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Hyde, Lisa Lynne, Allison W. Boyes, Lisa J. Mackenzie, Lucy Leigh, Christopher Oldmeadow, Carlos Riveros, and Rob Sanson-Fisher. "Electronic Health Literacy Among Magnetic Resonance Imaging and Computed Tomography Medical Imaging Outpatients: Cluster Analysis." Journal of Medical Internet Research 21, no. 8 (August 28, 2019): e13423. http://dx.doi.org/10.2196/13423.
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Background Variations in an individual’s electronic health (eHealth) literacy may influence the degree to which health consumers can benefit from eHealth. The eHealth Literacy Scale (eHEALS) is a common measure of eHealth literacy. However, the lack of guidelines for the standardized interpretation of eHEALS scores limits its research and clinical utility. Cut points are often arbitrarily applied at the eHEALS item or global level, which assumes a dichotomy of high and low eHealth literacy. This approach disregards scale constructs and results in inaccurate and inconsistent conclusions. Cluster analysis is an exploratory technique, which can be used to overcome these issues, by identifying classes of patients reporting similar eHealth literacy without imposing data cut points. Objective The aim of this cross-sectional study was to identify classes of patients reporting similar eHealth literacy and assess characteristics associated with class membership. Methods Medical imaging outpatients were recruited consecutively in the waiting room of one major public hospital in New South Wales, Australia. Participants completed a self-report questionnaire assessing their sociodemographic characteristics and eHealth literacy, using the eHEALS. Latent class analysis was used to explore eHealth literacy clusters identified by a distance-based cluster analysis, and to identify characteristics associated with class membership. Results Of the 268 eligible and consenting participants, 256 (95.5%) completed the eHEALS. Consistent with distance-based findings, 4 latent classes were identified, which were labeled as low (21.1%, 54/256), moderate (26.2%, 67/256), high (32.8%, 84/256), and very high (19.9%, 51/256) eHealth literacy. Compared with the low class, participants who preferred to receive a lot of health information reported significantly higher odds of moderate eHealth literacy (odds ratio 16.67, 95% CI 1.67-100.00; P=.02), and those who used the internet at least daily reported significantly higher odds of high eHealth literacy (odds ratio 4.76, 95% CI 1.59-14.29; P=.007). Conclusions The identification of multiple classes of eHealth literacy, using both distance-based and latent class analyses, highlights the limitations of using the eHEALS global score as a dichotomous measurement tool. The findings suggest that eHealth literacy support needs vary in this population. The identification of low and moderate eHealth literacy classes indicate that the design of eHealth resources should be tailored to patients’ varying levels of eHealth literacy. eHealth literacy improvement interventions are needed, and these should be targeted based on individuals’ internet use frequency and health information amount preferences.
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Tsukahara, Saki, Satoshi Yamaguchi, Futaba Igarashi, Reiko Uruma, Naomi Ikuina, Kaori Iwakura, Keisuke Koizumi, and Yasunori Sato. "Association of eHealth Literacy With Lifestyle Behaviors in University Students: Questionnaire-Based Cross-Sectional Study." Journal of Medical Internet Research 22, no. 6 (June 24, 2020): e18155. http://dx.doi.org/10.2196/18155.
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Background Maintenance of good health and a healthy lifestyle have significant impacts on the lives of university students. However, university students are prone to engage in risky health behaviors, resulting in impaired health status. Electronic health (eHealth) literacy is an important factor in maintaining a healthy lifestyle. However, no studies have assessed the eHealth literacy levels and the associated lifestyle behaviors among university students in Japan. Objective The purposes of this study were to clarify the eHealth literacy level, the participant characteristics associated with eHealth literacy, and the association of eHealth literacy with lifestyle behaviors of students in a Japanese university. Methods A questionnaire-based cross-sectional study of 3183 students at a national university in Japan was conducted. eHealth literacy was quantified using the Japanese version of the eHealth Literacy Scale (eHEALS). The association between participant characteristics (gender, school year, department of study, and living status) and eHEALS score was assessed using t tests. Additionally, the associations of eHealth literacy with lifestyle behaviors (exercise, smoking, alcohol consumption, etc.) were evaluated using logistic regression analyses. Results The mean eHEALS score was 23.6/40 points. The mean eHEALS score for students in medical departments was 27.0/40 points, which was 2.9 points higher than that of nonmedical students (P<.001). Similarly, the graduate school participants had higher scores than the undergraduate students. The proportion of participants who exercised regularly was higher in the high eHEALS score group than in the low score group, with an adjusted odds ratio of 1.39 (P<.001). Conclusions The eHealth literacy level of university students in Japan was comparable to that of the general Japanese population. Graduate students, as well as those in medical departments, had higher eHealth literacy. Furthermore, students with higher eHealth literacy had better exercise routines.
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Eto, Mamiko, and Koji Yamatsu. "Associations of eHealth Literacy with Social Activity among Community-Dwelling Older Adults: A Cross-Sectional Study." European Journal of Investigation in Health, Psychology and Education 14, no. 5 (May 6, 2024): 1279–94. http://dx.doi.org/10.3390/ejihpe14050084.
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Older adults who use digital technology are desired to adapt to digitalization and literacy. One required aspect is eHealth literacy, measured with the eHealth Literacy Scale (eHEALS). Many studies on eHealth literacy have used the eHEALS to examine the health behaviors of college students, relatively younger adults, and Internet users. However, the relevance of eHealth literacy to social activity has not yet been studied in older adults. The purposes of this study were to examine the relationship between eHealth literacy and health behaviors and social activities (community, cultural, and sports activities) and to investigate the factors associated with eHEALS scores among community-dwelling older adults. The mean eHEALS score was 12.4 points (SD 8.2), with the majority (73.3%) having the lowest score (the lowest score is 8 points). Males (17.6, SD 10.5) scored significantly higher than females (11.8, SD 7.7). The eHEALS score had a significant relationship with both cultural and community activity. Five factors significantly associated with having the lowest eHEALS score were cultural activity at least once a week, no cultural activity, no community activity, total IADL score, and intellectual activity. These results suggest that eHealth literacy is associated with community activity and cultural activity among older adults.
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An, Lawrence, Elizabeth Bacon, Sarah Hawley, Penny Yang, Daniel Russell, Scott Huffman, and Ken Resnicow. "Relationship Between Coronavirus-Related eHealth Literacy and COVID-19 Knowledge, Attitudes, and Practices among US Adults: Web-Based Survey Study." Journal of Medical Internet Research 23, no. 3 (March 29, 2021): e25042. http://dx.doi.org/10.2196/25042.
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Background During a global pandemic, it is critical that the public is able to rapidly acquire new and accurate health information. The internet is a major source of health information. eHealth literacy is the ability of individuals to find, assess, and use health information available on the internet. Objective The goals of this study were to assess coronavirus-related eHealth literacy and examine the relationship between eHealth literacy and COVID-19−related knowledge, attitudes, and practices (KAPs). Methods We conducted a web-based survey of a representative sample of 1074 US adults. We adapted the 8-item eHealth Literacy Scale to develop the Coronavirus-Related eHealth Literacy Scale (CoV-eHEALS) to measure COVID-19−related knowledge, conspiracy beliefs, and adherence to protective behaviors (eg, wearing facial masks and social distancing). Our analyses identified sociodemographic associations with the participants’ CoV-eHEALS scores and an association between the CoV-eHEALS measure and COVID-19 KAPs. Results The internal consistency of the adapted CoV-eHEALS measure was high (Cronbach α=.92). The mean score for the CoV-eHEALS was 29.0 (SD 6.1). A total of 29% (306/1074) of the survey participants were classified as having low coronavirus-related eHealth literacy (CoV-eHEALS score <26). Independent associations were found between CoV-eHEALS scores and ethnicity (standardized β=–.083, P=.016 for Black participants) and education level (standardized β=–.151, P=.001 for participants with high-school education or lower). Controlling for demographic characteristics, CoV-eHEALS scores demonstrated positive independent associations with knowledge (standardized β=.168, P<.001) and adherence to protective behaviors (standardized β=.241, P<.001) and a negative association with conspiracy beliefs (standardized β=–.082, P=.009). Conclusions This study provides an estimate of coronavirus-related eHealth literacy among US adults. Our findings suggest that a substantial proportion of US adults have low coronavirus-related eHealth literacy and are thus at a greater risk of lower and less-protective COVID-19 KAPs. These findings highlight the need to assess and address eHealth literacy as part of COVID-19 control efforts. Potential strategies include improving the quality of health information about COVID-19 available on the internet, assisting or simplifying web-based search for information about COVID-19, and training to improve general or coronavirus-specific search skills.
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Makowsky, Mark J., Shahnaz Davachi, and Charlotte A. Jones. "eHealth Literacy in a Sample of South Asian Adults in Edmonton, Alberta, Canada: Subanalysis of a 2014 Community-Based Survey." JMIR Formative Research 6, no. 3 (March 30, 2022): e29955. http://dx.doi.org/10.2196/29955.
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Background Digital health interventions are efficient and flexible methods for enhancing the prevention and management of cardiovascular disease and type 2 diabetes. However, little is known about the characteristics associated with eHealth literacy in the Canadian South Asian population. Objective The aim of this study is to describe perceived eHealth literacy and explore the extent to which it is associated with sociodemographic, health status, and technology use variables in a subset of South Asian Canadians. Methods We analyzed data from the e-Patient Project survey, a mixed-mode cross-sectional survey that occurred in 2014. The eHealth Literacy Scale (eHEALS) was used to measure eHealth literacy in a convenience sample of 511 English- or Punjabi-speaking South Asian adults recruited from a community pharmacy, a family physician office, and community events in Edmonton, Alberta. Multivariable quantile regression was used to explore variables associated with eHealth literacy. Results The analysis was restricted to 301 internet users (mean age 39.9, SD 14.8 years; 166/301, 55.1% female) who provided responses to all 8 eHEALS questions and complete demographic information. The mean overall eHEALS score was 29.3 (SD 6.8) out of 40, and 71.4% (215/301) agreed to at least 5 out of the 8 eHEALS items. The eHEALS item with the lowest level of agreement was “I can tell high-quality health resources from low-quality health resources on the internet” (182/301, 60.5%). Although there were statistically significant differences in eHEALS scores according to age, educational achievement, language preference, and the presence of chronic medical conditions, multivariable regression analysis indicated that language preference was the only variable independently associated with eHealth literacy (coefficient –6.0, 95% CI –9.61 to –2.39). Conclusions In our sample of South Asian Canadian internet users, preference for written health information in languages other than English was associated with lower eHealth literacy. Opportunities exist to improve eHealth literacy using culturally and linguistically tailored interventions.
