A Comprehensive Analysis of E-Health Literacy Research Focuses and Trends

Online Health Information Seeking, eHealth Literacy, and Health Behaviors Among Chinese Internet Users: Cross-Sectional Survey Study

BACKGROUND

The internet has become an increasingly vital platform for health-related information, especially in upper-middle-income countries such as China. While previous research has suggested that online health information seeking (OHIS) can significantly impact individuals' engagement in health behaviors, most research focused on patient-centered health communication.

OBJECTIVE

This study aims to examine how OHIS influences health behavior engagement among Chinese internet users, focusing on the role of eHealth literacy and perceived information quality in influencing relationships.

METHODS

An online cross-sectional survey was conducted in November 2021 among 10,000 Chinese internet users, using quota sampling based on sex, age, and urban and rural residence, in line with the 48th Statistical Report on Internet Development of China. Nonparametric tests were used to examine the differences in eHealth literacy across sociodemographic groups. Partial correlation analysis and stepwise linear regression were conducted to test the associations between key variables. Confirmatory factor analysis and structural equation modeling were conducted to test the hypotheses.

RESULTS

Our study identified significant disparities in functional and critical eHealth literacy between urban and rural residents across age groups, income levels, education backgrounds, and health conditions (all P<.001). In terms of sex and regional differences, we found higher functional literacy among female users than male users, and critical literacy varied significantly across different regions. The proposed structural model showed excellent fit (χ2404=4183.6, χ2404=10.4,P<.001; root mean square error of approximation value of 0.031, 95% CI 0.030-.031; standardized root mean square residual value of 0.029; and comparative fit index value of 0.955), highlighting reciprocal associations between 2 types of eHealth literacy and OHIS. Participants' functional eHealth literacy, critical eHealth literacy, and OHIS have positive impacts on their health behavioral engagement. Perceived information quality was found to mediate the influence of OHIS on health behavior (b=0.003, 95% CI 0.002-0.003; P<.001).

CONCLUSIONS

The study revealed the pathways linking sociodemographic factors, eHealth literacy, OHIS, and perceived information quality and how they together influenced health outcomes. The findings underscore the significance of enhancing eHealth literacy and improving information quality to promote better health outcomes among Chinese internet users.

Knowledge and Perceptions About Cervical Cancer and Human Papillomavirus, and Relationship with E-health Literacy, and Affecting Factors Among Female University Students

Purpose: The aim of this study is to reveal female university students' knowledge and perceptions about cervical cancer (CC) and human papillomavirus (HPV), and relationship with e-health literacy (e-HL). It also aims to determine the predictors affecting CC and HPV. Methods: A cross-sectional study was conducted with 589 female university students in Türkiye. Data were collected using a "Cervical Cancer and HPV Awareness Questionnaire" and an "E-health Literacy Scale (e-HLS)." Analysis involved Pearson correlation analysis, Independent Sample t-test, one-way analysis of variance, and Linear Regression analysis. Results: Results indicate that female students exhibited a low level of knowledge and perception about CC and HPV. Only 2.90% of students reported being vaccinated, while 39.90% had sexual experience. Higher knowledge levels were observed among married individuals, those familiar with HPV and the HPV vaccine, those who had undergone Pap smear tests, sexually active individuals, and consistent condom users. e-HL had a positive impact on knowledge and perceived threat about CC and HPV. The affecting predictors for knowledge about CC and HPV were found to be e-HLS (β = 0.911), having prior knowledge of HPV (β = 0.201), and being aware of the HPV vaccine (β = 0.172). In terms of perceived threat, the affecting predictors were e-HLS (β = 0.207), having heard of HPV (β = 0.101), and having knowledge of the HPV vaccine (β = 0.092). Conclusion: e-HL emerged as a crucial predictor positively influencing knowledge and perceptions about CC and HPV. This suggests the potential for organizing digital health campaigns to enhance awareness and understanding of CC and HPV.

