Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study (Preprint)

BACKGROUND Digital health, which encompasses the use of information and communications technology in support of health, is a key driving force behind the cultural transformation of medicine toward people-centeredness. Thus, eHealth literacy, assisted by innovative digital health solutions, may support better experiences of care. OBJECTIVE The purpose of this study is to explore the relationship between eHealth literacy and patient-reported experience measures (PREMs) among users of outpatient care in Hungary. METHODS In early 2019, we conducted a cross-sectional survey on a large representative online sample recruited from the Hungarian general population. eHealth literacy was measured with the eHealth Literacy Scale (eHEALS). PREMs with outpatient care were measured with a set of questions recommended by the Organisation for Economic Co-operation and Development (OECD) for respondents who attended outpatient visit within 12 months preceding the survey. Bivariate relationships were explored via polychoric correlation, the Kruskal–Wallis test, and chi-square test. To capture nonlinear associations, after controlling covariates, we analyzed the relationship between eHEALS quartiles and PREMs using multivariate probit, ordinary least squares, ordered logit, and logistic regression models. RESULTS From 1000 survey respondents, 666 individuals (364 females, 54.7%) were included in the study with mean age of 48.9 (SD 17.6) years and mean eHEALS score of 29.3 (SD 4.9). Respondents with higher eHEALS scores were more likely to understand the health care professionals’ (HCPs’) explanations (χ29=24.2, P=.002) and to be involved in decision making about care and treatment (χ29=18.2, P=.03). In multivariate regression, respondents with lowest (first quartile) and moderately high (third quartile) eHEALS scores differed significantly, where the latter were more likely to have an overall positive experience (P=.02) and experience fewer problems (P=.02). In addition, those respondents had better experiences in terms of how easy it was to understand the HCPs’ explanations (P<.001) and being able to ask questions during their last consultation (P=.04). Patient-reported experiences of individuals with highest (fourth quartile) and lowest (first quartile) eHEALS levels did not differ significantly in any items of the PREM instrument, and neither did composite PREM scores generated from the PREM items (P>.05 in all models). CONCLUSIONS We demonstrated the association between eHealth literacy and PREMs. The potential patient-, physician-, and system-related factors explaining the negative experiences among people with highest levels of eHealth literacy warrant further investigation, which may contribute to the development of efficient eHealth literacy interventions. Further research is needed to establish causal relationship between eHealth literacy and patient-reported experiences.

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Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study

Journal of Medical Internet Research ◽

10.2196/19013 ◽

2020 ◽

Vol 22 (8) ◽

pp. e19013

Author(s):

Zsombor Zrubka ◽

Óscar Brito Fernandes ◽

Petra Baji ◽

Ottó Hajdu ◽

Levente Kovacs ◽

...

Keyword(s):

Health Care Professionals ◽

Outpatient Care ◽

Digital Health ◽

Adult Population ◽

Ordinary Least Squares ◽

Information And Communications Technology ◽

Cross Sectional ◽

Ehealth Literacy ◽

Patient Reported ◽

The Relationship

Background Digital health, which encompasses the use of information and communications technology in support of health, is a key driving force behind the cultural transformation of medicine toward people-centeredness. Thus, eHealth literacy, assisted by innovative digital health solutions, may support better experiences of care. Objective The purpose of this study is to explore the relationship between eHealth literacy and patient-reported experience measures (PREMs) among users of outpatient care in Hungary. Methods In early 2019, we conducted a cross-sectional survey on a large representative online sample recruited from the Hungarian general population. eHealth literacy was measured with the eHealth Literacy Scale (eHEALS). PREMs with outpatient care were measured with a set of questions recommended by the Organisation for Economic Co-operation and Development (OECD) for respondents who attended outpatient visit within 12 months preceding the survey. Bivariate relationships were explored via polychoric correlation, the Kruskal–Wallis test, and chi-square test. To capture nonlinear associations, after controlling covariates, we analyzed the relationship between eHEALS quartiles and PREMs using multivariate probit, ordinary least squares, ordered logit, and logistic regression models. Results From 1000 survey respondents, 666 individuals (364 females, 54.7%) were included in the study with mean age of 48.9 (SD 17.6) years and mean eHEALS score of 29.3 (SD 4.9). Respondents with higher eHEALS scores were more likely to understand the health care professionals’ (HCPs’) explanations (χ29=24.2, P=.002) and to be involved in decision making about care and treatment (χ29=18.2, P=.03). In multivariate regression, respondents with lowest (first quartile) and moderately high (third quartile) eHEALS scores differed significantly, where the latter were more likely to have an overall positive experience (P=.02) and experience fewer problems (P=.02). In addition, those respondents had better experiences in terms of how easy it was to understand the HCPs’ explanations (P<.001) and being able to ask questions during their last consultation (P=.04). Patient-reported experiences of individuals with highest (fourth quartile) and lowest (first quartile) eHEALS levels did not differ significantly in any items of the PREM instrument, and neither did composite PREM scores generated from the PREM items (P>.05 in all models). Conclusions We demonstrated the association between eHealth literacy and PREMs. The potential patient-, physician-, and system-related factors explaining the negative experiences among people with highest levels of eHealth literacy warrant further investigation, which may contribute to the development of efficient eHealth literacy interventions. Further research is needed to establish causal relationship between eHealth literacy and patient-reported experiences.

