, or
ResearchGate, and perceived the Internet as a useful and important source of
information. Conclusions Future internet-delivered public health campaigns in Lebanon should account
for moderate-to-low levels of eHealth literacy and find ways to engage older
males with low education levels representing neglected segments (e.g.
Syrians). To be more inclusive, campaigns should reach neglected population
segments through non-digital, community-based outreach activities.
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Affiliation(s)
- Marco Bardus
- Institute of Applied Health Research, University of Birmingham, Edgbaston, UK
- Department of Health Promotion & Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Arda Keriabian
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Martine Elbejjani
- Clinical Research Institute & Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Samar Al-Hajj
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Seckin G, Hughes S. Patient-Reported Outcomes in a Nationally Representative Sample of Older Internet Users: Cross-sectional Survey. JMIR Aging 2021; 4:e16006. [PMID: 34822340 PMCID: PMC8663692 DOI: 10.2196/16006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/22/2019] [Accepted: 01/24/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The rapid diffusion of the internet has decreased consumer reliance on health care providers for health information and facilitated the patients' ability to be an agent in control of their own health. However, empirical evidence is limited regarding the effects of health-related internet use among older adults, which is complicated by the proliferation of online health and medical sources of questionable scientific accuracy. OBJECTIVE We explore the effects of health-related internet use, education, and eHealth literacy on medical encounters and patient-reported outcomes. Patient-reported outcomes are categorized into two dimensions: (1) self-reported health problem and (2) affective distress (feeling worried and anxious) due to information obtained. We were particularly interested in whether education and eHealth literacy moderate the association between perceived strain in medical encounters and patient-reported outcomes. METHODS Our study sample consisted of online panel members who have used the internet as a resource for health information, randomly drawn from one of the largest probability-based online research panels. This paper specifically reports results obtained from older panel members (age≥60 years: n=194). First, we examined descriptive statistics and bivariate associations (Pearson correlations and independent samples t tests). We used hierarchical ordinary least squares regression analyses by running separate regressions for each patient-reported outcome. In model 1, we entered the main effects. In model 2, technology and medical encounter variables were included. Model 3 added the statistical interaction terms. RESULTS Age (β=-.17; P=.02), gender (β=-.22; P=.01), and medical satisfaction (β=-.28; P=.01) were significant predictors of self-reported health problems. Affective distress was positively predicted by gender (β=.13; P=.05) and satisfaction with medical encounters (β=.34; P<.001) but negatively predicted by education (β=-.18; P=.03) and eHealth literacy (β=-.32; P=.01). The association between experiencing a health problem in relation to health-related internet use and perception of strained medical encounters was greater among respondents with lower levels of education (β=-.55; P=.04). There was also a significant interaction between education and eHealth literacy in predicting the level of affective distress (β=-.60; P=.05), which indicated that higher levels of education predicted lower averages of feeling anxiety and worry despite lower eHealth literacy. Older women reported higher averages of affective distress (β=.13; P=.05), while older men reported higher averages of experiencing a self-reported health problem (β=-.22; P=.01). CONCLUSIONS This study provides evidence for the effect of health-related internet use on patient-reported outcomes with implications for medical encounters. The results could be used to guide educational and eHealth literacy interventions for older individuals.