A qualitative interview study of patients' attitudes towards and intention to use digital interventions for depressive disorders on prescription

Background

Depressive disorders are an emerging public health topic. Due to their increasing prevalence, patients with depressive disorders suffer from the lack of therapeutic treatment. Digital health interventions may offer an opportunity to bridge waiting times, supplement, or even substitute in-person treatment. Among others, the Unified Theory of Acceptance and Use of Technology (UTAUT) explains that actual technology use is affected by users' behavioural intention. However, patients' perspectives on digital interventions are rarely discussed within the specific context of primary care provided by general practitioners (GP) and need further exploration.

Method

A qualitative study design with semi-structured interviews was used to explore DTx-acceptance of patients with mild or moderate depression (n = 17). The audio-recorded interviews were transcribed verbatim, coded, and thematically analysed by qualitative content analysis.

Results

Patients' performance expectancies reveal that DTx are not perceived as a substitute for face-to-face treatment. Effort expectancies include potential advantages and efforts concerning technical, motivational, and skill-based aspects. Moreover, we identified health status and experience with depressive disorders as other determinants and potential barriers to patients' DTx acceptance: Difficult stages of depression or long-time experience are perceived hurdles for DTx use. GPs' recommendations were just partly relevant for patients and varied according to patients' consultancy preferences. But still, GPs have a crucial role for access due to prescription. GPs' influence on patients' DTx acceptance varies between three situations: (1) pre-use for consultation, (2) pre-use for access and (3) during DTx-use. Further, GPs' guidance could be especially relevant for patients during DTx-use in routine care.

Discussion

The UTAUT-based exploration suggests that acceptance determinants should be considered independently and embedded in personal and situational aspects. DTx require a healthcare professional to prescribe or diagnose the disease, unlike other digital offerings. We identified prescription- and depression-related determinants, exceeding existing theoretical constructs. GPs' guidance can compensate for some barriers to DTx use e.g., by increasing commitment and motivational support to strengthen patients' acceptance.

Conclusion

We argue for a multidimensional integration of acceptance determinants for further development of health technology acceptance research. Future research should specify how DTx can be integrated into routine care to strengthen user acceptance.

The relationship between therapeutic alliance, frequency of consultation and uptake of telemedicine among patients seeking treatment for early psychosis: A moderated mediation model

Background

Telehealth services ensure the delivery of healthcare services to a wider range of consumers through online platforms. Nonetheless, the acceptance and uptake of telehealth remain elusive. This study aims to understand the (a) uptake and (b) acceptability of telemedicine, (c) if therapeutic alliance mediates the relationship between the frequency of consultations with clinicians and the uptake of telemedicine in patients with early psychosis, and (d) role of education in moderating the relationship between therapeutic alliance and the uptake of telemedicine for their mental healthcare.

Methods

A convenience sample of outpatients (n = 109) seeking treatment for early psychosis and their care providers (n = 106) were recruited from a tertiary psychiatric care centre. Sociodemographic and clinical characteristics, therapeutic alliance (Working Alliance Inventory), and telemedicine use were captured through self-administered surveys. The moderated mediation analysis was performed using PROCESS macro 3.4.1 with therapeutic alliance and level of education as the mediating and moderating factors, respectively.

Results

The acceptance of telemedicine was high (possibly will use: 47.7%; definitely will use: 26.6%) whilst the uptake was low (11%). Therapeutic alliance mediated the relationship between the frequency of consultation and the uptake of telemedicine (β: 0.326; CI: 0.042, 0.637). This effect was moderated by the level of education (β: -0.058; p < 0.05).

Conclusion

Therapeutic alliance mediates the relationship between the frequency of consultations and the uptake of telemedicine services with the level of education moderating this mediation. Focusing on the patients with lower education to improve their telemedicine knowledge and therapeutic alliance might increase the uptake.

Relationship Between Electronic Health Literacy and Self-Management in People With Type 2 Diabetes Using a Structural Equation Modeling Approach

BACKGROUND

Electronic health (eHealth) literacy is a relatively new concept used to determine health outcomes. However, it is not well known how eHealth literacy relates to health outcomes such as diabetes self-management.

PURPOSE

This study was designed to examine the relationships among eHealth literacy, self-efficacy, social support, and self-management in people with Type 2 diabetes.