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eHealth literacy: a marker for "digital divide" in health information

Reviews in Health Care ◽

10.7175/rhc.28133145-151 ◽

2012 ◽

Vol 3 (3) ◽

pp. 145 ◽

Cited By ~ 1

Author(s):

Efrat Neter ◽

Esther Brainin

Keyword(s):

Health Care ◽

Health Information ◽

Information Search ◽

Digital Health ◽

Adult Population ◽

Household Survey ◽

Information And Communications Technology ◽

The Internet ◽

Care Needs ◽

Ehealth Literacy

eHealth literacy is defined as the use of emerging information and communications technology to improve or enable health and health care. The study examined whether literacy disparities are diminished or enhanced in the search for health information on the Internet.We used a countrywide representative random-digital-dial telephone household survey of the Israeli adult population (18 years and older, N = 4286).Respondents who were highly eHealth literate tended to be younger and more educated than their less eHealth-literate counterparts. They were also more active consumers of all types of information on the Internet, used more search strategies, and scrutinized information more carefully than did the less eHealth-literate respondents. Finally, respondents who were highly eHealth literate gained more positive outcomes from the information search in terms of cognitive, instrumental (self-management of health care needs, health behaviors, and better use of health insurance), and interpersonal (interacting with their physician) gains.The association of eHealth literacy with background attributes indicates that the Internet reinforces existing social differences. The more comprehensive and sophisticated use of the Internet and the subsequent increased gains among the high eHealth literate create new inequalities in the domain of digital health information.http://dx.doi.org/10.7175/rhc.v3i3.281

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eHealth literacy: a marker for "digital divide" in health information

Reviews in Health Care ◽

10.7175/rhc.v3i3.281 ◽

2012 ◽

Vol 3 (3) ◽

pp. 145-151 ◽

Cited By ~ 2

Author(s):

Efrat Neter ◽

Esther Brainin

Keyword(s):

Health Care ◽

Health Information ◽

Information Search ◽

Digital Health ◽

Adult Population ◽

Household Survey ◽

Information And Communications Technology ◽

The Internet ◽

Care Needs ◽

Ehealth Literacy

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Collecting patient reported outcomes to facilitate prescription opioid management: Development and testing of the Opioid Management App (OM-App) (Preprint)

10.2196/preprints.23633 ◽

2020 ◽

Author(s):

Jessica Robinson-Papp ◽

Gabriela Cedillo ◽

Richa Deshpande ◽

Mary Catherine George ◽

Qiuchen Yang ◽

...

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Risk Behaviors ◽

Digital Health ◽

Monitoring Program ◽

Prescription Opioid ◽

Research Database ◽

Cross Sectional ◽

Study Duration ◽

Patient Reported

BACKGROUND Collecting patient-reported data needed by clinicians to adhere to opioid prescribing guidelines represents a significant time burden. OBJECTIVE We developed and tested an opioid management app (OM-App) to collect these data directly from patients. METHODS OM-App used a pre-existing digital health platform to deliver daily questions to patients via text-message and organize responses into a dashboard. We pilot tested OM-App over 9 months in 40 diverse participants with HIV who were prescribed opioids for chronic pain. Feasibility outcomes included: ability to export/integrate OM-App data with other research data; patient-reported barriers and adherence to OM-App use; capture of opioid-related harms, risk behaviors and pain intensity/interference; comparison of OM-App data to urine drug testing, prescription drug monitoring program data, and validated questionnaires. RESULTS OM-App data was exported/integrated into the research database after minor modifications. Thirty-nine of 40 participants were able to use OM-App, and over the study duration 70% of all OM-App questions were answered. Although the cross-sectional prevalence of opioid-related harms and risk behaviors reported via OM-App was low, some of these were not obtained via the other measures, and over the study duration all queried harms/risks were reported at least once via OM-App. Clinically meaningful changes in pain intensity/interference were captured. CONCLUSIONS OM-App was used by our diverse patient population to produce clinically relevant opioid- and pain-related data, which was successfully exported and integrated into a research database. These findings suggest that OM-App may be a useful tool for remote monitoring of patients prescribed opioids for chronic pain. CLINICALTRIAL NCT03669939 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1016/j.conctc.2019.100468