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Affiliation(s)
- Gul Seckin
- Department of Sociology, University of North Texas, Denton, TX, United States
| | - Susan Hughes
- Department of Sociology, Ouachita Baptist University, Arkadelphia, AR, United States
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Verma R, Saldanha C, Ellis U, Sattar S, Haase KR. eHealth literacy among older adults living with cancer and their caregivers: A scoping review. J Geriatr Oncol 2021; 13:555-562. [PMID: 34810146 DOI: 10.1016/j.jgo.2021.11.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/20/2021] [Accepted: 11/05/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Over 90% of people living with cancer access information online to inform healthcare decisions. Older adults with cancer are also increasingly adopting electronic healthcare services, or eHealth, particularly with the rapid transition to virtual care amidst the pandemic. Therefore, the purpose of this review is to understand the level of eHealth literacy among older adults with cancer and their caregivers, as well as any barriers and facilitators in terms of accessing, comprehending, and implementing eHealth information. METHODS This scoping review was guided by Arksey and O'Malley methodology and PRISMA ScR guidelines. Comprehensive searches for the concepts of "eHealth Literacy" and "cancer" were performed in MEDLINE, Scopus, CINAHL, PsycINFO, AMED and EMBASE, from 2000 to 2021. We used descriptive quantitative and thematic analysis to analyze the literature. RESULTS Of the 6076 articles screened by two reviewers, eleven articles were included. Quantitative findings suggest older adults with cancer and their caregivers have low self-perceived eHealth literacy and less confidence evaluating online health information for cancer decision-making. Low socioeconomic status, lower education levels, rapid expansion of digital applications, broadband access, reduced familiarity, and frequency of use were cited as prominent barriers. eHealth literacy appears to be positively correlated with caregivers seeking a second opinion, awareness of treatment options, shared decision making, and trust in the health care system. CONCLUSION With the growing reliance on eHealth tools, developing credible digital health applications that require minimal internet navigation skills, patient education, and collaborative efforts to address access and affordability are urgently warranted.
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Affiliation(s)
- Ridhi Verma
- School of Healthcare Sciences, Cardiff University, 19 Brent Avenue, Didcot, Oxforshire, United Kingdom
| | - Conchita Saldanha
- School of Physical and Occupational Therapy, McGill University, 5385 rue de Bernieres, Saint Leonard H1R 1M9, Canada
| | - Ursula Ellis
- Woodward Library, University of British Columbia, Vancouver, Canada
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, 4400, 4th Avenue, Rm 108, Regina, Saskatchewan S4T 0H8, Canada
| | - Kristen R Haase
- School of Nursing, Faculty of Applied Science, University of British Columbia, Vancouver, Canada.
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eHealth Literacy: From Theory to Clinical Application for Digital Health Improvement. Results from the ACCESS Training Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211800. [PMID: 34831555 PMCID: PMC8618977 DOI: 10.3390/ijerph182211800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022]
Abstract
Skills, knowledge, and awareness of digital and technological tools are essential to improve the state of well-being and health of older adults and also to mitigate the condition of social isolation in the aging process. For this reason, it is necessary to implement a social learning of electronic/digital tools for health of older people to support the achievement of eHealth and digital competences. The paper reports the results of an Italian innovative eHealth training for the European project ACCESS. The training has been based on blended didactical and interactive educational techniques, aimed at collecting as many points of view as possible from older adults. A total of 58 older adults were recruited to attend a four-week training program, which included five modules. The results showed a statistical significant difference between the eHealth Literacy Scale (eHEALS) mean value before and after the course. A significant negative correlation was found between eHEALS and positive/total Survey of Technology Use (SOTU), suggesting an inverse relationship between positive/total SOTU and eHEALS. There is a strong positive and statistically significant relationship between satisfaction with the training and eHEALS. The results indicate that the intervention increased the digital competences of participants connected to health.