METHODS

A cross-sectional design was used to examine secondary data from a field survey of people with Type 2 diabetes recruited from outpatient clinics from August to December 2021 ( N = 453). A structural equation model was used that first analyzed the measurement model using confirmatory factor analysis and then tested the hypothesized structural model to estimate the expected relationships among the study variables. The significance of the statistical estimates for the model was assessed based on the 95% bias-corrected bootstrap confidence interval from 5,000 bootstrap resamples.

RESULTS

Significant, indirect relationships were found between eHealth literacy and self-management via self-efficacy (β = 0.26, B = 0.17, 95% CI [0.10, 0.24]) and via social support and, in turn, self-efficacy (β = 0.08, B = 0.05, 95% CI [0.04, 0.08]). eHealth literacy, social support, and self-efficacy together explained 58.1% of the variance in self-management.

CONCLUSION/IMPLICATIONS FOR PRACTICE

This study provides new evidence regarding how eHealth literacy relates to self-management in people with Type 2 diabetes via two indirect pathways, including self-efficacy alone and social support and self-efficacy in series. An eHealth literacy program for self-management should be developed in clinical practice that includes strategies for inducing synergistic effects from self-efficacy and social support on self-management in people with Type 2 diabetes.

e-Health literacy and online health information utilization among Jordanians: A population-based study

Background

The internet has become an essential part of empowering people to access health-related information. Huge amounts of health-related information are available online, but few people have the skills to assess its validity and reliability. Accordingly, the concept of ehealth literacy competencies emerged to measure the skills necessary to validate such information. As a result, the purpose of this study was to assess Jordanian people's e-health literacy, online health information utilization, and associated factors.

Methods

This population-based cross-sectional study was conducted from March to December 2023.

Results

Results: The study found that participants rated their e-health literacy at 28.94 out of 40, indicating a sufficient level of health literacy, and their online health information utilization at 39.62, indicating a high level of engagement with online health resources. Furthermore, it is revealed that e-health literacy is associated with gender and geographic region, whereas online health information utilization is associated only with chronic disease.

Conclusion

In Jordan, there is a balance between traditional and online health information use. While healthcare providers and primary health centers are the main sources of information, Jordanians show a sufficient level of e-health literacy, with females and the capital region exhibiting higher levels. Furthermore, Jordanians were more likely to use online health information. Nevertheless, it is crucial to work on improving internet platforms to enhance the quality of online health-related information.

Research into the relationship between digital health literacy and healthy lifestyle behaviors: an intergenerational comparison

Introduction

Digital health literacy wields a pivotal role in individuals' health status in terms of seeking and choosing appropriate and accurate information, and useful services from a vast array of choices. This study is aimed at assessing the validity and reliability of the Turkish version of Digital Health Literacy Instrument (DHLI) and examining the relationship between DHL and the healthy lifestyle behaviors of participants from X, Y, and Z generations.

Methods

In this study, to conduct a cross-sectional web-based survey, an online self-report questionnaire was built, and a convenience sample with a snowball approach was used. The study was conducted among 1,274 respondents aged between 18 and 64 years. Data collection tools consisted of the Personal Information Form, Lifestyle Behavior Scale II (HLBS II), and DHLI. Cultural validation and psychometric testing of DHLI, exploratory factor analysis, confirmatory factor analysis, Cronbach's alpha test, and bivariate and multivariate regression analysis were used for statistical analysis.

Results

In the study, the Turkish version of the DHLI tool consisting of six dimensions proved to be valid and reliable, and deemed appropriate for use across all age groups. The average digital health literacy of the respondents was sufficient, but the mean of healthy lifestyle behavior scores was moderate. There was a positive significant relationship between the total mean scores of DHLI and HLBS. Among the subdimensions of DHLI, while the highest mean scores were in DHLI Reliability, DHLI Privacy, and DHLI Search, DHLI Navigation and DHLI Relevance showed the lowest mean scores. DHLI Reliability, DHLI Relevance, and DHLI Adding Content were statistically significant predictors of health-related behaviors of the respondents.

Conclusion

The most important feature and novelty of this study is that, although the DHLI scale has been widely translated for use in many countries, it has been translated and adapted to Turkish for the first time herein. The study offers crucial evidence about Generation X, Y, and Z's DHL level and its positive relationships with health-related behaviors. Therefore, the community and its partners should lead the way in empowering individuals to understand and use online information in an effective, secure, and health-promoting manner, along with governments.

