How is eHealth literacy measured and what do the measurements tell us? A systematic review

Astrid Karnoe ,Lars Kayser

doi:10.34105/j.kmel.2015.07.038

Astrid Karnoe , Lars Kayser

Open Access

https://doi.org/10.34105/j.kmel.2015.07.038

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Abstract

The increasing use of digital services and technologies in health care calls for effective tools to evaluate the users’ eHealth literacy in order to better understand the users’ interaction with health technologies. We here present a systematic review of existing tools to measure eHealth literacy and for what these tools have been used to investigate. We identified eight tools, of which three of them are bases upon a conceptual model of eHealth literacy and the remaining five are dual tools, i.a. comprised of individual measures for health literacy and digital literacy. Of these eight tools, only one tool (The eHealth literacy Scale - eHEALS) was used in other studies than the one it was originally published in. eHEALS has primarily been used to establish eHealth literacy levels in different populations. Five of the studies have been conducted by examining eHealth literacy’s impact on health outcomes, and one study has established an association between high eHealth literacy levels and increased likelihood of attending colorectal cancer screenings in a Japanese population. The two other concept-based tools, eHLS and PRE-HIT, reflect an elaborated understanding of eHealth literacy. The five dual tools were primarily used to screen for adequate and inadequate health literacy and digital literacy. In conclusion, there is very little knowledge about individuals’ eHealth literacy and how it relates to health outcomes or the clinical course of specific diseases. New tools developed for the new age of social media and new technologies should be used as eHEALS may have some limitations.

Highlights

The use of digital services is increasing within health care and may constitute either a new opportunity or barrier for the patients.Telehealth is moving treatment and monitoring into the homes of patients
Embrace domains such as classical literacy, media literacy, information seeking literacy, and science literacy, with only the computer itself and areas of media literacy left as a digital or technology literacy domain. We have used this simplified approach in order to create a strategy to find studies measuring eHealth literacy, digital health literacy, or technology health literacy, but we have included studies that measure health literacy and digital literacy as we find these two literacies to be the best proxies of eHealth literacy
The final review includes a total of 53 articles, of which 8 published articles examine tools for measuring eHealth literacy, and 45 articles comprise studies using the eHealth literacy measurement eHealth Literacy Scale (eHEALS) or validations of eHEALS translations

Summary

Introduction

The use of digital services is increasing within health care and may constitute either a new opportunity or barrier for the patients.Telehealth is moving treatment and monitoring into the homes of patients. The use of digital services is increasing within health care and may constitute either a new opportunity or barrier for the patients. The introduction of digital health services lead to increasing expectations for patients to be able to use and engage with digital health information. People need to be health literate and to have capabilities, resources, and motivation to find, understand, and appraise health information when using digital services and technology. In response to the need of being able to characterize peoples’ health literacy in a digital context, in 2006 Norman and Skinner introduced a new concept – electronic health literacy as the ability to seek, find, understand and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem (Norman & Skinner, 2006b). Synonyms to electronic health literacy, such as digital health literacy and health technology literacy, have been proposed (European Commission, 2014; Jordan-Marsh, 2011)

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