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Cheng C, Elsworth G, Osborne RH. Validity Evidence Based on Relations to Other Variables of the eHealth Literacy Questionnaire (eHLQ): Bayesian Approach to Test for Known-Groups Validity. J Med Internet Res 2021; 23:e30243. [PMID: 34647897 PMCID: PMC8554672 DOI: 10.2196/30243] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 12/03/2022] Open
Abstract
Background As health resources and services are increasingly delivered through digital platforms, eHealth literacy is becoming a set of essential capabilities to improve consumer health in the digital era. To understand eHealth literacy needs, a meaningful measure is required. Strong initial evidence for the reliability and construct validity of inferences drawn from the eHealth Literacy Questionnaire (eHLQ) was obtained during its development in Denmark, but validity testing for varying purposes is an ongoing and cumulative process. Objective This study aims to examine validity evidence based on relations to other variables—using data collected with the known-groups approach—to further explore if the eHLQ is a robust tool to understand eHealth literacy needs in different contexts. A priori hypotheses are set for the expected score differences among age, sex, education, and information and communication technology (ICT) use for each of the 7 eHealth literacy constructs represented by the 7 eHLQ scales. Methods A Bayesian mediated multiple indicators multiple causes model approach was used to simultaneously identify group differences and test measurement invariance through differential item functioning across the groups, with ICT use as a mediator. A sample size of 500 participants was estimated. Data were collected at 3 diverse health sites in Australia. Results Responses from 525 participants were included for analysis. Being older was significantly related to lower scores in 4 eHLQ scales, with 3. Ability to actively engage with digital services having the strongest effect (total effect –0.37; P<.001), followed by 1. Using technology to process health information (total effect –0.32; P<.001), 5. Motivated to engage with digital services (total effect –0.21; P=.01), and 7. Digital services that suit individual needs (total effect –0.21; P=.02). However, the effects were only partially mediated by ICT use. Higher education was associated with higher scores in 1. Using technology to process health information (total effect 0.22; P=.01) and 3. Ability to actively engage with digital services (total effect 0.25; P<.001), with the effects mostly mediated by ICT use. Higher ICT use was related to higher scores in all scales except 2. Understanding health concepts and language and 4. Feel safe and in control. Either no or ignorable cases of differential item functioning were found across the 4 groups. Conclusions By using a Bayesian mediated multiple indicators multiple causes model, this study provides supportive validity evidence for the eHLQ based on relations to other variables as well as established evidence regarding internal structure related to measurement invariance across the groups for the 7 scales in the Australian community health context. This study also demonstrates that the eHLQ can be used to gain valuable insights into people’s eHealth literacy needs to help optimize access and use of digital health and promote health equity.
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Affiliation(s)
- Christina Cheng
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Australia
| | - Gerald Elsworth
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Australia
| | - Richard H Osborne
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Australia
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Scheerens C, Gilissen J, Volow AM, Powell JL, Ferguson CM, Farrell D, Li B, Berry C, Sudore RL. Developing eHealth tools for diverse older adults: Lessons learned from the PREPARE for Your Care Program. J Am Geriatr Soc 2021; 69:2939-2949. [PMID: 34081773 PMCID: PMC8497394 DOI: 10.1111/jgs.17284] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVES Electronic Health (eHealth) tools offer opportunities for people to access health information online; yet, most tools are not designed to meet the unique needs of diverse older adults, leading to health disparities. Our goal was to provide guidance for the development of eHealth tools for diverse older populations for use in geriatric care models. DESIGN Guidance for eHealth tools was compiled from user design resources and eHealth design literature. Pragmatic examples were provided from an evidenced-based eHealth tool called PREPAREforYourCare.org (PREPARE). We used quantitative feasibility data from PREPARE research studies and qualitative analysis of PREPARE focus groups, cognitive interviews, and feedback from randomized trials to further inform our recommendations. RESULTS Guidance and lessons learned include: (1) define clear objectives and a conceptual framework; (2) co-create with the target population; (3) optimize the design and layout for accessibility and ease of use, such as text at the 5th grade reading level, closed captioning, etc.; (4) use simple, standardized navigation design; (5) use actionable information to enhance behavior change, such as modeling of behaviors; (6) align accompanying written materials with the eHealth tool; and (7) create tracking mechanisms for ongoing user feedback. PREPARE is used as a case example to provide pragmatic illustrations for how the guidance may be operationalized. CONCLUSION eHealth tools can be tailored to the unique characteristics, preferences, and needs of diverse older populations. Following the "lessons learned" may help decrease health disparities among diverse older adults and ensure eHealth tools are readily accessible and culturally appropriate.
