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

2012 ◽  
Vol 3 (3) ◽  
pp. 145 ◽  
Author(s):  
Efrat Neter ◽  
Esther Brainin

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

2012 ◽  
Vol 3 (3) ◽  
pp. 145-151 ◽  
Author(s):  
Efrat Neter ◽  
Esther Brainin

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.


10.2196/19013 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e19013
Author(s):  
Zsombor Zrubka ◽  
Óscar Brito Fernandes ◽  
Petra Baji ◽  
Ottó Hajdu ◽  
Levente Kovacs ◽  
...  

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.


2021 ◽  
pp. 872-880
Author(s):  
Amy E. Leader ◽  
Lisa M. Capparella ◽  
Lauren B. Waldman ◽  
Rebecca B. Cammy ◽  
Alison R. Petok ◽  
...  

PURPOSE eHealth literacy, or the ability to seek, find, understand, and appraise health information from electronic sources, has become increasingly relevant in the era of COVID-19, when so many aspects of patient care became dependent on technology. We aimed to understand eHealth literacy among a diverse sample of patients with cancer and discuss ways for health systems and cancer centers to ensure that all patients have access to high-quality care. METHODS A cross-sectional survey of patients with cancer and caregivers was conducted at an NCI-designated cancer center to assess access to the Internet, smartphone ownership, use of mobile apps, willingness to engage remotely with the health care team, and use of the patient portal. Descriptive statistics and bivariate analyses were used to assess frequencies and significant differences between variables. RESULTS Of 363 participants, 55% (n = 201) were female, 71% (n = 241) identified as non-Hispanic White, and 29% (n = 85) reported that their highest level of education was a high school diploma. Most (90%, n = 323) reported having access to the Internet and most (82%, n = 283) reported owning a smartphone. Younger patients or those with a college degree were significantly more likely to own a smartphone, access health information online, know how to download an app on their own, have an interest in communicating with their health care team remotely, or have an account on the electronic patient portal. CONCLUSION As cancer centers increasingly engage patients through electronic and mobile applications, patients with low or limited digital literacy may be excluded, exacerbating current cancer health disparities. Patient-, provider- and system-level technology barriers must be understood and mitigated.


2020 ◽  
Author(s):  
Zsombor Zrubka ◽  
Óscar Brito Fernandes ◽  
Petra Baji ◽  
Ottó Hajdu ◽  
Levente Kovacs ◽  
...  

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 (<i>χ</i><sup>2</sup><sub>9</sub>=24.2, <i>P</i>=.002) and to be involved in decision making about care and treatment (<i>χ</i><sup>2</sup><sub>9</sub>=18.2, <i>P</i>=.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 (<i>P</i>=.02) and experience fewer problems (<i>P</i>=.02). In addition, those respondents had better experiences in terms of how easy it was to understand the HCPs’ explanations (<i>P</i>&lt;.001) and being able to ask questions during their last consultation (<i>P</i>=.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 (<i>P</i>&gt;.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.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

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.


2016 ◽  
Vol 22 (4) ◽  
pp. 992-1016 ◽  
Author(s):  
Martina A Clarke ◽  
Joi L Moore ◽  
Linsey M Steege ◽  
Richelle J Koopman ◽  
Jeffery L Belden ◽  
...  

To synthesize findings from previous studies assessing information needs of primary care patients on the Internet and other information sources in a primary care setting. A systematic review of studies was conducted with a comprehensive search in multiple databases including OVID MEDLINE, CINAHL, and Scopus. The most common information needs among patients were information about an illness or medical condition and treatment methods, while the most common information sources were the Internet and patients’ physicians. Overall, patients tend to prefer the Internet for the ease of access to information, while they trust their physicians more for their clinical expertise and experience. Barriers to information access via the Internet include the following: socio-demographic variables such as age, ethnicity, income, education, and occupation; information search skills; and reliability of health information. Conclusion: Further research is warranted to assess how to create accurate and reliable health information sources for both Internet and non-Internet users.


2021 ◽  
Author(s):  
Kyoung-Eun Lee ◽  
Sun Ju Chang ◽  
Eunjin Yang ◽  
Hyunju Ryu

BACKGROUND The Internet use rate of older adults, who were considered underprivileged in the digital world, is steadily increasing. Specifically, the Internet is considered an important channel for providing health information to older adults, who are the largest consumers of medical services. However, due to factors such as technical difficulties, lack of learning opportunities, and deterioration of eHealth literacy, the Internet is not usually a common factor of delivering health information to older adults. Therefore, we developed an intervention program to improve eHealth literacy in older adults according to the information-motivation-behavioral skills (IMB) theory and Intervention Mapping. OBJECTIVE This study aimed to analyze the effect of developed intervention on information, motivation, behavioral skills, and behaviors related to eHealth information in older adults. METHODS This study applied a single group pretest–posttest design. The participants were 46 older adults over the age of 65 recruited from two senior welfare centers in a city in South Korea. We divided the participants into 4 groups and conducted 4 interventions in the computer room of the Senior Welfare Center from March to December 2019. One intervention was performed once a week (2 hours/1 time) for 5 weeks, and the total lecture time was 10 hours. The instructors were all researchers involved in the development of this intervention, and the instructors for each intervention consisted of one lecture instructor and two assistant instructors who supported the participants in the computer practices. RESULTS Participants’computer/web knowledge (χ²= 60.04, P <.001), perceived ease of use (χ²= 17.86, P <.001), perceived enjoyment (χ²= 23.06, P <.001), and attitude toward eHealth information (χ²= 18.47, P <.001) showed statistically significant increases. The eHealth information literacy efficacy score (χ²= 72.76, P< .001), searching performance score (χ²= 162.57, P < .001), and understanding score (χ²= 60.96, P< .001) were also significantly different from those before and after the intervention. However, there was no significant difference in perceived usefulness (χ²= 5.91, P = .052). CONCLUSIONS Our findings suggest that the application of the current theory based methodology can improve the quality of research in developing eHealth information literacy interventions. Additionally, it is necessary to develop and continuously apply various interventions to improve eHealth information literacy among older adults. Finally, measures to improve the Internet environment for older adults should be considered.


Author(s):  
Steven A. Demurjian ◽  
Alberto De la Rosa Algarín ◽  
Jinbo Bi ◽  
Solomon Berhe ◽  
Thomas Agresta ◽  
...  

In health care, patient information of interest to health providers, researchers, public health researchers, insurers, patients, etc., is stored in different locations via electronic media and/or hard-copy formats. All potential users need electronic access to health information technology systems such as: electronic health records, personal health records, patient portals, and ancillary systems such as imaging, laboratory, pharmacy, etc. Controlling access to information from multiple systems requires granularity levels of privileges ranging from one patient to a cohort to an entire population. In this paper, we present a viewpoint of the state of secure digital health care in the United States, focusing on the resources that need to be protected as dictated by legal entities and regulations, the available approaches in the present state-of-the art, and, the potential needs for the future of security for digital health care. By utilizing a real world scenario, the authors explore the limitations of health information exchange in the United States, and present one possible architecture for secure digital health care that builds on existing technology alternatives.


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