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Gazibara, Tatjana, Jelena Cakić, Milica Cakić, Redžeb Zejnelagić, Aleksandra Popović, and Anita Grgurević. "Exploring e-health literacy among students of sports vs. medical students." Medicinska istrazivanja 55, no. 3 (2022): 21–28. http://dx.doi.org/10.5937/medi55-39595.
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Introduction/Aim: Data about electronic health (eHealth) literacy and potential differences in eHealth literacy between university students are lacking. The aim of this study was to evaluate eHealth literacy in students of sports and medicine and to assess the factors associated with better eHealth literacy. Material and Methods: This cross-sectional study was carried out from April to October 2017 among final year students of the Faculty of Sports and Physical Education and the Faculty of Medicine, University of Belgrade, Serbia. A total of 89 sports students and 301 medical students were included. The eHealth Literacy Scale (eHEALS) was used to evaluate eHealth literacy. Results: Compared with sports students, medical students had higher median eHEALS score (27 vs. 30, respectively, p=0.008). Medical students were twice as confident as sports students in their efforts to locate helpful online health resources and use online health information. A significant hierarchical linear regression model was not obtained in the sample of sports students regarding predictors of better eHealth literacy. In the sample of medical students, the following was associated with better self-perceived eHealth literacy: being female, residing outside of the capital before becoming a student, younger age at the time of the first Internet use, the use of health-related websites and smartphone apps as well as lower influence of online health-related information on decision making regarding health. Conclusion: Medical students were more confident in perceiving their eHealth literacy skills compared to sports students. The factors associated with better eHealth literacy may depend on the fields of study.
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Bardus, Marco, Arda Keriabian, Martine Elbejjani, and Samar Al-Hajj. "Assessing eHealth literacy among internet users in Lebanon: A cross-sectional study." DIGITAL HEALTH 8 (January 2022): 205520762211193. http://dx.doi.org/10.1177/20552076221119336.
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Objective Assessing the level of eHealth literacy in a population is essential to designing appropriate public health interventions. This study aimed to assess eHealth literacy among adult internet users in Lebanon, recruited through social media and printed materials. The study examined the relationship between internet use, perceived eHealth literacy, and sociodemographic characteristics. Methods A cross-sectional study based on a web-based questionnaire was conducted between January and May 2020. The survey assessed internet use and eHealth literacy using the homonymous scale (eHEALS) in English and Arabic. Cronbach's alpha and factor analyses were used to evaluate eHEALS’ psychometric properties. A generalized linear model was used to identify factors predicting the eHEALS. Results A total of 2715 respondents were recruited mostly through Facebook (78%) and printed materials (17%). Most respondents completed the survey in English (82%), were aged 30 ± 11 years, female (60%), Lebanese (84%), unmarried (62%), employed (54%), and with a graduate-level education (53%). Those who completed the eHEALS questionnaire ( n = 2336) had a moderate eHealth literacy ( M = 28.7, SD = 5.5). eHEALS was significantly higher among older females with a high education level, recruited from Facebook, Instagram, or ResearchGate, and perceived the Internet as a useful and important source of information. Conclusions Future internet-delivered public health campaigns in Lebanon should account for moderate-to-low levels of eHealth literacy and find ways to engage older males with low education levels representing neglected segments (e.g. Syrians). To be more inclusive, campaigns should reach neglected population segments through non-digital, community-based outreach activities.
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Wong, Swee Shiuan, Hooi Min Lim, Adrian Jian Zhi Chin, Felicia Wen Si Chang, Kah Chun Yip, Chin Hai Teo, Adina Abdullah, and Chirk Jenn Ng. "eHealth literacy of patients attending a primary care clinic in Malaysia and its associated factors: A cross-sectional study." DIGITAL HEALTH 8 (January 2022): 205520762211353. http://dx.doi.org/10.1177/20552076221135392.
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Background People are overloaded with online health information (OHI) of variable quality. eHealth literacy is important for people to acquire and appraise reliable information to make health-related decisions. While eHealth literacy is widely studied in developed countries, few studies have been conducted among patients in low- and middle-income countries (LMICs). Objective We aimed to determine the level of eHealth literacy in patients attending a primary care clinic in Malaysia and its associated factors. Methods A cross-sectional study using a self-administered questionnaire was conducted in an urban primary care clinic. We used a systematic random sampling method to select patients aged 18 years and above who attended the clinic. The eHealth literacy scale (eHEALS) was used to measure eHealth literacy. Results A total of 381 participants were included. The mean eHEALS was 24.4 ± 7.6. The eHEALS statements related to skills in appraising OHI were scored lower than statements related to looking for online resources. Higher education level of attending upper secondary school (AOR 2.53, 95% CI 1.05–6.11), tertiary education (AOR 4.05, 95% CI 1.60–10.25), higher monthly household income of >US$470 (AOR 1.95, 95% CI 1.07–3.56), and those who had sought OHI in the past month (AOR 1.95, 95% CI 1.13–3.36) were associated with a higher eHealth literacy level. Conclusions This study found a low eHealth literacy level among primary care patients in Malaysia. While the patients were confident in searching for OHI, they lacked skills in appraising them. Our findings inform the interventions for improving eHealth literacy in LMICs, especially educating the public about OHI appraisal.
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Berkowsky, Ronald W. "Exploring Predictors of eHealth Literacy Among Older Adults: Findings From the 2020 CALSPEAKS Survey." Gerontology and Geriatric Medicine 7 (January 2021): 233372142110642. http://dx.doi.org/10.1177/23337214211064227.
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With the Internet continuously being used as a means of providing health education and promotion to the public, consumers are increasingly going online to gather pertinent health information. However, disparities exist with regards to consumers’ ability in finding, evaluating, and applying online health information (collectively referred to as eHealth literacy). Identifying these disparities may elucidate which segments of the population would benefit from targeted eHealth literacy interventions and ways to adapt online health promotion materials. This study uses data from the 2020 CALSPEAKS survey to identify disparities in eHealth literacy among older adults aged 65+ residing in California, USA ( N = 237). eHealth literacy is self-assessed using the previously validated 8-item eHEALS questionnaire. Ordinary least squares regression analyses are performed on individual eHEALS items and on a summed eHealth literacy score, with demographic and technology use-related characteristics as predictors. Results show that the strongest and most consistent predictors of eHealth literacy include education, frequency of Internet use, and breadth of Internet activities regularly performed. Findings suggest that those seeking to increase eHealth literacy specifically among older Californians may benefit from tailoring their interventions and online health promotion materials towards those with less education and those with less Internet experience.
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Norman, Cameron D., and Harvey A. Skinner. "eHEALS: The eHealth Literacy Scale." Journal of Medical Internet Research 8, no. 4 (November 14, 2006): e27. http://dx.doi.org/10.2196/jmir.8.4.e27.
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Wijaya, Maria Cellina, and Yudhistira Pradnyan Kloping. "Validity and reliability testing of the Indonesian version of the eHealth Literacy Scale during the COVID-19 pandemic." Health Informatics Journal 27, no. 1 (January 2021): 146045822097546. http://dx.doi.org/10.1177/1460458220975466.
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Nowadays, it is common for people to look for health care information on the internet. The eHealth Literacy Scale (eHEALS) is commonly used to measure eHealth literacy. As of the publication of this study, the Indonesian version for eHEALS has not been published even though eHealth literacy is necessary, especially in the current COVID-19 pandemic. We aimed to evaluate the validity and reliability of the Indonesian version of eHEALS (I-eHEALS). A total of 100 respondents in East Java were involved in this cross-sectional study. Pearson-product moment correlation method and construct validity were used to validate the results. The reliability was determined based on the Cronbach’s alpha internal consistency measurement and intraclass correlation coefficient (ICC). The Pearson correlation analysis results are significantly higher ( r > 0.254, p < 0.01) compared to the critical value table. Single factors accounting for 57.66% variance in the scales exhibit a unidimensional latent structure. The internal consistency between items is excellent as shown by the Cronbach’s alpha coefficient (0.91). The ICC analysis shows an acceptable result (0.552, p < 0.01). The I-eHEALS is valid and reliable to be used for evaluating the eHealth literacy of the Indonesian population.
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Gazibara, Tatjana, Jelena Cakic, Milica Cakic, Tatjana Pekmezovic, and Anita Grgurevic. "eHealth and adolescents in Serbia: psychometric properties of eHeals questionnaire and contributing factors to better online health literacy." Health Promotion International 34, no. 4 (May 25, 2018): 770–78. http://dx.doi.org/10.1093/heapro/day028.
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Abstract Internet is important resource of health-related information and health services. Factors associated with higher level of online health (eHealth) literacy among adolescence have been understudied. The aim of this study was to assess psychometric properties of the eHealth Literacy Scale (eHEALS) in Serbian language and to evaluate eHealth literacy among adolescents in Serbia. The study was carried out in four high schools in Belgrade, Serbia in the period December 2016 to January 2017. A total of 702 students comprised the study sample. The eHEALS was translated according to internationally accepted methodology and its psychometric properties were analyzed. The Cronbach’s alpha coefficient for the entire eHEALS was 0.849. On exploratory factor analysis we obtained two-factorial structure. Our adolescents reported low confidence in knowing what health resources are available online. High confidence was observed for knowing how to use and how to find health information online. There was no difference in eHEALS score between genders or between school years. After adjustment for gender, type of school program, parental marital status, fathers’ education level and household income, being female was associated with higher eHealth literacy (B = 1.12, 95% confidence interval 0.07–2.18; p = 0.036). Serbian version of the eHEALS is a valid instrument in assessment of online health literacy and can be further used in evaluation of eHealth literacy in other population groups in Serbian language. It is advised that some classes in school are dedicated to appraisal and use of online health websites. This could be achieved through peer-education.
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Zrubka, Zsombor, Óscar Brito Fernandes, Petra Baji, Ottó Hajdu, Levente Kovacs, Dionne Kringos, Niek Klazinga, et al. "Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study." Journal of Medical Internet Research 22, no. 8 (August 11, 2020): e19013. http://dx.doi.org/10.2196/19013.
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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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Chang, Angela, and Peter Schulz. "The Measurements and an Elaborated Understanding of Chinese eHealth Literacy (C-eHEALS) in Chronic Patients in China." International Journal of Environmental Research and Public Health 15, no. 7 (July 23, 2018): 1553. http://dx.doi.org/10.3390/ijerph15071553.
