Digitization and Health in Germany: Cross-sectional Nationwide Survey

Background Digital technologies are shaping medicine and public health. Objective The aim of this study was to investigate the attitudes toward and the use of digital technologies for health-related purposes using a nationwide survey. Methods We performed a cross-sectional study using a panel sample of internet users selected from the general population living in Germany. Responses to a survey with 28 items were collected using computer-assisted telephone interviews conducted in October 2020. The items were divided into four topics: (1) general attitudes toward digitization, (2) COVID-19 pandemic, (3) physical activity, and (4) perceived digital health (eHealth) literacy measured with the eHealth Literacy Scale (eHEALS; sum score of 8=lowest to 40=highest perceived eHealth literacy). The data were analyzed in IBM-SPSS24 using relative frequencies. Three univariate multiple regression analyses (linear or binary logistic) were performed to investigate the associations among the sociodemographic factors (age, gender, education, and household income) and digital technology use. Results The participants included 1014 internet users (n=528, 52.07% women) aged 14 to 93 years (mean 54, SD 17). Among all participants, 66.47% (674/1014) completed up to tertiary (primary and secondary) education and 45.07% (457/1017) reported a household income of up to 3500 Euro/month (1 Euro=US $1.18). Over half (579/1014, 57.10%) reported having used digital technologies for health-related purposes. The majority (898/1014, 88.56%) noted that digitization will be important for therapy and health care, in the future. Only 25.64% (260/1014) reported interest in smartphone apps for health promotion/prevention and 42.70% (433/1014) downloaded the COVID-19 contact-tracing app. Although 52.47% (532/1014) reported that they come across inaccurate digital information on the COVID-19 pandemic, 78.01% (791/1014) were confident in their ability to recognize such inaccurate information. Among those who use digital technologies for moderate physical activity (n=220), 187 (85.0%) found such technologies easy to use and 140 (63.6%) reported using them regularly (at least once a week). Although the perceived eHealth literacy was high (eHEALS mean score 31 points, SD 6), less than half (43.10%, 400/928) were confident in using digital information for health decisions. The use of digital technologies for health was associated with higher household income (odds ratio [OR] 1.28, 95% CI 1.11-1.47). The use of digital technologies for physical activity was associated with younger age (OR 0.95, 95% CI 0.94-0.96) and more education (OR 1.22, 95% CI 1.01-1.46). A higher perceived eHealth literacy score was associated with younger age (β=–.22, P<.001), higher household income (β=.21, P<.001), and more education (β=.14, P<.001). Conclusions Internet users in Germany expect that digitization will affect preventive and therapeutic health care in the future. The facilitators and barriers associated with the use of digital technologies for health warrant further research. A gap exists between high confidence in the perceived ability to evaluate digital information and low trust in internet-based information on the COVID-19 pandemic and health decisions.

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Digitization and Health in Germany: Cross-sectional Nationwide Survey (Preprint)

10.2196/preprints.32951 ◽

2021 ◽

Author(s):

Karina Karolina De Santis ◽

Tina Jahnel ◽

Elida Sina ◽

Julian Wienert ◽

Hajo Zeeb

Keyword(s):

