Digital Health Literacy as a Predictor of Awareness, Engagement, and Use of a National Online Personal Health Record: A Population-based Survey (Preprint)

2021 ◽  
Author(s):  
Christina Cheng ◽  
Emma Gearon ◽  
Melanie Hawkins ◽  
Crystal McPhee ◽  
Lisa Hanna ◽  
...  
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Digital Health ◽  
Fold Increase ◽  
Health Inequities ◽  
Population Based ◽  
Personal Health ◽  
Health Record ◽  
Digital Services ◽  
Population Based Survey

BACKGROUND Online personal health records (PHR) have the potential to improve quality, accuracy, and timeliness of health care. However, uptake of online PHRs internationally has been slow. Populations experiencing disadvantages are also less likely to use online PHRs, potentially widening health inequities within and between countries. OBJECTIVE With limited understanding of the predictors of community uptake and utilization of online PHR, the aim of this study was to determine the predictors of awareness, engagement, and use of the Australian national online PHR, My Health Record (MyHR). METHODS A population-based survey of participants aged over 18 residing in regional Victoria, Australia was undertaken in 2018 using telephone interviews. Logistic regression, adjusted for age, was used to assess the relationship between independent variables including digital health literacy, health literacy, and demographic characteristics and 3 dependent variables of MyHR awareness, engagement, and use. Digital health literacy and health literacy were measured by multidimensional tools, using all 7 scales of the eHealth Literacy Questionnaire (eHLQ) and 4 out of the 9 scales of the Health Literacy Questionnaire (HLQ). RESULTS A total of 998 responses were analyzed. Digital health literacy was found to be a strong statistical predictor of MyHR awareness, engagement, and use. A 1 unit increase in each of the 7 eHLQ scales was associated with a 2- to 4-fold increase in the odds of using MyHR: 1. Using technology to process health information (odd ratio [OR] 4.14, 95% CI 2.34-7.31); 2. Understanding of health concepts and language (OR 2.25, 95% CI 1.08-4.69); 3. Ability to actively engage with digital services (OR 4.44, 95% CI 2.55-7.75); 4. Feel safe and in control (OR 2.36, 95% CI 1.43-3.88); 5. Motivated to engage with digital services (OR 4.24, 95% CI 2.36-7.61); 6. Access to digital services that work (OR2.49, 95% CI 1.32-4.69); 7. Digital services that suit individual needs (OR 3.48, 95% CI 1.97-6.15). The HLQ scales of health care support, actively managing health, and social support were also associated with a 1- to 2-fold increase in the odds of using MyHR. Using the internet to search for health information was another strong predictor but older people and people with less education were less likely to use MyHR. CONCLUSIONS This study provides insights into the predictors of the use of an online PHR. The findings indicate that, while digital skills training is likely to increase uptake and use of online PHR, initiatives to provides access, develop responsive digital services, establish good health care, and social support are also important. Population groups that are likely to be non-users of online PHR were also identified. A holistic approach and targeted solutions are needed to ensure that online PHR can realize its full potential to help reduce health inequities. CLINICALTRIAL Not applicable

Exploring adolescent and clinician perspectives on Australia’s national digital health record, My Health Record

2021 ◽  
Vol 27 (2) ◽  
pp. 102
Author(s):  
Laura Beaton ◽  
Ian Williams ◽  
Lena Sanci
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Access To Health Care ◽  
School Health ◽  
Digital Health ◽  
Well Being ◽  
Health Record ◽  
Patient Privacy ◽  
Privacy And Security ◽  
School Based