E-health literacy and associated factors among Korean adults during the COVID-19 pandemic: age-group differences

The purpose of this study was to compare the mean scores of e-health literacy, health information, social relationships, and psychological status between younger, middle-aged, and older Korean adults during the COVID-19 pandemic and to identify the factors associated with e-health literacy as well as the moderating effect of age on the association between health information factors and e-health literacy. We used a cross-sectional survey of 2400 Korean adults aged 20 years or older residing in Seoul. Descriptive statistics, ANOVA, chi-square test, and hierarchical multiple regression analyses were used to analyze the data. Findings demonstrated an age-group difference in the mean score of e-health literacy with the older group having lower e-health literacy than the other groups. Health information, social support, and COVID-19-related anxiety were associated with e-health literacy and a moderating effect of age on the association between sources of health information and e-health literacy was also identified among the three age subgroups. This study emphasizes the importance of identifying e-health-related risk factors leading to health disparities between age groups.

Effects of Physical Activity on Mobile Phone Addiction Among College Students: The Chain-Based Mediating Role of Negative Emotion and E-Health Literacy

Background

Smartphones have become an important tool for college students' study and life, but mobile phone addiction caused by excessive dependence use of cell phones can have serious negative impacts on college students' mental health, life behaviors, and so on. It is urgent to explore the causes and influence mechanisms of college students' cell phone addiction.

Purpose

The purpose of this study was to investigate the relationship between physical exercise and mobile phone addiction among Chinese college students and the mediating role of negative affect and e-health literacy between the two.

Methods

The stratified sampling method was used to investigate the physical activity, mobile phone addiction, negative emotion and e-health literacy of 4621 university students in Jiangsu Province using the Physical Activity Rating scale, Mobile Phone Addiction scale, Depression-anxiety-stress scale and E-Health Literacy scale, Thus the data were statistically analysed using SPSS 26.0 and AMOS 23.0.

Results

(1) Physical exercise was significantly negatively correlated with mobile phone addiction and negative emotion among college students (r=-.713, P<0.01; r=-.571, P<0.01), and physical exercise was significantly positively correlated with e-health literacy (r=0.616, P<0.01); (2) Negative emotion and e-health literacy played independent mediating roles between physical exercise and mobile phone addiction, respectively; (3) Negative emotion and e-health literacy played chain mediating roles between physical exercise and mobile phone addiction.

Conclusion

This study explored the potential mechanisms of cell phone addiction in college students and found that physical activity can influence Internet addiction through the independent mediating effect including the chain mediating effect of negative emotions and e-health literacy. This study further reveals the mechanism of action of physical exercise affecting college students' cell phone addiction, and provides some reference value for the prevention and intervention of college students cell phone addiction.

Internet of Medical Things and Healthcare 4.0: Trends, Requirements, Challenges, and Research Directions

Healthcare 4.0 is a recent e-health paradigm associated with the concept of Industry 4.0. It provides approaches to achieving precision medicine that delivers healthcare services based on the patient's characteristics. Moreover, Healthcare 4.0 enables telemedicine, including telesurgery, early predictions, and diagnosis of diseases. This represents an important paradigm for modern societies, especially with the current situation of pandemics. The release of the fifth-generation cellular system (5G), the current advances in wearable device manufacturing, and the recent technologies, e.g., artificial intelligence (AI), edge computing, and the Internet of Things (IoT), are the main drivers of evolutions of Healthcare 4.0 systems. To this end, this work considers introducing recent advances, trends, and requirements of the Internet of Medical Things (IoMT) and Healthcare 4.0 systems. The ultimate requirements of such networks in the era of 5G and next-generation networks are discussed. Moreover, the design challenges and current research directions of these networks. The key enabling technologies of such systems, including AI and distributed edge computing, are discussed.

Internet Use, eHealth Literacy, and Influencing Factors in Turkish Cancer Patients: A Descriptive and Correlational Study

OBJECTIVES

This study aimed to determine the Internet use, eHealth literacy levels, and influencing factors in Turkish cancer patients.