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The rapid rise of Internet-based technologies to disseminate health information and services has been shown to enhance online health information acquisition. A Chinese version of the electronic health literacy scale (C-eHEALS) was developed to measure patients’ combined knowledge and perceived skills at finding and applying electronic health information to health problems. A valid sample of 352 interviewees responded to the online questionnaire, and their responses were analyzed. The C-eHEALS, by showing high internal consistency and predictive validity, is an effective screening tool for detecting levels of health literacy in clinical settings. Individuals’ sociodemographic status, perceived health status, and level of health literacy were identified for describing technology users’ characteristics. A strong association between eHealth literacy level, media information use, and computer literacy was found. The emphasis of face-to-face inquiry for obtaining health information was important in the low eHealth literacy group while Internet-based technologies crucially affected decision-making skills in the high eHealth literacy group. This information is timely because it implies that health care providers can use the C-eHEALS to screen eHealth literacy skills and empower patients with chronic diseases with online resources.
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Holch, Patricia, and Jordan R. Marwood. "EHealth Literacy in UK Teenagers and Young Adults: Exploration of Predictors and Factor Structure of the eHealth Literacy Scale (eHEALS)." JMIR Formative Research 4, no. 9 (September 8, 2020): e14450. http://dx.doi.org/10.2196/14450.
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Background Increasingly, teenagers and young adults (TYAs) seek out health information online; however, it is not clear whether they possess electronic health (eHealth) literacy, defined as “the ability to select, appraise, and utilize good quality health information from the internet.” A number of factors are included in the Lily model proposed by Norman and Skinner underpinning the development of eHealth literacy. It is important to understand which elements may influence the development of eHealth literacy in young people, as the current generation will continue to “Google it” when faced with a health problem throughout their lives. Objective The objectives of this study are to explore potential factors influencing young people’s eHealth literacy and explore the underlying constructs of the eHealth Literacy Scale (eHEALS) in a population of UK university students. Methods A total of 188 undergraduate psychology students from a large UK University were recruited as an opportunity sample. Of these, 88.8% (167/188) of participants were female with a mean age of 20.13 (SD 2.16) years and the majority were White British (159/188, 84.6%). Employing a cross-sectional design TYAs completed the following measures exploring eHealth literacy (eHEALS): Irrational Health Belief Scale; Newest Vital Sign (NVS), a measure of functional health literacy; Need for Cognition Scale, a preference for effortful cognitive activity; and General Self-Efficacy (GSE) Scale, exploring personal agency and confidence. The eHEALS was also subject to exploratory factor analysis (EFA), for which in addition to the total variance explained, the scree plot, eigenvalues, and factor loadings were assessed to verify the structure. Results eHEALS and GSE were significantly positively correlated (r=0.28, P<.001) and hierarchical linear modeling revealed GSE as the significant predictor of scores on the eHEALS (F1,186=16.16, P<.001, R2=0.08), accounting for 8.0% of the variance. Other notable relationships were GSE and need for cognition (NFC) were also positively correlated (r=0.33, P<.001), and NFC and irrational health beliefs were significantly negatively correlated (r=–.14, P=.03). Using Spearman correlations, GSE and NVS (rs=0.14, P=.04) and NFC and NVS (rs=0.19, P=.003) were positively correlated. An EFA revealed the scale to be stable and identified a 2-factor structure related to information acquisition and information application. Conclusions This is the first study in the UK to explore relationships between these key variables and verify the structure of the eHEALS in a TYA population in the UK. The findings that self-efficacy has a major influence firmly consolidate its status as fundamental to the development of eHealth literacy. Future studies will explore the influence of body image and the development of eHealth literacy in more diverse TYA populations.
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Tariq, Amina, Shanchita R. Khan, and Amna Basharat. "Internet Use, eHealth Literacy, and Dietary Supplement Use Among Young Adults in Pakistan: Cross-Sectional Study." Journal of Medical Internet Research 22, no. 6 (June 10, 2020): e17014. http://dx.doi.org/10.2196/17014.
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Background Increased access to the internet has facilitated widespread availability of health information. Thus, electronic health (eHealth) literacy—the ability to seek, find, understand, and appraise health information from electronic resources and apply that knowledge in making a health-related decision—is a crucial skill. Despite the increasing use of the internet as a source of health information in developing countries, only a few studies have examined the eHealth literacy of young adults, who frequently use the internet to access health information in these developing countries. Objective The aim of this study was to assess the patterns of internet use and eHealth literacy levels among university students pursuing a non–health-related degree in Pakistan. We also examined the association of the eHealth literacy levels of these young adults with their physical activity levels and dietary supplement intake. Methods Students from 2 leading engineering universities in Pakistan were invited to participate in a cross-sectional anonymous web-based survey in order to collect data on their internet use, eHealth literacy, and dietary supplement intake. Of the 900 eligible university students who were invited to participate, 505 (56.1%) students who completed the questionnaire were included in the analysis. The findings were converted to median values and frequency analyses were performed. The associations between the variables were determined using the chi-square test; P≤.05 was considered significant. Results In this study, the median eHealth literacy scale (eHEALS) score was 29, which did not vary across gender. The most common type of health-related information that was searched by the participants was that related to maintaining a healthy lifestyle (305/505, 60.4%). Participants with high eHEALS scores were those who used the internet frequently for finding people with similar health issues (P<.001). The use of specific social media platforms was not associated with the perceived eHealth literacy levels. Neither the frequency of physical activity nor the dietary supplement use was associated with the eHealth literacy of the participants. Conclusions University students in non–health-related disciplines in Pakistan expressed high confidence in their skills to find health-related information on the internet, as indicated by the aggregate eHEALS scores. However, the findings of our study show that the perceived eHealth literacy was not associated with health behaviors such as physical activity and dietary supplement intake. Further research is necessary to investigate the extent to which eHealth literacy can be considered as a panacea for solving public health challenges in developing countries.
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Wannheden, Carolina, Ulrica von Thiele Schwarz, Claes-Göran Östenson, Karin Pukk Härenstam, and Terese Stenfors. "What’s the Name of the Game? The Impact of eHealth on Productive Interactions in Chronic Care Management." Sustainability 13, no. 9 (May 7, 2021): 5221. http://dx.doi.org/10.3390/su13095221.
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Chronic care management is dependent on productive interactions between patients and healthcare professionals. Digital health technologies (eHealth) open up new possibilities for improving the quality of care, but there is a limited understanding of what productive interactions entail. This study explores characteristics of productive interactions to support self-care and healthcare in the context of eHealth use in diabetes care. We collected qualitative data based on interviews with nurses and responses to open-ended survey questions from patients, prior to and post using an eHealth service for self-monitoring and digital communication. We found that eHealth’s influence on productive interactions was characterized by unconstrained access, health parameter surveillance, and data-driven feedback, with implications for self-care and healthcare. Our findings indicate that eHealth perforates the boundaries that define interactions under traditional, non-digital care. This was manifested in expressions of uncertainty and in blurred boundaries between self-care and healthcare. We conclude that the attainment of a sustainable eHealth ecosystem will require healthcare to acknowledge eHealth as a disruptive change that may require re-organization to optimally support the productive use of eHealth services for both patients and staff, which includes agreement on new routines, as well as social interaction rules.
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Wångdahl, Josefin, Maria Jaensson, Karuna Dahlberg, and Ulrica Nilsson. "The Swedish Version of the Electronic Health Literacy Scale: Prospective Psychometric Evaluation Study Including Thresholds Levels." JMIR mHealth and uHealth 8, no. 2 (February 24, 2020): e16316. http://dx.doi.org/10.2196/16316.
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Background To enhance the efficacy of information and communication, health care has increasingly turned to digitalization. Electronic health (eHealth) is an important factor that influences the use and receipt of benefits from Web-based health resources. Consequently, the concept of eHealth literacy has emerged, and in 2006 Norman and Skinner developed an 8-item self-report instrument to measure these skills: the eHealth Literacy Scale (eHEALS). However, the eHEALS has not been tested for reliability and validity in the general Swedish population and no threshold values have been established. Objective The aim of this study was to translate and adapt eHEALS into a Swedish version; evaluate convergent validity and psychometric properties; and determine threshold levels for inadequate, problematic, and sufficient eHealth literacy. Methods Prospective psychometric evaluation study included 323 participants equally distributed between sexes with a mean age of 49 years recruited from 12 different arenas. Results There were some difficulties translating the English concept health resources. This resulted in this concept being translated as health information (ie, Hälsoinformation in Swedish). The eHEALS total score was 29.3 (SD 6.2), Cronbach alpha .94, Spearman-Brown coefficient .96, and response rate 94.6%. All a priori hypotheses were confirmed, supporting convergent validity. The test-retest reliability indicated an almost perfect agreement, .86 (P<.001). An exploratory factor analysis found one component explaining 64% of the total variance. No floor or ceiling effect was noted. Thresholds levels were set at 8 to 20 = inadequate, 21 to 26 = problematic, and 27 to 40 = sufficient, and there were no significant differences in distribution of the three levels between the Swedish version of eHEALS and the HLS-EU-Q16. Conclusions The Swedish version of eHEALS was assessed as being unidimensional with high internal consistency of the instrument, making the reliability adequate. Adapted threshold levels for inadequate, problematic, and sufficient levels of eHealth literacy seem to be relevant. However, there are some linguistic issues relating to the concept of health resources.
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Guo, Ziqiu, Sheng Zhi Zhao, Ningyuan Guo, Yongda Wu, Xue Weng, Janet Yuen-Ha Wong, Tai Hing Lam, and Man Ping Wang. "Socioeconomic Disparities in eHealth Literacy and Preventive Behaviors During the COVID-19 Pandemic in Hong Kong: Cross-sectional Study." Journal of Medical Internet Research 23, no. 4 (April 14, 2021): e24577. http://dx.doi.org/10.2196/24577.
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Background eHealth literacy can potentially facilitate web-based information seeking and taking informed measures. Objective This study aimed to evaluate socioeconomic disparities in eHealth literacy and seeking of web-based information on COVID-19, and their associations with COVID-19 preventive behaviors. Methods The COVID-19 Health Information Survey (CoVHIns), using telephonic (n=500) and web-based surveys (n=1001), was conducted among adults in Hong Kong in April 2020. The Chinese eHealth literacy scale (eHEALS; score range 8-40) was used to measure eHealth literacy. COVID-19 preventive behaviors included wearing surgical masks, wearing fabric masks, washing hands, social distancing, and adding water or bleach to the household drainage system. Adjusted beta coefficients and the slope indices of inequality for the eHEALS score by socioeconomic status, adjusted odds ratios (aORs) for seeking of web-based information on COVID-19 by socioeconomic status, and aORs for the high adherence to preventive behaviors by the eHEALS score and seeking of web-based information on COVID-19 were calculated. Results The mean eHEALS score was 26.10 (SD 7.70). Age was inversely associated with the eHEALS score, but education and personal income were positively associated with the eHEALS score and seeking of web-based information on COVID-19 (for all, P for trend<.05). Participants who sought web-based information on COVID-19 showed high adherence to the practice of wearing surgical masks (aOR 1.56, 95% CI 1.15-2.13), washing hands (aOR 1.33, 95% CI 1.05-1.71), social distancing (aOR 1.48, 95% CI 1.14-1.93), and adding water or bleach to the household drainage system (aOR 1.67, 95% CI 1.28-2.18). Those with the highest eHEALS score displayed high adherence to the practice of wearing surgical masks (aOR 3.84, 95% CI 1.63-9.05), washing hands (aOR 4.14, 95% CI 2.46-6.96), social distancing (aOR 2.25, 95% CI 1.39-3.65), and adding water or bleach to the household drainage system (aOR 1.94, 95% CI 1.19-3.16), compared to those with the lowest eHEALS score. Conclusions Chinese adults with a higher socioeconomic status had higher eHealth literacy and sought more web-based information on COVID-19; both these factors were associated with a high adherence to the guidelines for preventive behaviors during the COVID-19 pandemic.