Physical Activity ◽

Household Income ◽

Digital Technologies ◽

Nationwide Survey ◽

Digital Information ◽

Cross Sectional ◽

Ehealth Literacy ◽

Internet Users ◽

Younger Age ◽

Health Related

BACKGROUND Digital technologies are shaping medicine and public health. OBJECTIVE The aim of this study was to investigate the attitudes toward and the use of digital technologies for health-related purposes using a nationwide survey. METHODS We performed a cross-sectional study using a panel sample of internet users selected from the general population living in Germany. Responses to a survey with 28 items were collected using computer-assisted telephone interviews conducted in October 2020. The items were divided into four topics: (1) general attitudes toward digitization, (2) COVID-19 pandemic, (3) physical activity, and (4) perceived digital health (eHealth) literacy measured with the eHealth Literacy Scale (eHEALS; sum score of 8=lowest to 40=highest perceived eHealth literacy). The data were analyzed in IBM-SPSS24 using relative frequencies. Three univariate multiple regression analyses (linear or binary logistic) were performed to investigate the associations among the sociodemographic factors (age, gender, education, and household income) and digital technology use. RESULTS The participants included 1014 internet users (n=528, 52.07% women) aged 14 to 93 years (mean 54, SD 17). Among all participants, 66.47% (674/1014) completed up to tertiary (primary and secondary) education and 45.07% (457/1017) reported a household income of up to 3500 Euro/month (1 Euro=US $1.18). Over half (579/1014, 57.10%) reported having used digital technologies for health-related purposes. The majority (898/1014, 88.56%) noted that digitization will be important for therapy and health care, in the future. Only 25.64% (260/1014) reported interest in smartphone apps for health promotion/prevention and 42.70% (433/1014) downloaded the COVID-19 contact-tracing app. Although 52.47% (532/1014) reported that they come across inaccurate digital information on the COVID-19 pandemic, 78.01% (791/1014) were confident in their ability to recognize such inaccurate information. Among those who use digital technologies for moderate physical activity (n=220), 187 (85.0%) found such technologies easy to use and 140 (63.6%) reported using them regularly (at least once a week). Although the perceived eHealth literacy was high (eHEALS mean score 31 points, SD 6), less than half (43.10%, 400/928) were confident in using digital information for health decisions. The use of digital technologies for health was associated with higher household income (odds ratio [OR] 1.28, 95% CI 1.11-1.47). The use of digital technologies for physical activity was associated with younger age (OR 0.95, 95% CI 0.94-0.96) and more education (OR 1.22, 95% CI 1.01-1.46). A higher perceived eHealth literacy score was associated with younger age (β=–.22, P<.001), higher household income (β=.21, P<.001), and more education (β=.14, P<.001). CONCLUSIONS Internet users in Germany expect that digitization will affect preventive and therapeutic health care in the future. The facilitators and barriers associated with the use of digital technologies for health warrant further research. A gap exists between high confidence in the perceived ability to evaluate digital information and low trust in internet-based information on the COVID-19 pandemic and health decisions.

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A Population-Based Study of the Determinants of Physical Activity in Ovarian Cancer Survivors

Journal of Physical Activity and Health ◽

10.1123/jpah.6.3.339 ◽

2009 ◽

Vol 6 (3) ◽

pp. 339-346 ◽

Cited By ~ 32

Author(s):

Clare Stevinson ◽

Katia Tonkin ◽

Valerie Capstick ◽

Alexandra Schepansky ◽

Aliya B. Ladha ◽

...

Keyword(s):

Physical Activity ◽

Ovarian Cancer ◽

Cancer Survivors ◽

Social Cognitive ◽

Population Based ◽

Disease Stage ◽

Cross Sectional ◽

Physical Activity Guidelines ◽

Younger Age ◽

Health Related

Background:Regular physical activity is associated with quality of life and other health-related outcomes in ovarian cancer survivors, but participation rates are low. This study investigated the determinants of physical activity in ovarian cancer survivors.Methods:A population-based, cross-sectional, mailed survey of ovarian cancer survivors in Alberta, Canada, was conducted. Measures included self-reported physical activity, medical and demographic factors, and social-cognitive variables from the theory of planned behavior (TPB).Results:A total of 359 women participated (51.4% response rate), of whom 112 (31.1%) were meeting physical activity guidelines. Variables associated with meeting guidelines were younger age, higher education and income, being employed, lower body-mass index, absence of arthritis, longer time since diagnosis, earlier disease stage, and being disease free. Analysis of the TPB variables indicated that 36% of the variance in physical activity guidelines was explained, with intention being the sole independent correlate (β = .56; P < .001).Conclusion:Various demographic and medical factors can help identify ovarian cancer survivors at risk for physical inactivity. Interventions should attempt to increase physical activity intentions in this population by focusing on instrumental and affective attitudes, as well as perceptions of control.