DATA SOURCES

A descriptive and correlational study was conducted in a single cancer center with 296 patients. Data were collected using a personal information form, an Internet Usage Form, and the eHealth Literacy Scale (eHEALS). The data were analyzed using descriptive statistics, the Mann‒Whitney U test, Kruskal‒Wallis test, and multiple linear regression analysis.

CONCLUSION

The participants received health-related information from the Internet (36.8%) with a mean total eHEALS score of 22.92 ± 9.67. In the multiple linear regression analysis, the descriptive characteristics of the participants were negatively affected by age (β = -0.143) and education level (β = 0.204). The use of the Internet to obtain information about cancer (β = 0.455) positively affected the level of eHealth literacy. The eHealth literacy of patients is at a level that needs to be improved and there are factors affecting it.

IMPLICATIONS FOR NURSING PRACTICE

Nurses should increase patients' eHealth literacy and guide them on how to access accurate information about cancer on the Internet. While doing this, it should be planned to consider the age, education level, and Internet use of the patients.

Factors influencing the e-health literacy in cancer patients: a systematic review

PURPOSE

As Internet technology evolves, electronic health (e-health) literacy gradually becomes a key factor in healthy behaviors and health-related decision-making. However, little is known about the influencing factors of e-health literacy among cancer survivors. Thus, the objective of this study was to systematically review the status quo, assessment tools, and influencing factors of e-health literacy in cancer patients.

METHODS

We conducted a comprehensive search in several databases, including PubMed, MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese BioMedical Literature Database, and Chinese Science and Technology Journal Database between January 2000 and December 2021.

RESULTS

A total of nine articles were included in this review, all of which were cross-sectional studies. Following the JBI critical appraisal tool, seven of them were rated as high quality. The e-Health Literacy Scale (eHEALS) was the most commonly used measurement for e-health literacy in cancer patients. The level of e-health literacy in cancer survivors was not high, which was associated with a variable of factors. The behavioral model of health services use was adopted to summarize related influencing factors. From an individual's perspective, predisposing characteristics and enabling resources were the most significant factors, without factors related to needs characteristics.

CONCLUSION

The study has identified the influencing factors of e-health literacy among cancer survivors, including age, gender, domicile place, education level, information-seeking behavior, and social support. In the future, e-health literacy lectures need to be carried out for elderly cancer patients, especially those who live in rural areas and have no access to the Internet. Families and friends of cancer survivors should also be encouraged to offer them more support.

IMPLICATIONS FOR CANCER SURVIVORS

These findings of this review provide novel insights for both family members and medical workers to improve e-health literacy in cancer patients. Further research is required to develop easy-to-use electronic health information acquisition devices and establish propagable e-health literacy intervention programs for cancer survivors.

The relationship between eHealth literacy and palliative care knowledge, attitudes, and practice among nurses: a cross-sectional study

BACKGROUND

The crucial role that nurses play in offering palliative care to patients with life-threatening diseases is widely acknowledged, but the correlation between their eHealth literacy and their knowledge, attitudes, and practice in this domain has yet to be investigated. This study is conducted to investigate the status of eHealth literacy and knowledge, attitudes, and practice regarding palliative care among nurses, and to examine their relationship.

METHODS

A cross-sectional study design was conducted among 546 nurses selected from the first-class tertiary hospitals located both inside and outside of Zhejiang Province between May 12 and May 20, 2022. The online survey of eHealth literacy scale (eHEALS) and scale of knowledge, attitudes, and practice (KAP) regarding palliative care was performed using snowball sampling through the WeChat mini program "Questionnaire Star". The Spearman rank correlation and binary logistic regression model were used to analyze the independent association between eHealth literacy and KAP toward palliative care.

RESULTS

The median scores of eHEALS and KAP regarding palliative care were 32 (interquartile range[IQR] 29 to 38) and 82 (IQR 54 to 106) points. The results of correlation analysis showed that the KAP regarding palliative care was significantly correlated with eHEALS (rho = 0.189, P < 0.001). In addition, the results of binary logistic regression analysis demonstrated that the eHEALS score was independently associated with the KAP score regarding palliative care when controlling for sociodemographic factors (OR = 2.109; P < 0.001).

