COVID-19 preventive behaviors, health literacy, and information: a survey of information-evaluation and decision-making skills in Japanese adults (Preprint)

BACKGROUND Health literacy is important for the prevention of COVID-19. Research in Japan shows that health literacy is related to skills in evaluating information and decision making (not necessarily limited to health information). Such basic skills are important, particularly when individuals encounter new health issues for which there is insufficient evidence. OBJECTIVE This study aimed to determine the extent to which COVID-19 preventive behaviors were associated with health literacy and skills in evaluating information and making decisions. METHODS An online questionnaire survey was conducted using a Japanese Internet research company. A total of 3,914 valid responses were received. The measures comprised eight items on COVID-19 preventive behaviors, health literacy items (European Health Literacy Survey Questionnaire), five items on information evaluation, and four items on the decision-making process. Pearson correlations between these variables were calculated. Multivariate analyses were also conducted using COVID-19 preventive behavior score as a dependent variable. RESULTS COVID-19 preventive behaviors were significantly correlated with health literacy, information evaluation, and the decision-making process (.23, .24, .30, respectively). The multiple linear regression analysis results showed that the standardized regression coefficients for each were .11, .13, and .18; the highest value was for decision-making skills. CONCLUSIONS Although comprehensive health literacy is necessary for COVID-19 preventive behaviors, the skills to evaluate a wide range of information and to make appropriate decisions are no less important. Opportunities for people to acquire these skills should be available at all times.

Associations between health literacy and information-evaluation and decision-making skills in Japanese adults

Background Health literacy in Japanese people is often low because people find it difficult to evaluate health information and make informed decisions. Clarifying the association between health literacy and the skills to evaluate information and make appropriate decisions (not necessarily limited to health information) would inform efforts to improve health literacy. Therefore, the study objectives were to investigate the following issues using a nationwide survey in Japan: 1) When obtaining information, to what extent do people appropriately evaluate whether the information is reliable, and when making decisions, to what extent do they seek out available options and compare pros and cons based on their own values? 2) How strongly are these skills associated with health literacy and demographic characteristics? 3) What opportunities are available to learn these skills? Methods An online questionnaire survey was conducted using a Japanese Internet research company; 3,914 valid responses were received. The measures comprised health literacy (European Health Literacy Survey Questionnaire), five items on information evaluation, four items on the decision-making process, and items on the availability and location of learning opportunities. Pearson correlations were calculated to explore the association of health literacy with information-evaluation and decision-making skills. Multivariate analyses were also conducted using these factors as dependent variables. Results Less than half of respondents always or often evaluated information and engaged in the decision-making process. Health literacy was significantly correlated with information evaluation and the decision-making process (.26 and .30, respectively). More than 40% of respondents had no learning opportunities. Respondents who did have learning opportunities learned on their own, rather than at school or work, using sources such as the Internet and television. Conclusions Both information-evaluation and decision-making skills were associated with health literacy. However, these skills are not sufficiently widespread in Japan, because there are few opportunities to learn them. More research is needed to raise awareness of the importance of these skills for improving health literacy, and to provide appropriate learning opportunities. Additionally, an environment must be created in which all individuals can easily receive support at any time, so that they can make appropriate decisions based on reliable information.

How Do We Read and Evaluate Information?

Chapter 10 describes how games may help people practice critical literacy skills such as reading, evaluating, and interpreting information. How is it determined which evidence and data are valid and reliable, and how might games support this? How might games help people to engage with news and current events, or to counter fake news? The chapter includes an overview of why reading and interpreting information matters in civics and ethics, and why games may support this. It also includes the limitations of using games to explore evidence and information, and how to minimize those limitations. Finally, it reviews strategies that teachers can take to use games to practice literacy and information evaluation skills. It opens with the example of the game Factitious, and also shares three examples-in-action: Executive Command, Thoughts and Prayers, and Bad News.