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Association between eHealth Literacy and Health-Related Quality of Life among Chinese Older Adults: A Cross-Sectional Study (Preprint)

10.2196/preprints.19366 ◽

2020 ◽

Author(s):

Shaojie Li ◽

Yongtian Yin ◽

Lijun Chen ◽

Guanghui Cui ◽

Jiaqin Li ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Mental Component Summary ◽

Health Related Quality ◽

Cross Sectional ◽

Chinese Older Adults ◽

Ehealth Literacy ◽

Related Quality ◽

Health Related

BACKGROUND Older adults’ health literacy levels are crucial to improving health outcomes and health-related quality of life (HRQoL). However, the impact of eHealth literacy on HRQoL in older adults is unclear. OBJECTIVE The aim of this study was to examine the association between eHealth literacy and HRQoL of older adults and provide reference for the development of network intervention measures related to the health quality of life of the older adults. METHODS An anonymous cross-sectional survey was conducted among 1,201 adults aged 60 or older from Jinan, China. The eHealth Literacy Scale and Short-Form Health Survey (SF-12) were used to measure eHealth literacy and HRQoL. We used linear regression to test the adjusted association between eHealth literacy and HRQoL. RESULTS Most participants (88.9%) had inadequate eHealth literacy. Lower eHealth literacy was related to older age ( F=12.618, P<.001), female gender( t=3.303, P<.01), living in rural areas( F=11.356, P<.001), having less education( F=59.084, P<.001), being unmarried, divorced or widowed( t=4.416, P<.001), having a lower family income( F=38.017, P<.001), living with others(χ2=4.319, P<.05), and not having health insurance( F=12.713, P<.001). There were significant differences across physical functioning( t=-4.862, P<.001), role- physical( t=-2.485, P<.05), bodily pain( t=-3.470, P<.01), general health( t=-4.449, P<.001), vitality( t=-3.498, P<.001), role-emotional( t=-2.654, P<.01), mental health( t=-4.150, P<.001), physical component summary( t=-6.350, P<.001) and mental component summary( t=-4.483, P<.001) between adequate eHealth literacy and inadequate eHealth literacy. After controlling for age, gender, and other covariates, adequate eHealth literacy was positively related to physical component summary ( beta=7.6, P<.001) and mental component summary(beta=4.6, P=.001). CONCLUSIONS This study showed that Chinese older adults with higher eHealth literacy were more likely to contribute to higher HRQoL. Thus, Older adults’ eHealth literacy levels need to be taken into account when formulating health education and promotion programs for older adults, especially when the expected outcome is to improve HRQoL.

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Physical activity and screen-based media use: cross-sectional associations with health-related quality of life and the role of body satisfaction in a representative sample of German adolescents

Health Psychology and Behavioral Medicine ◽

10.1080/21642850.2013.809313 ◽

2013 ◽

Vol 1 (1) ◽

pp. 15-30 ◽

Cited By ~ 25

Author(s):

Emily Finne ◽

Jens Bucksch ◽

Thomas Lampert ◽

Petra Kolip

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Representative Sample ◽

Body Satisfaction ◽

Health Related Quality ◽

Cross Sectional ◽

Related Quality ◽

Health Related

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Engagement in a Community Physical Activity Program and Its Effects Upon the Health-Related Quality of Life of Elderly People: A Cross-Sectional Study

Value in Health Regional Issues ◽

10.1016/j.vhri.2018.10.002 ◽

2018 ◽

Vol 17 ◽

pp. 183-188 ◽

Cited By ~ 2

Author(s):

Claudio Andre Barbosa de Lira ◽

Henrique Viana Taveira ◽

Weverton Rufo-Tavares ◽

Alexandre dos Santos Amorim ◽

Lucas Matos Costa Ferreira ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Cross Sectional Study ◽

Health Related Quality ◽

Sectional Study ◽

Cross Sectional ◽

Activity Program ◽

Related Quality ◽

Health Related

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Reflecting on personal data in a health course: Integrating wearable technology and ePortfolio for eHealth

Australasian Journal of Educational Technology ◽

10.14742/ajet.4027 ◽

2019 ◽

Vol 35 (3) ◽

Author(s):

Tanja Sobko ◽

Gavin Brown

Keyword(s):