CONCLUSION

Nurses who worked in first-class tertiary hospitals have good levels of eHealth literacy, while the overall level of KAP regarding palliative care is moderate. Our findings highlight that the eHEALS score is independently associated with the KAP score regarding palliative care. Therefore, nursing managers should adopt multiple measures to comprehensively improve eHealth literacy among nurses, further enrich their knowledge of palliative care, promote a positive transformation of attitudes towards palliative care, and efficiently implement palliative care practice, in order to promote high-quality development of palliative care.

Predictors of eHealth literacy levels among nursing students: A descriptive and correlational study

AIM

The aim of the present study was to determine the eHealth literacy levels of nursing students and to predict the influencing factors of eHealth literacy.

BACKGROUND

It is essential for nursing students, as the future workforce of the nursing profession, to have proficient ehealth literacy skills.

DESIGN

This study was conducted as a descriptive and correlational study.

METHODS

The sample consisted of 1059 nursing students at nursing departments of two state universities in Ankara, Turkey. The data were collected by a questionnaire and the eHealth Literacy Scale. Multiple linear regression analysis was used to evaluate the data.

RESULTS

The mean age of the students was 21.14 ± 1.62 years and 86.2% were female. The mean eHealth literacy score of the students was 29.28 ± 4.73. T Fourth year students had higher eHealth literacy scores than those in any other year of study (p < 0.001). Students who use the Internet frequently and always, those who search for health-related information on the Internet, those who find accessing health information on the Internet important, and those who find the Internet useful when making health-decisions had significantly high eHealth literacy scores (p < 0.05).

CONCLUSIONS

The present study revealed that the majority of the nursing students displayed a moderate eHealth literacy level. Academic level, frequency of Internet use, and search for health-related information on the Internet impacted the eHealth literacy of the students. Therefore, eHealth literacy concepts should be integrated into nursing curricula to improve nursing students' skills in using information technology and to increase their health literacy level.

The effectiveness and usability of a novel mobile phone-based self-care intervention for patients with heart failure: A mixed-methods pilot study

AIM

To evaluate the preliminary effectiveness and usability of a novel mobile phone-based self-care intervention (named WithUs) for patients with heart failure (HF).

METHODS AND RESULTS

We conducted a mixed-methods pilot study with group pretest-posttest design and usability testing. Participants were 26 Korean HF patients (20 men; median age 62 years) who took part in this study after hospital discharge. Data were collected at baseline and after the 24-week intervention, using questionnaires and interviews. The outcome variables were eHealth literacy, disease knowledge, and self-care behaviours. The Wilcoxon signed-rank test was used to compare the pre- and post-intervention results. Thematic analysis was used for analysing qualitative data. The WithUs programme improved the eHealth literacy (p = .005), disease knowledge (p < .001), and self-care behaviours (p < .001) of patients with HF. The median score of total app usability was 4.1 out of 5 (interquartile range = 4.0-5.0). Four themes were identified which complemented the quantitative results. These were increased awareness of the importance of routine self-care behaviours, enhanced motivation toward self-care behaviours, challenges adapting to the new app, and suggestions for improving app adoption.

CONCLUSION

The app was effective in improving adherence to self-care behaviours, eHealth literacy, and disease knowledge in patients with HF. The usability evaluation results showed that the app is usable and has the potential to support HF patients in self-care. However, the app needs to be modified to improve its adoption.

Chronic kidney disease awareness among the general population: tool validation and knowledge assessment in a developing country

Introduction

Good knowledge and early identification of chronic kidney disease (CKD) can help in preventing disease progression in its early stages and reducing undesired outcomes. The aim of the current study was to assess the level of public knowledge about CKD, determine predictors of better knowledge, and to construct and validate a CKD knowledge scale for public health assessment and research use.

Methods

A community-based cross-sectional study was conducted using an electronic self-administered questionnaire. All people living in Lebanon and being 18 years of age and above were considered eligible for recruitment. CKD knowledge was assessed by a 37-item scale that was constructed by principal component analysis and then validated. The score of the CKD knowledge scale was computed from the extracted factors. A multivariable binomial logistic regression model evaluated the sociodemographic and clinical predictors of the knowledge score.