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Affiliation(s)
- Charlotte Scheerens
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- Department of Public Health and Primary Health Care, Ghent University, Ghent, Belgium
| | - Joni Gilissen
- Department of Public Health and Primary Health Care, Ghent University, Ghent, Belgium
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute (GBHI), University of California, San Francisco, California, USA
| | - Aiesha M Volow
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Jana L Powell
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Clarissa M Ferguson
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | | | - Brookelle Li
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | | | - Rebecca L Sudore
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Innovation and Implementation Center on Aging and Palliative Care, Division of Geriatrics, University of California, San Francisco, California, USA
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Pourrazavi S, Hashemiparast M, Bazargan-Hejazi S, Ullah S, Allahverdipour H. Why Older People Seek Health Information Online: A Qualitative Study. ADVANCES IN GERONTOLOGY 2021. [PMCID: PMC8425996 DOI: 10.1134/s2079057021030115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Despite the increasing number of older adults’ growing need for health information, little is known about their motivation to seek online health information. This exploratory qualitative study was conducted to examine why older adults seek required health information through online sources. In this qualitative content analysis, we purposefully approached 19 older adults with age in the range between 60–75 (63.78 ± 3.8 years) in Tabriz, Iran. Data were collected via individual, semi-structured face-to-face interviews at a place and time convenient to the study participants from October 2018 to September 2019. We evaluated the content of recorded data until saturation was reached, using MAXQDA 10 software. Subsequently, four central motivational themes were emerged including being self-reliant, achieving a healthier life, seeking reliable sources of health information, and accumulating health information. Older adults seek health information based on their needs and expectations to achieve optimal health status. Our findings provide valuable information for nurses and other health care providers to facilitate older adults’ access to trusting and valid online health information. It further suggests that, with the consideration of COVID-19 pandemic, fact-checking skills of elderly in identifying and accessing credible information sources should be addressed in future health literacy interventions.
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Affiliation(s)
- S. Pourrazavi
- Health Education and Promotion Department, Tabriz University of Medical Sciences, 5165665931 Tabriz, Iran
| | - M. Hashemiparast
- Health Education and Health Promotion Department, School of Public Health, Zanjan University of Medical Sciences, 4513956184 Zanjan, Iran
| | - S. Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, 90059 Los Angeles, CA USA
| | - S. Ullah
- Ayub Teaching Hospital, Khyber Medical College, Abbottabad, Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - H. Allahverdipour
- Health Education and Promotion Department, Tabriz University of Medical Sciences, 5165665931 Tabriz, Iran
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Razi Hospital, 5165665931 Tabriz, Iran
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Boumans R, van de Sande Y, Thill S, Bosse T. Voice-enabled Intelligent Virtual Agents for People with Amnesia: Systematic Review (Preprint). JMIR Aging 2021; 5:e32473. [PMID: 35468084 PMCID: PMC9086881 DOI: 10.2196/32473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/14/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Roel Boumans
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Yana van de Sande
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Serge Thill
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Tibor Bosse
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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El Benny M, Kabakian-Khasholian T, El-Jardali F, Bardus M. Application of the eHealth Literacy Model in Digital Health Interventions: Scoping Review. J Med Internet Res 2021; 23:e23473. [PMID: 34081023 PMCID: PMC8212628 DOI: 10.2196/23473] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 04/14/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Digital health interventions (DHIs) are increasingly being adopted globally to address various public health issues. DHIs can be categorized according to four main types of technology: mobile based, web based, telehealth, and electronic health records. In 2006, Norman and Skinner introduced the eHealth literacy model, encompassing six domains of skills and abilities (basic, health, information, scientific, media, and computer) needed to effectively understand, process, and act on health-related information. Little is known about whether these domains are assessed or accounted for in DHIs. OBJECTIVE This study aims to explore how DHIs assess and evaluate the eHealth literacy model, describe which health conditions are addressed, and which technologies are used. METHODS We conducted a scoping review of the literature on DHIs, based on randomized controlled trial design and reporting the assessment of any domain of the eHealth literacy model. MEDLINE, CINAHL, Embase, and Cochrane Library were searched. A duplicate selection and data extraction process was performed; we charted the results according to the country of origin, health condition, technology used, and eHealth literacy domain. RESULTS We identified 131 unique DHIs conducted in 26 different countries between 2001 and 2020. Most DHIs were conducted in English-speaking countries (n=81, 61.8%), delivered via the web (n=68, 51.9%), and addressed issues related to noncommunicable diseases (n=57, 43.5%) or mental health (n=26, 19.8%). None of the interventions assessed all six domains of the eHealth literacy model. Most studies focused on the domain of health literacy (n=96, 73.2%), followed by digital (n=19, 14.5%), basic and media (n=4, 3%), and information and scientific literacy (n=1, 0.7%). Of the 131 studies, 7 (5.3%) studies covered both health and digital literacy. CONCLUSIONS Although many selected DHIs assessed health or digital literacy, no studies comprehensively evaluated all domains of the eHealth literacy model; this evidence might be overlooking important factors that can mediate or moderate the effects of these interventions. Future DHIs should comprehensively assess the eHealth literacy model while developing or evaluating interventions to understand how and why interventions can be effective.