Knowledge Acquisition ◽

Health Knowledge ◽

Personal Information ◽

Personal Data ◽

Digital Information ◽

Ehealth Literacy ◽

Health Course ◽

Health Related ◽

Health Action ◽

Literacy Scores

Activity trackers (ATs) equipped with biometric sensors may support deep knowledge acquisition of health and active learning. The mechanism may be via personal data being pushed to the students, which deepens the knowledge about their own health and may impact long-term health action processes. To understand health knowledge acquisition, 43 students attending an undergraduate university course were equipped with an AT over a period of five months. Weekly observation on emerging personal data and consequent actions (lifestyle adaptations) were reflected in an individual course-related ePortfolio. Students’ change in health action process was assessed using a short standard eHealth literacy scale at the beginning and end of the course. The usability of ePortfolio tool was tested with two previously validated scales. The combination of personal information from an AT and ePortfolio may have enhanced students’ critical assessment of health-related personal and available digital information. eHealth literacy scores significantly increased by the end of the course (p < .01). The ePortfolio helped with learning, and the usability of the ePortfolio did not really interfere. The combination of AT and ePortfolio constitutes a novel and productive method of using ePortfolios in higher education in regards to eHealth literacy acquisition.

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Prestroke physical activity could influence acute stroke severity (part of PAPSIGOT)

Neurology ◽

10.1212/wnl.0000000000006354 ◽

2018 ◽

Vol 91 (16) ◽

pp. e1461-e1467 ◽

Cited By ~ 15

Author(s):

Malin Reinholdsson ◽

Annie Palstam ◽

Katharina S. Sunnerhagen

Keyword(s):

Physical Activity ◽

Acute Stroke ◽

Odds Ratio ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Activity Level ◽

Stroke Severity ◽

Cross Sectional ◽

Severe Stroke ◽

Younger Age

ObjectiveTo investigate the influence of prestroke physical activity (PA) on acute stroke severity.MethodsData from patients with first stroke were retrieved from registries with a cross-sectional design. The variables were PA, age, sex, smoking, diabetes, hypertension and statin treatment, stroke severity, myocardial infarction, new stroke during hospital stay, and duration of inpatient care at stroke unit. PA was assessed with Saltin-Grimby's 4-level Physical Activity Level Scale, and stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Logistic regression was used to predict stroke severity, and negative binomial regression was used to compare the level of PA and stroke severity.ResultsThe study included 925 patients with a mean age of 73.1 years, and 45.2% were women. Patients who reported light or moderate PA levels were more likely to present a mild stroke (NIHSS score 0 to 5) compared with physically inactive patients in a model that also included younger age as a predictor (odds ratio = 2.02 for PA and odds ratio = 0.97 for age). The explanatory value was limited at 6.8%. Prestroke PA was associated with less severe stroke, and both light PA such as walking at least 4 h/wk and moderate PA 2–3 h/wk appear to be beneficial. Physical inactivity was associated with increased stroke severity.ConclusionsThis study suggests that PA and younger age could result in a less severe stroke. Both light PA such as walking at least 4 h/wk and moderate PA 2–3 h/wk appear to be beneficial.

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Proximity to Facilities and Its Association with the Health-Related Habits of Functionally Independent Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228677 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8677

Author(s):

Mónica Machón ◽

Kalliopi Vrotsou ◽

Isabel Larrañaga ◽

Itziar Vergara

Keyword(s):

Physical Activity ◽

Older Adults ◽

Social Life ◽

Basque Country ◽

Community Dwelling ◽

Green Spaces ◽

Walking Distance ◽

Residential Areas ◽

Cross Sectional ◽

Health Related

The aim was to examine how proximity to facilities, as a component of community determinants, is associated with the health-related habits of functionally independent community-dwelling older adults. This was a cross-sectional study. Data were collected by face-to-face interviews. Participants were >65 years old, living in 15 municipalities of Gipuzkoa (Basque Country, Spain). Proximity to park-green spaces, cultural-sport centers, market-food stores, retirement associations, religious centers, primary care centers and hospitals was explored. Sociodemographic variables and health-related habits (diet, physical activity and self-perceived social life) were collected. Logistic regression models were performed. The sample comprised of 634 individuals (55% women; mean age: 74.8, SD 6.7 years). Older age (odds ratio-OR: 0.94, 95% CI: 0.91–0.97) was associated with lower physical activity, while being male (OR: 1.71, 95% CI: 1.08–2.68) and proximity to park-green spaces (OR: 1.64, 95% CI: 1.03–2.61) were related to more physical activity. Individuals with good self-perceived health (OR: 3.50, 95% CI: 1.82–6.74) and religious centers within walking distance (OR: 2.66, 95% CI: 1.40–5.04) had higher odds of a satisfactory social life. Encouraging the creation of park-green spaces and leisure centers near residential areas can assist in promoting physical activity and improving the social life of older adults.