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Lee, Jiyeon, Eun-Hyun Lee, and Duckhee Chae. "eHealth Literacy Instruments: Systematic Review of Measurement Properties." Journal of Medical Internet Research 23, no. 11 (November 15, 2021): e30644. http://dx.doi.org/10.2196/30644.
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Background The internet is now a major source of health information. With the growth of internet users, eHealth literacy has emerged as a new concept for digital health care. Therefore, health professionals need to consider the eHealth literacy of consumers when providing care utilizing digital health technologies. Objective This study aimed to identify currently available eHealth literacy instruments and evaluate their measurement properties to provide robust evidence to researchers and clinicians who are selecting an eHealth literacy instrument. Methods We conducted a systematic review and meta-analysis of self-reported eHealth literacy instruments by applying the updated COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) methodology. Results This study included 7 instruments from 41 articles describing 57 psychometric studies, as identified in 4 databases (PubMed, CINAHL, Embase, and PsycInfo). No eHealth literacy instrument provided evidence for all measurement properties. The eHealth literacy scale (eHEALS) was originally developed with a single-factor structure under the definition of eHealth literacy before the rise of social media and the mobile web. That instrument was evaluated in 18 different languages and 26 countries, involving diverse populations. However, various other factor structures were exhibited: 7 types of two-factor structures, 3 types of three-factor structures, and 1 bifactor structure. The transactional eHealth literacy instrument (TeHLI) was developed to reflect the broader concept of eHealth literacy and was demonstrated to have a sufficient low-quality and very low-quality evidence for content validity (relevance, comprehensiveness, and comprehensibility) and sufficient high-quality evidence for structural validity and internal consistency; however, that instrument has rarely been evaluated. Conclusions The eHealth literacy scale was the most frequently investigated instrument. However, it is strongly recommended that the instrument's content be updated to reflect recent advancements in digital health technologies. In addition, the transactional eHealth literacy instrument needs improvements in content validity and further psychometric studies to increase the credibility of its synthesized evidence.
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Lee, Jiyeon, Eun-Hyun Lee, and Duckhee Chae. "eHealth Literacy Instruments: Systematic Review of Measurement Properties." Journal of Medical Internet Research 23, no. 11 (November 15, 2021): e30644. http://dx.doi.org/10.2196/30644.
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Background The internet is now a major source of health information. With the growth of internet users, eHealth literacy has emerged as a new concept for digital health care. Therefore, health professionals need to consider the eHealth literacy of consumers when providing care utilizing digital health technologies. Objective This study aimed to identify currently available eHealth literacy instruments and evaluate their measurement properties to provide robust evidence to researchers and clinicians who are selecting an eHealth literacy instrument. Methods We conducted a systematic review and meta-analysis of self-reported eHealth literacy instruments by applying the updated COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) methodology. Results This study included 7 instruments from 41 articles describing 57 psychometric studies, as identified in 4 databases (PubMed, CINAHL, Embase, and PsycInfo). No eHealth literacy instrument provided evidence for all measurement properties. The eHealth literacy scale (eHEALS) was originally developed with a single-factor structure under the definition of eHealth literacy before the rise of social media and the mobile web. That instrument was evaluated in 18 different languages and 26 countries, involving diverse populations. However, various other factor structures were exhibited: 7 types of two-factor structures, 3 types of three-factor structures, and 1 bifactor structure. The transactional eHealth literacy instrument (TeHLI) was developed to reflect the broader concept of eHealth literacy and was demonstrated to have a sufficient low-quality and very low-quality evidence for content validity (relevance, comprehensiveness, and comprehensibility) and sufficient high-quality evidence for structural validity and internal consistency; however, that instrument has rarely been evaluated. Conclusions The eHealth literacy scale was the most frequently investigated instrument. However, it is strongly recommended that the instrument's content be updated to reflect recent advancements in digital health technologies. In addition, the transactional eHealth literacy instrument needs improvements in content validity and further psychometric studies to increase the credibility of its synthesized evidence.
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Efthymiou, Areti, Nicos Middleton, Andreas Charalambous, and Evridiki Papastavrou. "Adapting the eHealth Literacy Scale for Carers of People With Chronic Diseases (eHeals-Carer) in a Sample of Greek and Cypriot Carers of People With Dementia: Reliability and Validation Study." Journal of Medical Internet Research 21, no. 11 (November 28, 2019): e12504. http://dx.doi.org/10.2196/12504.
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Background As the population ages, many more people will be in need of long-term care. According to a recent report by Alzheimer's Disease International and the Karolinska Institute, 84% of people with dementia are cared for at home and 16% in nursing homes. Several Web-based interventions have been developed to assist the work of carers at home. Measuring the levels of electronic health (eHealth) literacy is of top priority to facilitate inclusion of this population and develop training programs to enhance eHealth literacy skills. Objective This study aimed to adapt the eHealth Literacy Scale (eHeals) for carers of people with dementia, who speak Greek as their native language and live in Greece and Cyprus, and to test the reliability and validity of the scale for carers. Methods The content validity of the eHealth Literacy Scale for Carers of People With Chronic Diseases (eHeals-Carer) was assessed with an expert panel (N=10). A descriptive study with face-to-face interviews among 101 primary carers of people with dementia was conducted. In addition to the eHeals-Carer to assess their perceived eHealth literacy, participants responded to a brief questionnaire regarding characteristics of internet use and provided sociodemographic data. The internal consistency of the tool and the construct validity via an exploratory factor analysis (EFA) were explored. Results The Mean Item-Level Content Validity Index (CVI) and Scale-Level CVI Average was 0.93. The participants were mostly women (75.2%, 76/101), aged less than 60 years (67.3%, 68/101) with secondary education. The internal consistency was estimated at a Cronbach alpha of .83. Two factors were extracted from the EFA: information seeking questions 1 to 5 (factor 1) and evaluation questions 6 to 8 (factor 2). Conclusions eHeals-Carer is the first perceived eHealth literacy tool adapted for carers of people with dementia. The use of Web-based services available for carers could help them and improve the health care system in the long term. In Greece and Cyprus, there is a lack of services, and improving the digital skills of carers could provide them with the means to support themselves at home and improve care provision. International Registered Report Identifier (IRRID) RR2-10.2196/resprot.8080
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Broomhead, Sean C., Maurice Mars, Richard E. Scott, and Tom Jones. "EHealth Investment Appraisal in Africa: A Scoping Review." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 58 (January 2021): 004695802110599. http://dx.doi.org/10.1177/00469580211059999.
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eHealth is an opportunity cost, competing for limited available funds with other health priorities such as clinics, vaccinations, medicines and even salaries. As such, it should be appraised for probable impact prior to allocation of funds. This is especially pertinent as recognition grows for the role of eHealth in attaining Universal Health Coverage. Despite optimism about eHealth’s potential role, in Africa there remain insufficient data and skills for adequate economic appraisals to select optimal investments from numerous competing initiatives. The aim of this review is to identify eHealth investment appraisal approaches and tools that have been used in African countries, describe their characteristics and make recommendations regarding African eHealth investment appraisal in the face of limited data and expertise. Methods: Literature on eHealth investment appraisals conducted in African countries and published between January 1, 2010 and June 30, 2020 was reviewed. Selected papers’ investment appraisal characteristics were assessed using the Joanna Briggs Institute checklist for economic evaluations and a newly developed Five-Case Model for Digital Health (FCM-DH) checklist for investment appraisal. 5 papers met inclusion criteria. Their assessments revealed important appraisal gaps. In particular, none of the papers addressed risk exposure, affordability, adjustment for optimism bias, clear delivery milestones, practical plans for implementation, change management or procurement, and only 1 paper described plans for building partnerships. Discussion: Using this insight, an extended 5-Case Model is proposed as the foundation of an African eHealth investment appraisal framework. This, combined with building local eHealth appraisal capabilities, may promote optimal eHealth investment decisions, strengthen implementations and improve the number and quality of related publications.
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Park, Hyejin, Geraldine Martorella, and Glenna Schluck. "Electronic health literacy among adults with chronic pain: A descriptive, cross-sectional survey." International Health Trends and Perspectives 1, no. 3 (December 1, 2021): 390–403. http://dx.doi.org/10.32920/ihtp.v1i3.1469.
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Background: Approximately 100 million American adults are living with chronic pain, which costs the healthcare system an average of $560–635 billion each year. Levels of health literacy and ehealth literacy are important factors in determining a patient’s capacity to manage pain and the multidimensional impact of pain. To our knowledge, few studies have specifically examined the level of ehealth literacy and its association with health literacy among chronic pain patients. The purpose of this study was to 1) assess the levels of health literacy and ehealth literacy in adults with chronic pain, and 2) examine the relationship between health literacy and ehealth literacy skills among adults diagnosed and living with chronic pain. Methods: A non-experimental, descriptive cross-sectional survey was distributed to adults with chronic pain. A total of 196 participants were asked to complete questionnaires related to demographic characteristics, ehealth literacy (eHEALS), and health literacy (HLQ). Descriptive statistics were calculated to summarize data from all the scales used in the study. Results: The average level of ehealth literacy was 32.6 (SD 4.4) out of 40. The level of health literacy was measured by four subscales: having sufficient information to manage my health (mean=2.8; SD=0.55), appraisal of health information (mean=3.27; SD=0.41), ability to find good health information (mean=3.68; SD=0.45), and understanding health information well enough to know what to do (mean=3.66; SD=0.48). Two subscales (i.e., appraisal of health information, ability to find good health information) were significant in predicting ehealth literacy total score. Discussion and Conclusions: Examining ehealth literacy and health literacy can assist in the dissemination of accessible and understandable chronic-pain-related health information for individuals of all health literacy levels. In addition, this will allow the development of interventions for enhancing ehealth literacy skills and/or usability of web-based information for adults with chronic pain.
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Mitsuhashi, Toshiharu. "Effects of two-week e-learning on eHealth literacy: a randomized controlled trial of Japanese Internet users." PeerJ 6 (July 13, 2018): e5251. http://dx.doi.org/10.7717/peerj.5251.