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Affiliation(s)
- Mariam El Benny
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Tamar Kabakian-Khasholian
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Marco Bardus
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Papp-Zipernovszky O, Horváth MD, Schulz PJ, Csabai M. Generation Gaps in Digital Health Literacy and Their Impact on Health Information Seeking Behavior and Health Empowerment in Hungary. Front Public Health 2021; 9:635943. [PMID: 34055714 PMCID: PMC8158579 DOI: 10.3389/fpubh.2021.635943] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/13/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Today the internet is a major source of health information, and younger generations have more confidence in their digital information seeking skills and awareness of online resources than older generations. Older generations, however, are more in demand of health services. The aim of our study was to explore these generational differences as related to self-perceived eHealth literacy and health care system utilization. Methods: A cross-sectional survey study with 522 subjects was done in Hungary. Every subject belonged to one of four generations (Baby boomers, X, Y, and Z). The Web-based survey was designed and tested in English-speaking countries and translated into Hungarian for the present study. Variables include Internet health information seeking, eHealth literacy (measured by eHeals score), the self-perceived gain in empowerment by that information, and the number of health care appointments. One-way ANOVA was used for comparing the scores of the generations, and correlational and linear regression analysis was employed within the generations for further data analysis. Results: We found significant differences among the generations in eHealth literacy as well as in the self-perceived gain in empowerment: while Boomers were the generation with the lowest eHeals scores, they showed the highest empowerment. Internet health information seeking behavior showed no differences. While subjects who use the Internet more frequently to search for health information have worse self-rated health status, the ones with higher eHeals scores report better subjective health status. We also identified the associations of the above variables within the older generations (Boomers and X) with the frequency of using health-care services: within the generation of Boomers the number of health care appointments was only associated with Internet health information seeking, while in Generation X with eHeals. Conclusions: Baby boomers seek Internet health information as often as the younger generations, which provides a solid motivation for developing their eHealth literacy skills. We find it crucial to plan the Hungarian health promotion programmes utilizing this high frequency of Internet health information seeking, since the eHealth literacy skills of older generations have an effect on their subjective health status, and they are the most capable of applying information in making decisions.
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Affiliation(s)
- Orsolya Papp-Zipernovszky
- Department of Personality, Clinical and Health Psychology, Institute of Psychology, University of Szeged, Szeged, Hungary
| | - Mária Dóra Horváth
- Department of Health Economics, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Peter J Schulz
- Institute of Communication and Health, Faculty of Communication Science, University of Lugano, Lugano, Switzerland
| | - Márta Csabai
- Department of Personality, Clinical and Health Psychology, Institute of Psychology, University of Szeged, Szeged, Hungary
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Chang SJ, Jang SJ, Lee H, Kim H. Building on Evidence to Improve eHealth Literacy in Older Adults: A Systematic Review. Comput Inform Nurs 2021; 39:241-247. [PMID: 32925185 DOI: 10.1097/cin.0000000000000674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This review aimed to provide information on ways to improve eHealth literacy in older adults by assessing current studies examining eHealth literacy. To achieve the aim, this review focused on what theories or theoretical frameworks were used in the studies, what factors were related to eHealth literacy, and what outcome variables were used in eHealth literacy interventions for older adults. Five electronic databases were searched to identify eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was followed to select relevant studies, and narrative synthesis was performed. Among a total of 27 studies, 13 described theories or theoretical frameworks. Credibility in Internet health information, knowledge, and experience were identified as modifiable factors related to eHealth literacy. The most frequently used outcome variable was eHealth literacy efficacy. Nurses who are interested in improving eHealth literacy in older adults should consider appropriate theoretical frameworks and multiple factors influencing eHealth literacy.