Adolescence is often a time when risk-taking behaviours emerge and attendance at primary health care is low. School-based health services can serve to improve access to health care. Clinicians play a key role in improving adolescents’ health literacy and capacity to make informed care decisions. Australia’s national digital health record, My Health Record (MHR), has posed significant challenges for both clinicians and adolescents in understanding impacts on patient privacy. Guidance is required on how best to communicate about MHR to adolescents. This exploratory qualitative study aims to examine adolescents’ understanding of MHR, clinicians’ knowledge of MHR and their use of MHR with adolescents. Focus groups with students, school health and well-being staff and semistructured interviews with GPs and nurses were undertaken in one regional and one urban secondary school-based health service in Victoria. Transcripts from audio recorded sessions were examined using thematic analysis. Resulting themes include minimal understanding and use of MHR, privacy and security concerns, possible benefits of MHR and convenience. The results suggest opportunities to address gaps in understanding and to learn from adolescents’ preferences for digital health literacy education. This will support primary care clinicians to provide best-practice health care for adolescents.

scholarly journals The role of smart monitoring digital health care system based on smartphone application and personal health record platform for patients diagnosed with coronavirus disease 2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jong Hun Kim ◽  
Won Suk Choi ◽  
Joon Young Song ◽  
Young Kyung Yoon ◽  
Min Ja Kim ◽  
...  
Keyword(s):  
Health Care ◽  
Digital Health ◽  
Personal Health Record ◽  
Vital Signs ◽  
Signs And Symptoms ◽  
Smartphone Application ◽  
Personal Health ◽  
Health Record ◽  
Health Care Monitoring

Abstract Background The massive outbreak of the novel coronavirus disease 2019 (COVID-19) in Daegu city and Gyeongsangbuk-do, Republic of Korea (ROK), caused the exponential increase in new cases exceeding 5000 within 6 weeks. Therefore, the community treatment center (CTC) with a digital health care monitoring system based on the smartphone application and personal health record platform (PHR) was implemented. Thus, we report our experience in one of the CTCs to investigate the role of CTC and the feasibility of the digital health care monitoring system in the COVID-19 pandemic. Methods The Gyeongbuk-Daegu 2 CTC was set up at the private residential facility. Admission criteria were 1) patients < 65 years with COVID-19, 2) patients without underlying medical comorbidities, and 3) COVID-19 disease severity of mild class. Admitted patients were placed under monitoring of vital signs and symptoms. Clinical information was collected using the smartphone application or telephone communication. Collected information was displayed on the PHR platform in a real-time fashion for close monitoring. Results From Mar 3, 2020, to Mar 26, 2020, there was a total of 290 patients admitted to the facility. Males were 104 (35.9%). The median age was 37 years. The median time between the COVID-19 diagnosis and admission was 7 days. Five patients were identified and were transferred to the designed COVID-19 treatment hospital for their urgent medical needs. The smartphone application usage to report vital signs and symptoms was noted in 96% of the patients. There were no deaths of the patients. Conclusions Our results suggest that implementation of the CTC using a commercial residence facility and digital health care technology may offer valuable solutions to the challenges posed by the COVID-19 outbreak.

scholarly journals 31.C. Workshop: Development and implementation of action plans on health literacy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Digital Health ◽  
Action Plan ◽  
Knowledge Society ◽  
Implementation Strategies ◽  
Social Consequences ◽  
Action Plans

Abstract Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health. Key messages Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.

scholarly journals Patient empowerment through a user-centered design of an electronic personal health record: a qualitative study of user requirements in chronic kidney disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Esmaeel Toni ◽  
Habibollah Pirnejad ◽  
Khadijeh Makhdoomi ◽  
Azam Mivefroshan ◽  
Zahra Niazkhani
Keyword(s):  
Chronic Kidney Disease ◽  
Health Literacy ◽  
Kidney Disease ◽  
Qualitative Study ◽  
Personal Health Record ◽  
Self Management ◽  
Personal Health ◽  
Health Record ◽  
User Centered Design ◽  
Electronic Personal Health Record