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Objective and Subjective Outcomes in Patients with Hearing Aids: A Cross-Sectional, Comparative, Associational Study

Audiology and Neurotology ◽

10.1159/000516623 ◽

2021 ◽

pp. 1-9

Author(s):

Xunyi Wang ◽

Yun Zheng ◽

Gang Li ◽

Jingzhe Lu ◽

Yan Yin

Keyword(s):

Hearing Aids ◽

Patient Reported Outcomes ◽

Cross Sectional ◽

Patient Reported ◽

Objective Tests ◽

The Difference ◽

Potential Factors ◽

Positive Correlations ◽

The Relationship ◽

Subjective Outcomes

Introduction: Outcome assessment for hearing aids (HAs) is an essential part of HA fitting and validation. There is no consensus about the best or standard approach for evaluating HA outcomes. And, the relationship between objective and subjective measures is ambiguous. This study aimed to determine the outcomes after HA fitting, explore correlations between subjective benefit and acoustic gain improvement as well as objective audiologic tests, and investigate several variables that may improve patients’ perceived benefits. Methods: Eighty adults with bilateral symmetrical hearing loss using HAs for at least 1 month were included in this study. All subjects completed the pure tone average (PTA) threshold and word recognition score (WRS) tests in unaided and aided conditions. We also administered the Chinese version of International Outcome Inventory for Hearing Aids (IOI-HA), to measure participants’ subjective benefits. Objective HA benefit (acoustic gain improvement) was defined as the difference in thresholds or scores between aided and unaided conditions indicated with ΔPTA and ΔWRS. Thus, patients’ baseline hearing levels were taken into account. Correlations were assessed among objective audiologic tests (PTA and WRS), acoustic gain improvement (ΔPTA and ΔWRS), multiple potential factors, and IOI-HA overall scores. Results: PTA decreased significantly, but WRS did not increase when aided listening was compared to unaided listening. Negative correlations between PTAs and IOI-HA scores were significant but weak (r = −0.370 and r = −0.393, all p < 0.05). Significant weak positive correlations were found between WRSs and IOI-HA (r = 0.386 and r = 0.309, all p < 0.05). However, there was no correlation among ΔPTA, ΔWRS, and IOI-HA (r = 0.056 and r = −0.086, all p > 0.05). Moreover, 2 nonaudiological factors (age and daily use time) were significantly correlated with IOI-HA (r = −0.269 and r = 0.242, all p < 0.05). Conclusions: Correlations among objective audiologic tests, acoustic gain, and subjective patient-reported outcomes were weak or absent. Subjective questionnaires and objective tests do not reflect the same hearing capability. Therefore, it is advisable to evaluate both objective and subjective outcomes when analyzing HA benefits on a regular basis and pay equal attention to nonaudiological and audiological factors.

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Pre and post flooding malaria parasitemia in gravid women, South East, Nigeria

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1368 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Ekwebene OC ◽

◽

Obidile VC ◽

Nnamani CP ◽

Eleje GU ◽

...

Keyword(s):

Climate Change ◽

Pregnant Women ◽

Health Care Professionals ◽

Malaria Parasite ◽

P Value ◽

Cross Sectional ◽

Vector Borne Diseases ◽

Seasonal Flooding ◽

Vector Borne ◽

The Relationship

The effect of global change on the incidence of vector borne diseases including malaria is of great importance. Malaria has been regarded as one of the most sensitive disease that responds fast to climate change. Pregnant women tend to have reduced immunity are more vulnerable to vector borne diseases such as malaria especially with climate change like flooding where these vectors borne diseases are endemic. To measure malaria parasitaemia in gravid women pre and post flooding and also to determine the relationship between malaria and seasonal flooding in South east Nigeria. This was a hospital-based cross-sectional study involving pregnant women aged 15- 45 years attending the antenatal clinics of two maternity centres in a rural community South east Nigeria. Malaria was determined using the thick and thick blood films. Plasmodium falciparum species was examined in this study. Chi-square was used to assess the relationship between malaria and seasonal flooding. One Hundred and fifty pregnant women were recruited for the study. The prevalence of malaria in the gravid women pre and post flooding were 60.00% and 65.30% respectively. Malaria parasite was highest in the gravid women aged 28-31 years and the primigravids. There was no statistical difference between malaria and parity. The mean parasite density in the gravid women was significantly higher post flooding than pre flooding with p-value of 0.001. There was no significant relationship between malaria parasite in gravid women and the periods of investigation. The prevalence of malaria parasite among gravid women in the study area is high regardless of the seasonal flooding. Hence, the need for adherence to malaria prophylaxis protocol by the health care professionals and increase on community health education on malaria preventive strategies.