Toward the dialectical evaluation of online information: the roles of personality, self-efficacy and attitude

PurposeUser behavior in online information evaluation is the result of a multitude of factors related to social, cultural, personal and psychological issues. The present study aimed to examine the effects of three important psychological variables including personality, self-efficacy and attitude on online information evaluation.Design/methodology/approachFour validated measures were administrated in person and online among 355 postgraduate students at Shahed University, Tehran, Iran. For testing the possible relationships among the variables, the reliability, normality and Pearson correlation tests were performed by using SPSS 24.0. Moreover, to test the ten hypotheses of the research, the structural equation modeling was considered using AMOS 26.0.FindingsThe findings confirmed the first five research hypotheses indicating the direct positive relationships among the four variables except for the impact of self-efficacy on attitude. The mediated effects of the variables were not supported except for the mediating role of attitude in the impact of personality on online evaluation behavior. The variable personality was found to be fundamental among the tested paths because it influenced the information evaluation behavior, both directly and indirectly.Originality/valueThe study showed the impacts of the three variables, which demonstrates that online information evaluation is greatly affected by psychological factors.

Measuring Electronic Health Literacy: Development, Validation, and Test of Measurement Invariance of the 3-factor eHealth literacy inventory (3F-EHLI) (Preprint)

BACKGROUND The World Wide Web has become an essential source of health information. Especially the COVID-19 pandemic has shown that the amount and the quality of information provided can lead to an information overload. Therefore, people do need certain skills to search, identify and evaluate information from the internet. In the context of health information, these competences are described as eHealth literacy, which could be confirmed as predictor of various health-related outcomes. Existing instruments assessing eHealth literacy reveal limitation of methodological standards of test development and validation. Furthermore, existing scales do not cover the entire cognitive processes, which are proposed within the construct of eHealth literacy. OBJECTIVE The objective of this study is the development and validation of an extended eHealth literacy scale to provide an economic and empirically confirmed measurement of eHealth literacy in German language. METHODS For development, items from 2 international, validated instruments were merged to cover a wide bandwidth of the construct of eHealth literacy. Translation into German followed scientific guidelines and recommendations ensuring content validity. A convenience sample of N=470 German-speaking people was collected from October to November 2020. Validation was carried out by confirmatory factor analysis. Correlations were performed to examine for convergent, discriminant, and criterion validity. Additionally, analyses of measurement invariance of gender, age, and educational level were conducted. RESULTS Analyses revealed a 3-factorial model of eHealth literacy. By item-reduction, the 3 factors information seeking, information identification, and information evaluation were measured with 11 items reaching good model fits (CFI: 0.959 ; TLI: 0.945; RMSEA: 0 .068; SRMR: 0.045). Convergent validity was confirmed by positive correlations of information seeking, information identification, and information evaluation with health literacy (r=0.43, P<.001; r= 0.53, P<.001; r= 0.55, P<.001, respectively). No significant correlations with impulsivity (r=-0.06, P=.16; r=-0.08, P=.08; r=-0.08, P=.10, respectively) confirmed discriminant validity. Criterion validity was supported by positive correlations of information identification and information evaluation with mental health (r=0.29, P<.001; r= 0.21, P<.001, respectively). Analyses with further variables confirmed convergent, discriminant and criterion validity. Strict measurement invariance of gender (CFI: 0.941; TLI: 0.941 ; RMSEA: 0.073; SRMR: 0.059), age (CFI: 0.943; TLI: 0.943 ; RMSEA: 0.070; SRMR: 0 .053), and educational level (CFI: 0.956; TLI: 0.959 ; RMSEA: 0.059; SRMR: 0.060) was confirmed. CONCLUSIONS Following scientific suggestions for translation and performing analyses confirming 3-factorial structure, we developed the 3-factor eHealth literacy inventory (3F-EHLI) as an economic and valid assessment of eHealth literacy. By verifying measurement invariance of gender, age, and educational level, the 3F-EHLI is an applicable measurement independently of these main sociodemographic variables. The 3F-EHLI represents a valid and economic instrument international further development of the measurement of the important health-related construct of eHealth literacy.