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Background The Internet is widely used as a source of information by people searching for medical or healthcare information. However, information found on the Internet has several drawbacks, and the ability to consume accurate health information on the Internet (eHealth literacy) is increasingly important. This study’s goal was to clarify the extent to which eHealth literacy is improved after e-learning in a randomized controlled trial. Methods Data were collected on 301 Japanese adults through an online survey. Participants were assigned to the intervention (e-learning about eHealth literacy) group or the control group in a 1:1 ratio. The intervention group included 148 participants, and 153 participants were in the control group. The participants provided information at baseline on demographic characteristics, self-rated health, and frequency of Internet searching. The eHealth Literacy Scale (eHEALS), which was the main measure of eHealth literacy, and data on secondary outcomes (the Healthy Eating Literacy Scale and skill for evaluating retrieved search results) were obtained at baseline and at follow-up. The score difference was calculated by subtracting the score at baseline from the score at follow-up. Linear regression analysis and multinomial regression analysis were performed using the differences in score as the dependent variables and the intervention as the explanatory variable. Intention-to-treat analysis was employed. Results The results from participants who responded to all of the questions both times were analyzed (134 in the intervention group and 148 in the control group). eHEALS increased 1.57 points due to the intervention effect (Δ score change = 1.57; 95% CI [0.09–3.05]; p = 0.037). Skills for evaluating retrieved search results improved more in the intervention group than in the control group (relative risk ratio = 2.47; 95% Confidence Interval: 1.33, 4.59; p = 0.004). There were no large differences at baseline between the intervention and control groups in the eHEALS, Healthy Eating Literacy scale, or skill for evaluating retrieved search results. However, at follow-up, the intervention group had improved more than the control group on both the eHEALS and skill for evaluating retrieved search results. Discussion eHealth literacy improved after the e-learning, as evidenced by the change to the eHEALS scores and increased skill for evaluating retrieved search results. There was no significant effect of e-learning, which did not include content on healthy eating, on the Healthy Eating Literacy Scale scores. This indicates that scores did not increase much due to effects other than e-learning, as is sometimes seen with the Hawthorne effect. Although it was statistically significant, the effect size was small. Therefore, future research is necessary to verify the clinical implications. In sum, this study suggests that e-learning is an effective way to improve eHealth literacy.
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Valdovinos, Cristina, Giselle Perez-Aguilar, Roberto Gonzalez Huerta, Chesca Barrios, Griselda Gutiererrez, Carmen Mendez, Anshu Abhat, Gerardo Moreno, Arleen Brown, and Alejandra Casillas. "Electronic Health Literacy among Linguistically Diverse Patients in the Los Angeles County Safety Net Health System." Ethnicity & Disease 32, no. 1 (January 20, 2022): 21–30. http://dx.doi.org/10.18865/ed.32.1.21.
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Background: Electronic health (eHealth) literacy may affect telehealth uptake, yet few studies have evaluated eHealth literacy in underserved populations.Objective: The objective of this study was to describe technology access and use patterns as well as eHealth literacy levels among English-speaking and LEP patients in a Los Angeles safety net health system.Methods: Patients, aged ≥18 years with a diagnosis of diabetes mellitus and/or hypertension, and their caregivers were recruited from three primary care safety-net clinics in Los Angeles County (California) between June – July 2017. Participants’ electronic health literacy was assessed by the eHealth Literacy Scale (eHEALS); participants were also asked about technology access and use. We examined these measures in English-speaking and limited English proficient (LEP) Spanish-speaking patients.Results: A total of 71 participants (62 patients and 9 caregivers) completed the questionnaire. The mean age of the respondents was 56 years old. More than half of participants used a phone that could connect to the Internet (67%). The mean score for 10 eHEALS items was in the moderate range (26/50 points). There was no difference in mean eHEALS between language groups. However, 47% of Spanish-speaking participants “agreed/strongly agreed” that they knew how to use the Internet to answer their health questions, compared to 68% of English-speaking participants (P<.05).Conclusions: In this sample of patients from a diverse safety net population, perceived skills and confidence in engaging with electronic health systems were low, particularly among LEP Spanish-speakers, despite moderate levels of electronic health literacy. More studies are needed among diverse patient populations to better assess eHealth literacy and patients’ digital readiness, and to examine how these patient metrics directly impact telehealth utilization.Ethn Dis. 2022;32(1):21-30; doi:10.18865/ed.32.1.21
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Vis, Christiaan, Leah Bührmann, Heleen Riper, and Hans C. Ossebaard. "Health technology assessment frameworks for eHealth: A systematic review." International Journal of Technology Assessment in Health Care 36, no. 3 (April 16, 2020): 204–16. http://dx.doi.org/10.1017/s026646232000015x.
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ObjectivesTraditionally, health technology assessment (HTA) focuses on assessing the impact of pharmaceutical technologies on health and care. Resources are scarce and policy makers aim to achieve effective, accessible health care. eHealth innovations are increasingly more integrated in all healthcare domains. However, how eHealth is assessed prior to its implementation in care practices is unclear. To support evidence-informed policy making, this study aimed to identify frameworks and methods for assessing eHealth's impact on health care.MethodsThe scientific literature in five bibliographical databases was systematically reviewed. Articles were included if the study was conducted in a clinical setting, used an HTA framework and assessed an eHealth service. A systematic qualitative narrative approach was applied for analysis and reporting.ResultsTwenty-one HTA frameworks were identified in twenty-three articles. All frameworks addressed outcomes related to the technical performance and functionalities of eHealth service under assessment. The majority also addressed costs (n = 19), clinical outcomes (n = 14), organizational (n = 15) and system level aspects (n = 13). Most frameworks can be classified as dimensional (n = 13), followed by staged (n = 3), hybrid (n = 3), and business modeling frameworks (n = 2). Six frameworks specified assessment outcomes and methods.ConclusionsHTA frameworks are available for a-priori impact assessment of eHealth services. The frameworks vary in assessment outcomes, methods, and specificity. Demonstrated applicability in practice is limited. Recommendations include standardization of: (i) reporting characteristics of eHealth services, and (ii) specifying assessment outcomes and methods following a stepped-approach tailored to the functional characteristics of eHealth services. Standardization might improve the quality and comparability of eHTA assessments.
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Aggarwal, Apoorva, Sanjana Bhasin, Prerak Maheshwari, Anjana Manogna Bhaskar Sirivella, Disha Kalra, Nithin Kumar, T. Rekha, Bhaskaran Unnikrishnan, Prasanna Mithra, and Ramesh Holla. "IJCM_133A: E- Health Literacy and Satisfaction regarding Medical Care among Patients attending a Tertiary Care Hospital in Mangalore." Indian Journal of Community Medicine 49, Suppl 1 (April 2024): S39. http://dx.doi.org/10.4103/ijcm.ijcm_abstract133.
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Background: Health literacy is crucial for understanding health information and making informed decisions. It encompasses the ability to obtain, process, and understand basic health information. Factors like education, income, and age influence health literacy, impacting health outcomes negatively when low. E Health literacy extends to navigating electronic health resources. Patient-doctor communication suffers when doctors overestimate patient literacy. Poor health literacy leads to misunderstandings, medication errors, and poorer health outcomes. In today’s healthcare landscape, patient satisfaction is key. Understanding the link between eHealth literacy, communication, compliance, and satisfaction is vital. The study aims to evaluate patients’ e-health literacy levels, evaluate the degree of patient satisfaction with healthcare services, to ascertain the relationship between patient satisfaction and eHealth literacy. Methodology: The study involved 234 patients who visited the hospitals affiliated to Kasturba Medical College, Mangalore. eHealth literacy was assessed using eHEALS, patient satisfaction was assessed using Patient Satisfaction Questionnaire Short Form (PSQ-18). The correlation between eHealth literacy scores and patient satisfaction scores was tested using Pearson correlation coefficient where P is less than 0.05 was considered statistically significant correlation. Results: Preliminary findings suggest that majority of the participants found the Internet to be useful in making decisions about health. The results of our study show that 65% of our participants have good eHealth literacy and 27.8% have moderate literacy. The comparison of patient satisfaction based on eHealth literacy showed that there was no significant difference in patient satisfaction between participants who had good literacy or poor literacy. Conclusion: Both eHealth Literacy and Patient Satisfaction among our study participants were good, however there was no correlation found between eHealth Literacy and Patient Satisfaction.
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Lee, Jung Jae, Chung Yan Poon, Siobhan O'Connor, Janet Yuen Ha Wong, Jojo Yan Yan Kwok, Edmond Pui Hang Choi, Wing Nga Tsang, and Man Ping Wang. "Associations of eHealth literacy and knowledge with preventive behaviours and psychological distress during the COVID-19 pandemic: a population-based online survey." BMJ Open 13, no. 12 (December 2023): e069514. http://dx.doi.org/10.1136/bmjopen-2022-069514.
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ObjectivesTo compare the associations of COVID-19 preventive behaviours and depressive and anxiety symptoms with eHealth literacy and COVID-19 knowledge among Korean adults.DesignA cross-sectional online survey was conducted in April 2020.SettingSeoul metropolitan area in South Korea.Participants1057 Korean adults were recruited.Main outcome measuresAssociations between eHealth literacy, COVID-19 knowledge, COVID-19 preventive behaviours and psychological distress were computed using Pearson’s correlation and logistic regression analyses. eHealth literacy, COVID-19 knowledge, COVID-19 preventive behaviours and psychological distress were weighted by sex and age distribution of the general population in Seoul Metropolitan area.Results68.40% (n=723) perceived high eHealth literacy level (eHEALS ≥26), while 57.43% (n=605) had high levels of COVID-19 knowledge (score ≥25). No significant association between eHealth literacy and COVID-19 knowledge was identified (r=0.05, p=0.09). eHealth literacy and COVID-19 knowledge were significantly associated with COVID-19 preventive behaviours (aOR=1.99, 95% CI 1.51 to 2.62 L; aOR=1.81, 95% CI 1.40 to 2.34, respectively). High eHealth literacy was significantly associated with anxiety symptom (aOR=1.71, 95% CI 1.18 to 2.47) and depressive symptom (aOR=1.69, 95% CI 1.24 to 2.30). COVID-19 knowledge had negative and no associations with the symptoms (aOR=0.62, 95% CI 0.46 to 0.86; aOR=0.79, 95% CI 0.60 to 1.03, respectively). High eHealth literacy with low COVID-19 knowledge was positively and significantly associated with COVID-19 preventive behaviours (aOR=2.30, 95% CI 1.52 to 3.43), and anxiety (aOR=1.81, 95% CI 1.09 to 3.01) and depressive symptoms (aOR=2.24, 95% CI 1.41 to 3.55). High eHealth literacy with high COVID-19 knowledge were significantly associated with more preventive behaviours (aOR=3.66, 95% CI 2.47 to 5.42) but no significant associations with anxiety and depressive symptoms.ConclusionWe identified that eHealth literacy and COVID-19 knowledge were not associated each other, and differently associated with individuals’ COVID-19 preventive behaviours and psychological well-being. Public health strategies should pay attention to enhancing both eHealth literacy and COVID-19 knowledge levels in the public to maximise their COVID-19 preventive behaviours and mitigate their psychological distress during COVID-19 pandemic.
