Abstract
BackgroundElectronic health (eHealth) literacy is an important skill that allows patients to navigate intelligibly through the vast, often misleading Web-based world. Although eHealth literacy has been investigated in general and specific demographic populations, it has not yet been analyzed on users of online health communities (OHCs). Evidence shows that OHCs are important Web 2.0 applications for patients for managing their health, but at the same time, warnings have been expressed regarding the quality and relevance of shared information. No studies exist that investigate levels of eHealth literacy among users of OHCs and differences in eHealth literacy between different types of users.ObjectiveThe study aimed to investigate eHealth literacy across different types of users of OHCs based on a revised and extended eHealth literacy scale (eHEALS).MethodsThe study was based on a cross-sectional Web survey on a simple random sample of 15,000 registered users of the most popular general OHC in Slovenia. The final sample comprised 644 users of the studied OHC. An extended eHEALS (eHEALS-E) was tested with factor analytical procedures, whereas user types were identified with a hierarchical clustering algorithm. The research question was analyzed with analysis of variance (ANOVA) procedure and pairwise comparison tests.ResultsFactor analysis of the revised and extended eHEALS revealed six dimensions: awareness of sources, recognizing quality and meaning, understanding information, perceived efficiency, validating information, and being smart on the Net. The factor solution demonstrates a good fit to the data (root mean square error of approximation [RMSEA]=.059). The most developed dimension of eHEALS-E is awareness of different Internet sources (mean=3.98, standard deviation [SD]=0.61), whereas the least developed is understanding information (mean=3.11, SD=0.75). Clustering resulted in four user types: active help-seekers (48.3%, 311/644), lurkers (31.8%, 205/644), core relational users (16.9%, 109/644), and low-engaged users (3%, 19/644). Analysis of the research question showed statistically significant differences among user types across all six dimensions of eHEALS-E. Most notably, core relational users performed worse than lurkers on the validating information dimension (P=.01) and worse than active help-seekers on the being smart on the Net dimension (P=.05). Active help-seekers have the highest scores in all dimensions of the eHEALS-E, whereas low-engaged users have statistically significantly lower scores on all dimensions of the eHEALS-E in comparison with the other groups.ConclusionsThose who are looking for advice and support in OHCs by making queries are well equipped with eHealth literacy skills to filter potential misinformation and detect bad advice. However, core relational users (who produce the most content in OHCs) have less-developed skills for cross-validating the information obtained and navigating successfully through the perils of the online world. Site managers should monitor their activity to avoid the spread of misinformation that might lead to unhealthy practices.
Highlights
Those who are looking for advice and support in online health communities (OHCs) by making queries are well equipped with electronic health (eHealth) literacy skills to filter potential misinformation and detect bad advice
With the undeniable prevalence of self-managing patients who are building expertise and making health decisions based on experiences in the online world, the recent upsurge of research on electronic health literacy is not surprising [1,2,3,4,5,6]. eHealth literacy originates from the multidimensional, dynamic concept of health literacy [7], which pertains to the cognitive and social skills for obtaining, processing, understanding, communicating, and using health-related information to function in the contemporary health care environment and to engage in appropriate self-care [7,8,9,10]
Users with low eHealth literacy can fall a prey to advertising misguidance [39] and might be unable to detect irrelevant or invalid information [40] or practices that can lead to very problematic health outcomes, for example, in the case of OHCs in which users have been stimulated to practice unhealthy lifestyles [41,42]
Summary
EHealth Literacy and Online Health CommunitiesWith the undeniable prevalence of self-managing patients who are building expertise and making health decisions based on experiences in the online world, the recent upsurge of research on electronic health (eHealth) literacy is not surprising [1,2,3,4,5,6]. eHealth literacy originates from the multidimensional, dynamic concept of health literacy [7], which pertains to the cognitive and social skills for obtaining, processing, understanding, communicating, and using health-related information to function in the contemporary health care environment and to engage in appropriate self-care [7,8,9,10]. In addition to the dimension of health literacy, eHealth literacy embraces the human ability to meaningfully and efficiently navigate vast online spaces and is vital for the contemporary Internet patient to be able to make informed decisions that lead to successful health self-management, more effective contact with physicians, and positive health outcomes [2,6,11,12,13] This literacy has been investigated mostly on general or specific demographic segments of populations in different national contexts, and it has not yet emerged as a topic researched among users of online health communities (OHCs). No studies exist that investigate levels of eHealth literacy among users of OHCs and differences in eHealth literacy between different types of users
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