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The Association Between Patients' eHealth Literacy and Satisfaction With Shared Decision-making and Well-being: Multicenter Cross-sectional Study (Preprint)

10.2196/preprints.26721 ◽

2020 ◽

Author(s):

Richard Huan Xu ◽

Ling-Ming Zhou ◽

Eliza Lai-Yi Wong ◽

Dong Wang

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Regression Models ◽

Well Being ◽

Shared Decision ◽

Background Characteristics ◽

Cross Sectional ◽

Ehealth Literacy ◽

High Level ◽

The Relationship

BACKGROUND Although previous studies have shown that a high level of health literacy can improve patients’ ability to engage in health-related shared decision-making (SDM) and improve their quality of life, few studies have investigated the role of eHealth literacy in improving patient satisfaction with SDM (SSDM) and well-being. OBJECTIVE This study aims to assess the relationship between patients’ eHealth literacy and their socioeconomic determinants and to investigate the association between patients’ eHealth literacy and their SSDM and well-being. METHODS The data used in this study were obtained from a multicenter cross-sectional survey in China. The eHealth Literacy Scale (eHEALS) and Investigating Choice Experiments Capability Measure for Adults were used to measure patients’ eHealth literacy and capability well-being, respectively. The SSDM was assessed by using a self-administered questionnaire. The Kruskal-Wallis one-way analysis of variance and Wilcoxon signed-rank test were used to compare the differences in the eHEALS, SSDM, and Investigating Choice Experiments Capability Measure for Adults scores of patients with varying background characteristics. Ordinary least square regression models were used to assess the relationship among eHealth literacy, SSDM, and well-being adjusted by patients’ background characteristics. RESULTS A total of 569 patients completed the questionnaire. Patients who were male, were highly educated, were childless, were fully employed, were without chronic conditions, and indicated no depressive disorder reported a higher mean score on the eHEALS. Younger patients (SSDM≥61 years=88.6 vs SSDM16-30 years=84.2) tended to show higher SSDM. Patients who were rural residents and were well paid were more likely to report good capability well-being. Patients who had a higher SSDM and better capability well-being reported a significantly higher level of eHealth literacy than those who had lower SSDM and poorer capability well-being. The regression models showed a positive relationship between eHealth literacy and both SSDM (β=.22; P<.001) and well-being (β=.26; P<.001) after adjusting for patients’ demographic, socioeconomic status, lifestyle, and health status variables. CONCLUSIONS This study showed that patients with a high level of eHealth literacy are more likely to experience optimal SDM and improved capability well-being. However, patients’ depressive status may alter the relationship between eHealth literacy and SSDM. CLINICALTRIAL

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The Relationship Between eHealth Literacy, Social Media Self-Efficacy and Health Communication Intention Among Chinese Nursing Undergraduates: A Cross-Sectional Study (Preprint)

10.2196/preprints.35985 ◽

2021 ◽

Author(s):

Huiping Sun ◽

Lin Qian ◽

Mengxin Xue ◽

Ting Zhou ◽

Jiling Qu ◽

...

Keyword(s):