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Bevilacqua, Roberta, Stefano Strano, Mirko Di Rosa, Cinzia Giammarchi, Katerina Katka Cerna, Claudia Mueller, and Elvira Maranesi. "eHealth Literacy: From Theory to Clinical Application for Digital Health Improvement. Results from the ACCESS Training Experience." International Journal of Environmental Research and Public Health 18, no. 22 (November 10, 2021): 11800. http://dx.doi.org/10.3390/ijerph182211800.
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Skills, knowledge, and awareness of digital and technological tools are essential to improve the state of well-being and health of older adults and also to mitigate the condition of social isolation in the aging process. For this reason, it is necessary to implement a social learning of electronic/digital tools for health of older people to support the achievement of eHealth and digital competences. The paper reports the results of an Italian innovative eHealth training for the European project ACCESS. The training has been based on blended didactical and interactive educational techniques, aimed at collecting as many points of view as possible from older adults. A total of 58 older adults were recruited to attend a four-week training program, which included five modules. The results showed a statistical significant difference between the eHealth Literacy Scale (eHEALS) mean value before and after the course. A significant negative correlation was found between eHEALS and positive/total Survey of Technology Use (SOTU), suggesting an inverse relationship between positive/total SOTU and eHEALS. There is a strong positive and statistically significant relationship between satisfaction with the training and eHEALS. The results indicate that the intervention increased the digital competences of participants connected to health.
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Wu, Jingxuan, Huamao Peng, Zhiyu Fan, and Heng Zhao. "FAMILY GUIDANCE WEAKENS AN EFFECT OF OLD PEOPLE’S EDUCATIONAL ATTAINMENT ON EHEALTH LITERACY BY INTERNET EXPERIENCE." Innovation in Aging 7, Supplement_1 (December 1, 2023): 953–54. http://dx.doi.org/10.1093/geroni/igad104.3063.
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Abstract Background In the emerging era of digitalization, eHealth literacy is of great importance in older adults’ health and social adaptation. Objective: Explore the effect of educational attainment on eHealth literacy among older adults and examine the mediating role of Internet experience and the moderating role of guidance on the Internet from family members to reveal the underlying mechanism. Method: Four hundred and ninety-one older adults (aged 59–76 years old, Mage = 65.69±4.41) completed the eHealth Literacy Scale (eHEALS) and Internet Experience among Older Adults Scale (IEOAS) and reported their educational attainment and the frequency of family members guiding them on how to use the Internet. Results eHealth literacy of older adults with lower educational attainment did not reach an intermediate level (M = 2.46±1.17). It was significantly lower than that of older adults with higher educational attainment whose scores were beyond the intermediate level (M = 3.43±0.90). Internet experience mediated the effect of older adults’ educational attainment on eHealth literacy. This mediation model was moderated by family members’ guidance on the Internet. Discussion our results have implications for understanding how educational attainment reinforced the inequality in eHealth literacy among older adults and how to address this gap. Specifically, If older adults with lower educational attainment are given guidance on Internet use by their family members frequently, they will no longer be at a disadvantage in accumulating Internet experience and further cultivate eHealth literacy to search for, distinguish, and take advantage of health information on the Internet well.
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Marsall, Matthias, Gerrit Engelmann, Eva-Maria Skoda, Martin Teufel, and Alexander Bäuerle. "Measuring Electronic Health Literacy: Development, Validation, and Test of Measurement Invariance of a Revised German Version of the eHealth Literacy Scale." Journal of Medical Internet Research 24, no. 2 (February 2, 2022): e28252. http://dx.doi.org/10.2196/28252.
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Background The World Wide Web has become an essential source of health information. Nevertheless, the amount and quality of information provided may lead to information overload. Therefore, people need certain skills to search for, identify, and evaluate information from the internet. In the context of health information, these competencies are summarized as the construct of eHealth literacy. Previous research has highlighted the relevance of eHealth literacy in terms of health-related outcomes. However, the existing instrument assessing eHealth literacy in the German language reveals methodological limitations regarding test development and validation. The development and validation of a revised scale for this important construct is highly relevant. Objective The objective of this study was the development and validation of a revised German eHealth literacy scale. In particular, this study aimed to focus on high methodological and psychometric standards to provide a valid and reliable instrument for measuring eHealth literacy in the German language. Methods Two internationally validated instruments were merged to cover a wide scope of the construct of eHealth literacy and create a revised eHealth literacy scale. Translation into the German language followed scientific guidelines and recommendations to ensure content validity. Data from German-speaking people (n=470) were collected in a convenience sample from October to November 2020. Validation was performed by factor analyses. Further, correlations were performed to examine convergent, discriminant, and criterion validity. Additionally, analyses of measurement invariance of gender, age, and educational level were conducted. Results Analyses revealed a 2-factorial model of eHealth literacy. By item-reduction, the 2 factors information seeking and information appraisal were measured with 8 items reaching acceptable-to-good model fits (comparative fit index [CFI]: 0.942, Tucker Lewis index [TLI]: 0.915, root mean square error of approximation [RMSEA]: 0.127, and standardized root mean square residual [SRMR]: 0.055). Convergent validity was comprehensively confirmed by significant correlations of information seeking and information appraisal with health literacy, internet confidence, and internet anxiety. Discriminant and criterion validity were examined by correlation analyses with various scales and could partly be confirmed. Scalar level of measurement invariance for gender (CFI: 0.932, TLI: 0.923, RMSEA: 0.122, and SRMR: 0.068) and educational level (CFI: 0.937, TLI: 0.934, RMSEA: 0.112, and SRMR: 0.063) were confirmed. Measurement invariance of age was rejected. Conclusions Following scientific guidelines for translation and test validation, we developed a revised German eHealth Literacy Scale (GR-eHEALS). Our factor analyses confirmed an acceptable-to-good model fit. Construct validation in terms of convergent, discriminant, and criterion validity could mainly be confirmed. Our findings provide evidence for measurement invariance of the instrument regarding gender and educational level. The newly revised GR-eHEALS questionnaire represents a valid instrument to measure the important health-related construct eHealth literacy.
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Pedersen, Natalia, Peter Thielsen, Lars Martinsen, Mette Bennedsen, Anne Haaber, Ebbe Langholz, Zsuzsanna Végh, et al. "eHealth." Inflammatory Bowel Diseases 20, no. 12 (December 2014): 2276–85. http://dx.doi.org/10.1097/mib.0000000000000199.
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Zvárová, J., and B. Blobel. "eHealth." Methods of Information in Medicine 49, no. 02 (2010): 121–22. http://dx.doi.org/10.1055/s-0038-1625240.
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Wijnen, Ria, and Toon Verlaan. "eHealth." Geron 19, no. 2 (June 2017): 3. http://dx.doi.org/10.1007/s40718-017-0021-x.
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Lin, Chung-Ying, Maryam Ganji, Mark D. Griffiths, Marie Ernsth Bravell, Anders Broström, and Amir H. Pakpour. "Mediated effects of insomnia, psychological distress and medication adherence in the association of eHealth literacy and cardiac events among Iranian older patients with heart failure: a longitudinal study." European Journal of Cardiovascular Nursing 19, no. 2 (September 13, 2019): 155–64. http://dx.doi.org/10.1177/1474515119873648.
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Background: Given the importance of improving health for patients with heart failure, the present study examined the temporal associations between eHealth literacy, insomnia, psychological distress, medication adherence, quality of life and cardiac events among older patients with heart failure. Methods: With a longitudinal design older patients with echocardiography verified heart failure ( N=468; 50.4% New York Heart Association class II, mean age 69.3±7.3 years; 238 men) in need of cardiac care at seven Iranian university outpatient clinics went through clinical examinations and completed the following questionnaires at baseline: eHealth literacy scale (eHEALS, assessing eHealth literacy); 5-item medication adherence report scale (MARS-5, assessing medication adherence); Minnesota living with heart failure questionnaire (MLHFQ, assessing quality of life); insomnia severity index (ISI, assessing insomnia); and hospital anxiety and depression scale (HADS, assessing psychological distress). All the patients completed the ISI and HADS again 3 months later; and the MARS-5 6 months later. Also, their cardiac events were collected 18 months later. Three mediation models were then conducted. Results: eHealth literacy had direct and indirect effects (through insomnia and psychological distress) on medication adherence and quality of life. Moreover, eHealth literacy had protecting effects on cardiac events (hazard ratio (HR) 0.53; 95% confidence interval (CI) 0.37, 0.65) through the mediators of insomnia (HR 0.19; 95% CI 0.15, 0.26), psychological distress (HR 0.08; 95% CI 0.05, 0.12) and medication adherence (HR 0.05; 95% CI 0.04, 0.08). Conclusion: As eHealth literacy was a protector for patients with heart failure, healthcare providers may plan effective programmes to improve eHealth literacy for the population. Additional benefits of improving eHealth literacy in heart failure may be decreased insomnia and psychological distress, improved quality of life, as well as decreased cardiovascular events.
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Solhjoo, Niloofar, Nader Naghshineh, and Fatima Fahimnia. "Veterinarians' information Prescription and Clients' eHealth Literacy." Journal of the Canadian Health Libraries Association / Journal de l'Association des bibliothèques de la santé du Canada 40, no. 2 (July 9, 2019): 32–44. http://dx.doi.org/10.29173/jchla29377.
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Introduction: The aim of this study is to investigate the relationship between pet owner’s combined knowledge, comfort, and perceived skills at finding, evaluating, applying online pet health information, and the application of the information prescription (IP) provided for pet owners education on the internet.
Methods: Thirty telephone interviews were conducted followed by a questionnaire of eHealth Literacy Scale (eHEALS) with pet owners after receiving an IP with a suggested websites in addition to their customary veterinary services in a vet clinic at the center of Tehran, Iran. Qualitative and quantitative data were merged to explore differences and similarities among respondents with different eHealth literacy levels.
Results: Results indicate that pet owners with higher score of eHealth literacy more accessed the suggested websites and reported positive feelings about this addition to their veterinary services. Similarly, among the eight-item self-reported eHealth Literacy skills, perceived skills at evaluating and applying, were significantly associated with the use of IPs. Lastly eHealth literacy level was significantly associated with the outcomes of prescribed information, such as veterinarians-client communication outcome and learning outcomes.