Abstract Background To improve chronic disease outcomes, self-management is an effective strategy. An electronic personal health record (ePHR) is a promising tool with the potential to support chronic patient’s education, counseling, and self-management. Fitting ePHRs within the daily practices of chronic care providers and chronic patients requires user-centered design approaches. We aimed to understand users’ needs and requirements in chronic kidney disease (CKD) care to consider in the design of an ePHR to facilitate its implementation, adoption, and use. Methods A qualitative study was conducted in a major Iranian nephrology center including inpatient and outpatient settings in 2019. We conducted 28 semi-structured interviews with CKD patients, nurses, and adult nephrologists. To confirm or modify the requirements extracted from the interviews, a focus group was also held. Data were analyzed to extract especially those requirements that can facilitate implementation, adoption, and sustained use based on the PHR adoption model and the unified theory of acceptance and use of technology. Results Participants requested an ePHR that provides access to up to date patient information, facilitates patient-provider communication, and increases awareness about patient individualized conditions. Participants expected a system that is able to cater to low patient e-health literacy and high provider workload. They requested the ePHR to include purposeful documentation of medical history, diagnostic and therapeutic procedures, tailored educational content, and scheduled care reminders. Messaging function, tailored educational content to individual patients’ conditions, and controlled access to information were highly valued in order to facilitate its implementation, adoption, and use. Conclusions We focused on the ePHR’s content and functionalities in the face of facilitators and/or barriers envisioned for its adoption in nephrology care. Designers and implementers should value CKD patients’ needs and requirements for self-management such as providing personalized education and counseling (on the basis of their condition and risk factors), health literacy, and disease progression levels. The socio-technical aspects of care also need further attention to facilitate ePHR’s adoption.

scholarly journals Examining attitudes toward and ability to interact with an online personal health record: A case study in Saudi Arabia

2019 ◽  
Vol 6 (1) ◽  
pp. 1 ◽  
Author(s):  
Bandar Faisal Al-Mifgai ◽  
Joseph Sharit ◽  
Arzu Onar-Thomas ◽  
Shihab Asfour
Keyword(s):  
Saudi Arabia ◽  
Health Literacy ◽  
Health Systems ◽  
Health Management ◽  
Personal Health Record ◽  
The Internet ◽  
Personal Health ◽  
Health Record ◽  
Health Numeracy ◽  
Electronic Health

Objective: This study examined the ability for adults from a developing country to use a personal health record (PHR) to perform health-management tasks. The effects of gender differences as well as differences in attitudes about using the internet to manage health prior to and after exposure to the PHR were also investigated.Methods: A simulation of a PHR based on a well-established U.S. online patient portal was designed and tailored for this particular study population. Two hundred and three adults with a mean age of 40.9 years were recruited from various areas in Saudi Arabia and asked to perform seven common health-management tasks of varying degrees of difficulty. Their electronic health literacy and health numeracy, as well as their attitudes about using online health systems for managing their health prior to and following their interaction with the PHR, were assessed using questionnaires.Results: After controlling for education, perceived health status, and comfort using the internet, electronic health literacy and health numeracy were still found to be significant predictors of participants’ task performance, but only for the more challenging health-management tasks. No important differences based on gender were found. Exposure to the PHR significantly increased the acceptability of using the internet for managing their health.Conclusions: The change in attitudes following interaction with the PHR suggests that many adults in this society could benefit from these electronic health systems, including females who, due to cultural considerations, may desire greater control in managing their health. However, the importance of electronic health literacy and health numeracy suggests the need for designs that minimize the impact of these factors for successful performance of health-management tasks.

scholarly journals Associations of health literacy with socioeconomic position, health risk behavior, and health status: a large national population-based survey among Danish adults

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Majbritt Tang Svendsen ◽  
Carsten Kronborg Bak ◽  
Kristine Sørensen ◽  
Jürgen Pelikan ◽  
Signe Juul Riddersholm ◽  
...  
Keyword(s):  
Health Status ◽  
Health Literacy ◽  
Health Risk ◽  
Risk Behavior ◽  
Socioeconomic Position ◽  
Population Based ◽  
Health Risk Behavior ◽  
National Population ◽  
Population Based Survey
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