Results

A total of 1308 participants were included. The scale items converged over 9 factors with Eigenvalue greater than 1 and explaining 53.26% of the total variance, and the total scale had a high Cronbach’s alpha of 0.804. All items of the scale significantly correlated with the full scale with correlation coefficients ranging from 0.082 to 0.558. The ROC curve analysis determined an optimal cutoff point of better knowledge at 47.5 with 70.6% sensitivity and 44.2% specificity. The CKD knowledge score had a median of 51.00 (IQR 47.00–55.00). Higher knowledge score was significantly associated with old age (ORa = 1.018, 95% CI 1.006–1.030, P = 0.003),, occupation (ORa = 3.919, 95% CI 2.107–7.288, P <  0.001), and recent renal function assessment (ORa = 2.314, 95% CI 1.532–3.495, P <  0.001). However, a lower knowledge score was significantly associated with lower level of education (ORa = 0.462, 95% CI 0.327–0.653, P <  0.001).

Conclusion

A reliable tool to assess public knowledge and awareness about CKD was developed and validated. The overall knowledge was good, however, important gaps in CKD awareness were detected in some areas and subpopulations. Therefore, public health stakeholders need to implement targeted CKD educational activities to minimize the disease burden.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12882-022-02889-2.

Digital Health Literacy: Bibliometric Analysis

Background

Digital health is growing at a rapid pace, and digital health literacy has attracted increasing attention from the academic community.

Objective

The purposes of this study are to conduct a systematic bibliometric analysis on the field of digital health literacy and to understand the research context and trends in this field.

Methods

Methods: A total of 1955 scientific publications were collected from the Web of Science core collection. Institutional co-operation, journal co-citation, theme bursting, keyword co-occurrence, author co-operation, author co-citation, literature co-citation, and references in the field of digital health literacy were analyzed using the VOSviewer and CiteSpace knowledge mapping tools.

Results

The results demonstrate that the United States has the highest number of publications and citations in this field. The University of California System was first in terms of institutional contributions. The Journal of Medical Internet Research led in the number of publications, citations, and co-citations. Research areas of highly cited articles in the field of digital health literacy mainly include the definition and scale of health literacy, health literacy and health outcomes, health literacy and the digital divide, and the influencing factors of health literacy.

Conclusions

We summarized research progress in the field of digital health literacy and reveal the context, trends, and trending topics of digital health literacy research through statistical analysis and network visualization. We found that digital health literacy has a significant potential to improve health outcomes, bridge the digital divide, and reduce health inequalities. Our work can serve as a fundamental reference and directional guide for future research in this field.

A bibliometric analysis on global eHealth

Background

The current coronavirus disease 2019 pandemic highlights the potential of eHealth. Drawing the knowledge map of eHealth research through data mining and visual analysis technology was helpful to systematically present the research status and future trends of global academic circles.

Methods

Based on the web of Science Core Collection (SCIE/SSCI) database, using bibliometric theory and visual analysis technology, this work analyzed the global eHealth research publications from 2000 to 2021, and introduced the interdisciplinary characteristics, hot topics and future trends in this field.

Results

A total of 10188 authors, 891 journals, 3586 institutions, 98 countries using 12 languages had conducted eHealth research in the world. The United States, the Netherlands, Australia and the United Kingdom were the main forces and international cooperation. However, the international co-operation between Eastern and Western countries was still relatively few. The frontier of global eHealth research mainly focused on #0eHealth innovation, #1physical activity, #2generalised anxiety disorder, #3lightweight authentication protocol, #4 eHealth information, #5technology readiness, #6 ehealth literacy scale, #7family carer, #8citance analysis, #9 guiding patient. Clusters #3 lightweight authentication protocol and #9 guiding patient were the latest clusters, indicating the research trend and direction of eHealth in the future.

Conclusions

Cooperation network framework at the regional, national and global levels and the cooperation of multidisciplinary teams with complementary backgrounds and expertise were needed to realize the in-depth popularization and application of eHealth knowledge. Interdisciplinary international cooperation should be the trend of eHealth research in the future.

The Dispersion of Health Information Seeking Behavior and Health Literacy in a State in the Southern United States: A Cross-Sectional Study (Preprint)

Background

Objective

Methods

Results

Conclusions