Conclusion: Disparities in application of the veterinarian’s IPs for online pet healthcare information, and its outcomes are associated with different eHealth literacy skills. Veterinarians should collaborate with information specialists and librarians to perform education efforts to raise awareness on online pet health information quality and impact of veterinarian directed information prescription especially among low health literate owners.
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Milanti, Ariesta, Dorothy Ngo Sheung Chan, Kai Chow Choi, and Winnie Kwok Wei So. "eHealth literacy of migrant domestic workers in Hong Kong in the COVID-19 pandemic: A mixed methods study." PLOS ONE 19, no. 4 (April 18, 2024): e0296893. http://dx.doi.org/10.1371/journal.pone.0296893.
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Background Health communication in the COVID-19 pandemic can be effectively implemented if all members of the populations, including marginalized population such as migrant domestic workers (MDWs), have good eHealth literacy. Lessons learned during this critical period may help improve planning and mitigation of the impacts of future health crises. Methods This study aimed to examine and explore the eHealth literacy levels of the MDWs in Hong Kong during the COVID-19 pandemic by using a convergent mixed methods research design. A total of 1156 Hong Kong MDWs participated in a paper-based survey using a multistage cluster random sampling design for the quantitative component. eHealth literacy was measured using an eHealth literacy Scale (eHEALS). For the qualitative component, a purposive sampling of 19 MDWs participated in face-to-face, semi-structured, in-depth interviews. Descriptive statistics and multiple regression analyses were used to carry out the quantitative analysis, while thematic analysis was used for the qualitative analysis. Both quantitative and qualitative data were merged and integrated for mixed-methods analysis. Results The meta-inferences of the quantitative and qualitative results mainly confirmed that MDWs in Hong Kong had good levels of eHealth literacy. The use of Instagram, YouTube and WhatsApp as the COVID-19 information sources, in addition to having an interest in the topic of the current spread of COVID-19 together with the Hong Kong government’s policies related to COVID-19, were found to be associated with eHealth literacy. Conclusions The eHealth literacy level of MDWs in Hong Kong was shown to be good and it was influenced by the use of popular social media platforms including Instagram, YouTube, and WhatsApp. It is realistic to suggest that such platforms should be harnessed for health communication during the pandemic. Yet, regulations to combat false information on these media are also urgently needed.
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Rathnayake, Sarath, and Indrajith Prasanna Liyanage. "Cross-cultural adaptation and psychometric properties of the Sinhala version of electronic health literacy scale: A cross-sectional validation study." PLOS ONE 17, no. 4 (April 8, 2022): e0266515. http://dx.doi.org/10.1371/journal.pone.0266515.
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eHealth Literacy Scale (eHEALS) is the most widely used, valid and reliable tool to assess eHealth literacy skills, but no culturally appropriate tool exists to assess these skills among Sinhala-speaking Sri Lankans, including health professionals. This study aimed to cross-culturally adapt the original eHEALS from English to Sinhala and evaluate its psychometric properties. The study was conducted in two phases. The first phase involved translation and cross-cultural validation of the questionnaire. The second phase involved a cross-sectional survey conducted online among 268 health science students from a state university in Sri Lanka to confirm the psychometric properties of the questionnaire. An analysis of test-retest reliability was conducted with a subset of 72 students. The pre-final version of Sinhala eHEALS (Si-eHEALS) was developed following the cross-cultural adaptation process. The mean score of Si-eHEALS was 28.51±4.87. A satisfactory level of internal consistency was achieved (Cronbach’s alpha = 0.91). The test-retest reliability was acceptable (intraclass correlation coefficient -.776). Content validity index of Si-eHEALS was.97. The principal component analysis supported the unidimensionality of the scale, explaining 61.2 variance. There was a significant positive association between Si-eHEALS score with academic year (rs = .146, p = .017), self-rated internet skills (rs = .122, p = .046), usefulness of internet in health decision making (rs = .212, p < .001) and importance of ability to access health resources on the internet (rs = .230, p < .001), confirming concurrent validity. No significant difference based on gender (U = 5854, p = .550) and degree program (X2(2) = 2.965, p = .564) was found, confirming discriminant validity. In line with many previous validation studies, our study demonstrated good psychometric properties for Si-eHEALS. Si-eHEALS is a valid and reliable tool that assesses eHealth literacy in Sinhala speaking Sri Lankans, particularly health professionals.
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Duplaga, Mariusz, Karolina Sobecka, and Sylwia Wójcik. "The Reliability and Validity of the Telephone-Based and Online Polish eHealth Literacy Scale Based on Two Nationally Representative Samples." International Journal of Environmental Research and Public Health 16, no. 17 (September 3, 2019): 3216. http://dx.doi.org/10.3390/ijerph16173216.
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Adequate ehealth literacy is one of the key instruments safeguarding people against unreliable health-related information obtained from the Internet. This paper presents an assessment of the reliability and the validity of a Polish version of the ehealth literacy scale (Pl-eHEALS). The assessment was carried out on the basis of two nationally representative samples of the Polish population. In the first survey of adults at least 50 years old, the technique of computer-assisted telephone interviewing (CATI) was applied. In the second survey of young adult women (18–35 years old), the technique of computer-assisted web interviewing (CAWI) was used. The reliability and the validity of the Pl-eHEALS was analyzed. There were no floor or ceiling effects revealed in either sample. The Cronbach’s alpha coefficients were 0.90 and 0.88, and Guttman split-half coefficients were 0.89 and 0.81, respectively. Exploratory factors analysis revealed single factor models in both cases. The sum of squared loadings in the first survey was 6.090 and accounted for 58.72% of the variance. In the second survey, the sum was 5.927 and was responsible for 55.06% of the variance. Hypothesis testing showed that, for older adults, higher ehealth literacy was prevalent in the respondents who used the Internet more frequently. Among young adult women, higher readiness to use the Internet as a primary source of health-related information and to undertake specific internet health-related activities was associated with higher ehealth literacy. The analysis reported in this paper confirmed the reliability and the validity of the instrument. It should be stressed that, prior to this study, there was no validated Polish version of the eHEALS that could be used with Polish-speaking respondents.
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Lin, Chung-Ying, Anders Broström, Mark D. Griffiths, and Amir H. Pakpour. "Psychometric Evaluation of the Persian eHealth Literacy Scale (eHEALS) Among Elder Iranians With Heart Failure." Evaluation & the Health Professions 43, no. 4 (February 11, 2019): 222–29. http://dx.doi.org/10.1177/0163278719827997.
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The purpose of the present study was to examine the psychometric properties of the eHealth Literacy Scale (eHEALS) using classical test theory and modern test theory among elderly Iranian individuals with heart failure (HF). Individuals with objectively verified HF ( n = 388, 234 males, mean age = 68.9 ± 3.4) completed the (i) eHEALS, (ii) Hospital Anxiety and Depression Scale, (iii) Short Form 12, (iv) 9-item European Heart Failure Self-Care Behavior Scale, and (v) 5-item Medication Adherence Report Scale. Two types of analyses were carried out to evaluate the factorial structure of the eHEALS: (i) confirmatory factor analysis (CFA) in classical test theory and (ii) Rasch analysis in modern test theory. A regression model was constructed to examine the associations between eHEALS and other instruments. CFA supported the one-factor structure of the eHEALS with significant factor loadings for all items. Rasch analysis also supported the unidimensionality of the eHEALS with item fit statistics ranging between 0.5 and 1.5. The eHEALS was significantly associated with all the external criteria. The eHEALS is suitable for health-care providers to assess eHealth literacy for individuals with HF.
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Hübner, U. "What Are Complex eHealth Innovations and How Do You Measure Them?" Methods of Information in Medicine 54, no. 04 (2015): 319–27. http://dx.doi.org/10.3414/me14-05-0001.
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SummaryObjectives: eHealth and innovation are often regarded as synonyms – not least because eHealth technologies and applications are new to their users. This position paper challenges this view and aims at exploring the nature of eHealth innovation against the background of common definitions of innovation and facts from the biomedical and health informatics literature. A good understanding of what constitutes innovative eHealth developments allows the degree of innovation to be measured and interpreted.Methods: To this end, relevant biomedical and health informatics literature was searched mainly in Medline and ACM digital library. This paper presents seven facts about implementing and applying new eHealth developments hereby drawing on the experience published in the literature.Results: The facts are: 1. eHealth innovation is relative. 2. Advanced clinical practice is the yardstick. 3. Only used and usable eHealth technology can give birth to eHealth innovatio. 4. One new single eHealth function does not make a complex eHealth innovation. 5. eHealth innovation is more evolution than revolution. 6. eHealth innovation is often triggered behind the scenes; and 7. There is no eHealth innovation without sociocultural change.Conclusions: The main conclusion of the seven facts is that eHealth innovations have many ingredients: newness, availability, advanced clinical practice with proven outcomes, use and usability, the supporting environment, other context factors and the stakeholder perspectives. Measuring eHealth innovation is thus a complex matter. To this end we propose the development of a composite score that expresses comprehensively the nature of eHealth innovation and that breaks down its complexity into the three dimensions: i) eHealth adoption, ii) partnership with advanced clinical practice, and iii) use and usability of eHealth. In order to better understand the momentum and mechanisms behind eHealth innovation the fourth dimension, iv) eHealth supporting services and means, needs to be studied. Conceptualising appropriate measurement instruments also requires eHealth innovation to be distinguished from eHealth sophistication, performance and quality, although innovation is intertwined with these concepts. The demanding effort for defining eHealth innovation and measuring it properly seem worthwhile and promise advances in creating better systems. This paper thus intends to stimulate the necessary discussion.
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Wangdahl, Josefin M., Karuna Dahlberg, Maria Jaensson, and Ulrica Nilsson. "Psychometric validation of Swedish and Arabic versions of two health literacy questionnaires, eHEALS and HLS-EU-Q16, for use in a Swedish context: a study protocol." BMJ Open 9, no. 9 (September 2019): e029668. http://dx.doi.org/10.1136/bmjopen-2019-029668.