Social Media ◽

Health Communication ◽

Health Information ◽

Self Efficacy ◽

Mediating Effect ◽

Cluster Sampling ◽

Cross Sectional ◽

Ehealth Literacy ◽

Mediating Role ◽

The Relationship

BACKGROUND With the popularization of the Internet, it has become possible to widely disseminate health information via social media. Medical staff’s health communication through social media can improve the public’s health literacy, and improving the intention of health communication among nursing undergraduates is of great significance for them to actively carry out health communication after entering clinical practice. OBJECTIVE To explore the relationship among eHealth literacy, social media self-efficacy, and health communication intention and to determine the mediating role of social media self-efficacy in the relationship between eHealth literacy and health communication intention. METHODS A cross-sectional descriptive correlation design was used in this study.Stratified cluster sampling was used to select 958 nursing students from four nursing colleges in Jiangsu Province, China, from June to July 2021.Data were collected using the eHealth Literacy Scale, the Social Media Self-efficacy Scale, and the Health Communication Intention Questionnaire. Sociodemographic data were also collected. Correlation analysis and regression analysis were used to determine the relationship between eHealth literacy, social media self-efficacy, and health communication intention. RESULTS Health communication intention is positively correlated with eHealth literacy and social media self-efficacy. eHealth literacy directly affects the intention of health communication significantly (p < 0.001), and social media self-efficacy played a mediating role in the influence of eHealth literacy on health communication intention (the mediating effect accounted for 37.2% of the total effect). CONCLUSIONS Improving the eHealth literacy of nursing undergraduates can directly affect or promote health communication intention and can also indirectly improve health communication intention through improving social media self-efficacy. In view of these results, targeted educational programs must be developed to improve eHealth literacy and social media self-efficacy among nursing undergraduates, thereby promoting their health information transmission.

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Cigarette smoking dose-response and suicidal ideation among young people in Nepal: a cross-sectional study

Nepal Journal of Epidemiology ◽

10.3126/nje.v10i1.28277 ◽

2020 ◽

Vol 10 (1) ◽

pp. 821-829 ◽

Cited By ~ 1

Author(s):

Brijesh Sathian ◽

Ritesh G Menezes ◽

Mohammad Asim ◽

Ahammed Mekkodathil ◽

Jayadevan Sreedharan ◽

...

Keyword(s):

Suicidal Ideation ◽

Young People ◽

Dose Response ◽

Health Care Professionals ◽

Adult Population ◽

Well Being ◽

Cross Sectional Study ◽

Cross Sectional ◽

Smoking Group ◽

Mental Well Being

Background: Worldwide, tobacco smoking is a major risk factor for morbidity and early mortality among adult population. The present study aimed to find out the association between current smoking and suicidal ideation among young people in Nepal. Materials and Methods: A cross-sectional questionnaire-based survey was carried out among 452 youths from Pokhara, Nepal. The present study included both genders (age 18-24 years) who were smokers as well as non-smokers. Results: Across the study period, 452 participants were identified after matching for age, and sex (226 in the smoking group and 226 in the non-smoking group). The mean age of participants was 21.6±1.2 years and 58.8% were males. The overall rate of suicidal ideation in our cohort was 8.9%. Smokers were slightly more likely to report suicidal ideation than non-smokers (aOR 1.12). The risk of developing suicidal ideation was 3.56 (95% CI 1.26-10.09) times more in individuals who smoked greater than 3.5 cigarettes per week (p=0.01). Conclusion: The rate of suicidal ideation was slightly higher among smokers and a dose-response relationship was identified with the number of cigarettes smoked per week. Being aware of the link between smoking and suicidal ideation may help health care professionals working with young people to address more effectively the issues of mental well-being and thoughts about suicide.

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Sociodemographic and Lifestyle Factors Associated with Adherence to Mediterranean Diet in Representative Adult Population in Casablanca City, Morocco: A Cross-Sectional Study

Journal of Nutrition and Metabolism ◽

10.1155/2020/3105271 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Karima Mohtadi ◽

Rajaa Msaad ◽

Najwa Benalioua ◽

Ali Jafri ◽

Hasnaa Meftah ◽

...

Keyword(s):

Mediterranean Diet ◽

Adult Population ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Dairy Consumption ◽

High Adherence ◽

The Relationship

Several studies had revealed that following the Mediterranean diet (MD) contributes to beneficial health status and a decreased risk of many chronic diseases. The aim of our study was to assess adherence to MD in Casablanca City and to identify the relationship between MD adherence and sociodemographic and lifestyle parameters. This cross-sectional study concerned 719 subjects with complete dietary data. Data collection was performed using a questionnaire including sociodemographic and lifestyle factors. The dietary intake was assessed with the use of a food-frequency questionnaire. The compliance with MD was evaluated with a simplified MD score. Our study showed that high adherence to the MD was characterized by high intakes of vegetables, fruits, pulses, fish, cereals, olive oil, and low meat and dairy consumption according to the Simplified MD score. As regard to the multivariate logistic, being a man, being married, persons with a level of education >6 years, luxurious housing, and consumption of alcohol were associated with a higher adherence to MD, while, the overweight was negatively associated with a higher adherence to MD. Maintaining the traditional MD pattern is crucial for public health; in this way, more research is needed in this area in order to precisely measure these associations.

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