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Affiliation(s)
- Sun Ju Chang
- Author Affiliations: College of Nursing & Research Institute of Nursing Science, Seoul National University (Dr Chang); and Red Cross College of Nursing, Chung-Ang University (Drs Jang and Lee), Seoul; and Division of Nursing & Research Institute of Nursing Science, Hallym University, Chuncheon (Dr Kim), South Korea
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Hochmuth A, Wrona KJ, Exner AK, Dockweiler C. Digitization and health inequality and equity in nursing. Pflege 2021; 34:151-158. [PMID: 33890829 DOI: 10.1024/1012-5302/a000803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: The use of information and communication technologies (ICT) in health care is increasing attention. To describe health inequalities and equity with regard to the use of digital health technologies in a care context and to understand interrelationships, it is of particular importance for the field of care research to use models and theories that explain health inequalities and equity in the use of digital technologies. Aims: This article aims to identify models and theories from the field of nursing and health research that explain the phenomenon of health inequalities and the influence of digital health technologies on the emergence of inequalities. Methods: Relevant articles were searched in electronic databases (MEDLINE, CINAHL & SocINDEX) between July and August 2019 in German and English, within the methodological framework of a scoping review. The systematic literature search and data extraction were performed by 2 reviewers. The description of data refers to standard criteria by 8-1Christiansen and Baum (1997). Results: From a total of 25 relevant articles, 2 were identified for inclusion in the current overview. One model is focusing on ICT for health and the other model focuses on eHealth. No nursing theory could be identified in the context of describing the phenomenon of digital inequality. Conclusions: In both models, there is a lack of discussion about the impact of nursing aspects on the use and acceptance of eHealth technologies. One point should also be the development of models and theories that consider the user perspective of vulnerable groups.
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Affiliation(s)
| | - Kamil J Wrona
- Dept. Demography and Health & Centre for ePublic Health Research, School of Public Health, Bielefeld University, Bielefeld
| | | | - Christoph Dockweiler
- Centre for ePublic Health Research, School of Public Health, Bielefeld University, Bielefeld
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Esser P, Mehnert-Theuerkauf A. [Cancer survivorship care programs and self-management]. DER ONKOLOGE : ORGAN DER DEUTSCHEN KREBSGESELLSCHAFT E.V 2021; 27:766-770. [PMID: 33935378 PMCID: PMC8063579 DOI: 10.1007/s00761-021-00945-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Survivorship care programs (SCP) are increasingly being implemented in order to ensure long-term and comprehensive care of physical and psychosocial cancer-related sequelae among survivors. In this article, we provide a short overview of SCP and the importance of health-related self-management. RESULTS The broad definition of "survivorship" and the high diversity of impairments among cancer survivors warrants a personalized and multidimensional approach. This in turn requires both interdisciplinary and integrated care. To date, the state of knowledge on the efficacy of SCP is limited. A central aim of SCP is to increase health-related self-management, which in turn requires the ability to correctly evaluate and apply health-related information in order to resolve health-related problems (health literacy). Due to the technological developments, additional skills are needed to stay health literate (digital health literacy). CONCLUSION Further research on the efficacy of SCP is warranted. Both advantages and risks of digital health programs need to be carefully weighed to avoid inequalities in health care ("digital divide"). Specific education programs to improve digital health literacy may help to minimize such risks.
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Affiliation(s)
- Peter Esser
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Deutschland
| | - Anja Mehnert-Theuerkauf
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Deutschland
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