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IntroductionEquity in health and access to healthcare regardless of gender, ethnicity or social position is a major political issue worldwide. Regardless of an individual’s knowledge, motivation and competence, individuals are expected to be engaged and take responsibility of their own care. Migrants have been identified as a vulnerable population in healthcare, and an explanation for the inequity in health and in healthcare is limited health literacy. Furthermore, with increasing digitalisation in healthcare, it also puts demand on the individual to have digital or electronic health (eHealth) literacy.The overall aim of this study is to conduct a psychometric evaluation of the Swedish and Arabic versions of HLS-EU-Q16 and eHEALS and to compare Arabic and Swedish speakers’ Health literacy and eHealth literacy levels in Sweden.Methods and analysisThis is a prospective, psychometric evaluation study with the intent of including 300 Arabic-speaking and 300 Swedish-speaking participants. Questionnaires: The Health Literacy Survey European Questionnaire (HLS-EU-Q16) includes 16 items measuring perceived personal skills of finding, understanding, judging and applying health information to maintain and improve their health. The eHealth literacy scale (eHEALS) is an 8-item scale measuring health literacy skills in relation to online information and applications.This study will be conducted in four phases. Phase 1: Translation of HLS-EU-Q16 and eHEALS from English to Swedish and Arabic versions following the principles of translation of questionnaires. Phase 2: Content validity testing of eHEALS, including face validity and interpretability, conducted with five Arabic and five Swedish-speaking participants. Phase 3: Psychometric testing including construct validity, reliability, feasibility and floor ceiling effects. Phase 4: Distribution and comparison of eHealth and HLS-EU-Q16 analysed with χ2and Fisher’s exact test as appropriate. To assess associations between HLS-EU-Q16, eHEALS and demographic variables, binary logistic regression analyses will be performed.Ethics and disseminationThe project has been approved by the regional ethical review board in Stockholm, Sweden (2019/5:1) and will follow the principles outlined in the 1964 Helsinki Declaration and its later amendments. Results from this study will be disseminated in peer-reviewed journals, scientific conferences and social media.
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Ashaba, Justus, and Josephine Nabukenya. "Beyond monitoring functionality to results evaluation of eHealth interventions: Development and validation of an eHealth evaluation framework." Health Informatics Journal 28, no. 4 (October 2022): 146045822211418. http://dx.doi.org/10.1177/14604582221141834.
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Evidencing eHealth interventions, benefits generates data as a basis for assessing whether observed changes in behavior, processes or healthcare outcomes can be attributed to the eHealth interventions. Generating such evidence requires the use of frameworks or some other type of organizing schemes to help in guiding the process and making sense of eHealth systems and the findings. The frameworks available in literature do not clearly guide on how to monitor eHealth implementation and evaluate eHealth implementation results. This study aimed to develop and validate an eHealth evaluation framework to guide the process of monitoring eHealth implementations and evaluation of eHealth results in terms of outcomes and impact on healthcare in developing countries. The Design Science Research Methodology was followed to conduct this study. Recommendations from an eHealth evaluation exploratory study in Uganda and other eHealth evaluation literature formed key inputs into the design and development of the framework. The framework consists of a generic reference model with eHealth monitoring and evaluation dimensions, performance indicators, and guidelines on how to conduct eHealth monitoring and evaluation. The eHealth evaluation framework received high acceptance (>80%) as regards its fitness for purpose during its validation.
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Bonten, Tobias N., Anneloek Rauwerdink, Jeremy C. Wyatt, Marise J. Kasteleyn, Leonard Witkamp, Heleen Riper, Lisette JEWC van Gemert-Pijnen, et al. "Online Guide for Electronic Health Evaluation Approaches: Systematic Scoping Review and Concept Mapping Study." Journal of Medical Internet Research 22, no. 8 (August 12, 2020): e17774. http://dx.doi.org/10.2196/17774.
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Background Despite the increase in use and high expectations of digital health solutions, scientific evidence about the effectiveness of electronic health (eHealth) and other aspects such as usability and accuracy is lagging behind. eHealth solutions are complex interventions, which require a wide array of evaluation approaches that are capable of answering the many different questions that arise during the consecutive study phases of eHealth development and implementation. However, evaluators seem to struggle in choosing suitable evaluation approaches in relation to a specific study phase. Objective The objective of this project was to provide a structured overview of the existing eHealth evaluation approaches, with the aim of assisting eHealth evaluators in selecting a suitable approach for evaluating their eHealth solution at a specific evaluation study phase. Methods Three consecutive steps were followed. Step 1 was a systematic scoping review, summarizing existing eHealth evaluation approaches. Step 2 was a concept mapping study asking eHealth researchers about approaches for evaluating eHealth. In step 3, the results of step 1 and 2 were used to develop an “eHealth evaluation cycle” and subsequently compose the online “eHealth methodology guide.” Results The scoping review yielded 57 articles describing 50 unique evaluation approaches. The concept mapping study questioned 43 eHealth researchers, resulting in 48 unique approaches. After removing duplicates, 75 unique evaluation approaches remained. Thereafter, an “eHealth evaluation cycle” was developed, consisting of six evaluation study phases: conceptual and planning, design, development and usability, pilot (feasibility), effectiveness (impact), uptake (implementation), and all phases. Finally, the “eHealth methodology guide” was composed by assigning the 75 evaluation approaches to the specific study phases of the “eHealth evaluation cycle.” Conclusions Seventy-five unique evaluation approaches were found in the literature and suggested by eHealth researchers, which served as content for the online “eHealth methodology guide.” By assisting evaluators in selecting a suitable evaluation approach in relation to a specific study phase of the “eHealth evaluation cycle,” the guide aims to enhance the quality, safety, and successful long-term implementation of novel eHealth solutions.
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Sinabell, Irina, and Elske Ammenwerth. "Agile, Easily Applicable, and Useful eHealth Usability Evaluations: Systematic Review and Expert-Validation." Applied Clinical Informatics 13, no. 01 (January 2022): 67–79. http://dx.doi.org/10.1055/s-0041-1740919.
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Abstract Background Electronic health (eHealth) usability evaluations of rapidly developed eHealth systems are difficult to accomplish because traditional usability evaluation methods require substantial time in preparation and implementation. This illustrates the growing need for fast, flexible, and cost-effective methods to evaluate the usability of eHealth systems. To address this demand, the present study systematically identified and expert-validated rapidly deployable eHealth usability evaluation methods. Objective Identification and prioritization of eHealth usability evaluation methods suitable for agile, easily applicable, and useful eHealth usability evaluations. Methods The study design comprised a systematic iterative approach in which expert knowledge was contrasted with findings from literature. Forty-three eHealth usability evaluation methods were systematically identified and assessed regarding their ease of applicability and usefulness through semi-structured expert interviews with 10 European usability experts and systematic literature research. The most appropriate eHealth usability evaluation methods were selected stepwise based on the experts' judgements of their ease of applicability and usefulness. Results Of these 43 eHealth usability evaluation methods identified as suitable for agile, easily applicable, and useful eHealth usability evaluations, 10 were recommended by the experts based on their usefulness for rapid eHealth usability evaluations. The three most frequently recommended eHealth usability evaluation methods were Remote User Testing, Expert Review, and Rapid Iterative Test and Evaluation Method. Eleven usability evaluation methods, such as Retrospective Testing, were not recommended for use in rapid eHealth usability evaluations. Conclusion We conducted a systematic review and expert-validation to identify rapidly deployable eHealth usability evaluation methods. The comprehensive and evidence-based prioritization of eHealth usability evaluation methods supports faster usability evaluations, and so contributes to the ease-of-use of emerging eHealth systems.
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Sadiku, Matthew N. O., Mahamadou Tembely, Sarhan M. Musa, and Omonowo D. Momoh. "eHealth Literacy." International Journal of Advanced Research in Computer Science and Software Engineering 7, no. 6 (June 30, 2017): 68–69. http://dx.doi.org/10.23956/ijarcsse/v7i6/01614.
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Lokshina, Izabella V., and Michael R. Bartolacci. "Thinking eHealth." International Journal of Interdisciplinary Telecommunications and Networking 6, no. 3 (July 2014): 27–36. http://dx.doi.org/10.4018/ijitn.2014070103.
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This paper focuses on a mathematical background of an individual health status monitoring system to empower young people to manage their health. The proposed health status monitoring system uses symptoms observed with mobile sensing devices and prior information about health and environment (provided it exists) to define individual physical and psychological status. It assumes that a health status identification process is influenced by many parameters and conditions. It has a flexible logical inference system providing positive psychological influence on young people since full acceptance of recommendations on their behavioral changes towards healthy lifestyles is reached and a correct interpretation is guaranteed. The model and algorithms of the individual health status monitoring system are developed based on the composition inference rule in Zadeh's fuzzy logic. The model allows us to include in the algorithms of logical inference the possibility of masking (by means of a certain health condition) the symptoms of other health situations as well as prior information (if it exists) regarding health and environment. The algorithms are generated by optimizing the truth of a single natural “axiom”, which connects an individual health status (represented by classes of health situations) with symptoms and matrices of influence of health situations on symptoms and masking of symptoms. The new algorithms are fairly different from traditional algorithms, in which the result is produced in the course of numerous single processing rules. Therefore, the use of a composition inference rule makes a health status identification process faster and the obtained results more precise and efficient comparing to traditional algorithms.
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Stock, Carol. "eHealth Nursing." Gastroenterology Nursing 28, no. 2 (March 2005): 178. http://dx.doi.org/10.1097/00001610-200503000-00092.
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Nguyen, Long Hoang, Lien Thi Khanh Nguyen, Tham Thi Nguyen, Vu Anh Trong Dam, Thuc Minh Thi Vu, Hao Anh Si Nguyen, Giang Thu Vu, Carl A. Latkin, Roger C. M. Ho, and Cyrus S. H. Ho. "Practices, Perceived Benefits, and Barriers Among Medical Students and Health Care Professionals Regarding the Adoption of eHealth in Clinical Settings: Cross-sectional Survey Study." JMIR Medical Education 8, no. 3 (September 13, 2022): e34905. http://dx.doi.org/10.2196/34905.
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Background eHealth is increasingly becoming an indispensable part of health practice and policy-making strategies. However, the use of eHealth tools in clinical practice and the perceptions of eHealth among medical students and health care professionals in Vietnam are not well understood. Objective This study aims to investigate perceptions and practices regarding eHealth and their associated factors among medical students and health care professionals. Methods A web-based cross-sectional study was conducted on 523 medical students and health care professionals. Information about the practices for, perceived barriers to, and benefits of eHealth application in clinical practices was collected. Multivariate Tobit and logistic regression models were used to determine factors associated with perceptions and practices. Results In total, 61.6% (322/523) of participants used eHealth tools in clinical practices, with moderate levels of eHealth literacy. The score for the perceived benefits of eHealth tools was low. The most common barrier for eHealth utilization was human resources for IT (240/523, 45.9%), followed by security and risk control capacity (226/523, 43.2%) and no training in eHealth application (223/523, 42.6%). Age, eHealth literacy, and the use of the internet for updating medical knowledge were positively associated with using eHealth tools in clinical practices. Conclusions eHealth tools were moderately used in clinical practices, and the benefits of eHealth were underestimated among health care professionals and medical students in Vietnam. Renovating the current medical education curriculum to integrate eHealth principles should be required to equip health care professionals and medical students with essential skills for rapid digital transformation.