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Can traditional games be an option in increasing the physical activity of women following mastectomy?

Biomedical Human Kinetics ◽

10.1515/bhk-2015-0014 ◽

2015 ◽

Vol 7 (1) ◽

Author(s):

Małgorzata Bronikowska ◽

Michał Bronikowski ◽

Agata Glapa ◽

Bartosz Prabucki

Keyword(s):

Physical Activity ◽

Older Women ◽

Age Groups ◽

Recovery Process ◽

Age Group ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Younger Women ◽

Younger Age ◽

Ring Net

SummaryStudy aim: the purpose of the present study was to investigate the potential of traditional games as a method of increasing the physical activity (PA) of women following mastectomy. A cross-sectional survey during the 20th ONCO Games was conducted and the sample included data from women divided into two groups: up to 50 years old (n = 26) and over 50 years old (n = 86).Material and methods: PA was assessed using a questionnaire, and the number of steps taking during 30-minute periods was measured using pedometers during each of the games. Exertion was evaluated using Borg’s Scale.Results: there was no difference in levels of coherence between the age groups. The group of younger women were statistically more active (M = 3.34 days/week) than the older group (M = 2.77 days/week). All the games were evaluated to be of light intensity, with ringo perceived as being statistically more fatiguing in the over 50 age group. The highest number of steps was performed during the game of ring-net-ball (M = 1903 steps/30 min) in both age groups, with older women performing statistically more steps. Similar situations were observed in the cases of pétanque and speedminton. In ringo, the situation was reversed. The lowest number of steps was recorded in pétanque in the younger age group (M = 296 steps/30 min).Conclusion: this study indicates that in the rehabilitation and recovery process after mastectomy, traditional games could be a bridging link between exercising and sports as they provide not just activity but also a unique and valuable social context.

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Associations between Activity Pacing, Fatigue, and Physical Activity in Adults with Multiple Sclerosis: A Cross Sectional Study

Journal of Functional Morphology and Kinesiology ◽

10.3390/jfmk5020043 ◽

2020 ◽

Vol 5 (2) ◽

pp. 43 ◽

Cited By ~ 2

Author(s):

Ulric S. Abonie ◽

Femke Hoekstra ◽

Bregje L. Seves ◽

Lucas H. V. van der Woude ◽

Rienk Dekker ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Multiple Sclerosis ◽

Perceived Risk ◽

Cross Sectional Study ◽

Health Related Quality ◽

Cross Sectional ◽

Related Quality ◽

Health Related

Fatigue is common in people with multiple sclerosis (MS). Activity pacing is a behavioral way to cope with fatigue and limited energy resources. However, little is known about how people with MS naturally pace activities to manage their fatigue and optimize daily activities. This study explored how activity pacing relates to fatigue and physical activity in people with MS. Participants were 80 individuals (60 females, 20 males) with a diagnosis of MS. The participants filled in questionnaires on their activity pacing, fatigue, physical activity, and health-related quality of life, 3–6 weeks before discharge from rehabilitation. The relationships between the variables were examined using hierarchical regression. After controlling for demographics, health-related quality of life, and perceived risk of overactivity, no associations were found between activity pacing and fatigue (β = 0.20; t = 1.43, p = 0.16) or between activity pacing and physical activity (β = −0.24; t = −1.61, p = 0.12). The lack of significant associations between activity pacing and fatigue or physical activity suggests that without interventions, there appears to be no clear strategy amongst people with MS to manage fatigue and improve physical activity. People with MS may benefit from interventions to manage fatigue and optimize engagement in physical activity.

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