Association Of eHealth Literacy Research Articles

Urban-Rural Differences in the Association of eHealth Literacy With Medication Adherence Among Older People With Frailty and Prefrailty: Cross-Sectional Study.

With advances in science and technology and improvements in health literacy, more studies have focused on frailty prevention by promoting medication adherence, emphasizing the role of eHealth literacy. However, the association between eHealth literacy and medication adherence in frail older adults has not been well studied, and it is unknown whether urban-rural differences exist in this relationship. This study aims to examine the relationship between eHealth literacy and medication adherence in older people with different frailty statuses, emphasizing variations between rural and urban areas. Between November and December 2020, a total of 4218 urban and rural community members (aged ≥60 years) in China were recruited as participants using a multistage random sampling method. A face-to-face structured questionnaire survey was conducted to collect information on demographic characteristics, eHealth literacy (consisting of application, evaluation, and decision dimensions), and medication adherence. eHealth literacy was assessed using the Chinese version of the eHealth Literacy Scale developed by Norman and Skinner, and medication adherence was measured using the 4-item Morisky scale. We used a general descriptive analysis and stratified logistic regression models to examine how eHealth literacy is linked to medication adherence and urban-rural differences. There were 4218 respondents, of which 2316 (54.9%) lived in urban areas and 1902 (45.1%) in rural areas, respectively. After adjusting for potential confounders, among participants with prefrailty, eHealth literacy was associated with medication adherence in urban areas in terms of less application (adjusted odds ratio [AOR] 1.16, 95% CI 0.82-1.63), less evaluation (AOR 1.29, 95% CI 0.92-1.81), and less decision ability (AOR 1.20, 95% CI 0.86-1.68); eHealth literacy was linked with medication adherence in the rural areas in terms of less application (AOR 1.10, 95% CI 0.56-2.13), less evaluation (AOR 1.05, 95% CI 0.61-1.79), and less decision ability (AOR 1.10, 95% CI 0.64-1.90). Among frail participants, less eHealth literacy (AOR 0.85, 95% CI 0.48-1.51), along with its dimensions, including less application (AOR 0.85, 95% CI 0.47-1.54), evaluation (AOR 0.89, 95% CI 0.50-1.57), and decision ability (AOR 0.99, 95% CI 0.55-1.76), were associated with medication adherence in urban areas; less eHealth literacy (AOR 0.89, 95% CI 0.48-1.65), along with its dimensions, including less application (AOR 1.23, 95% CI 0.62-2.44), evaluation (AOR 0.98, 95% CI 0.53-1.82), and decision ability (AOR 0.90, 95% CI 0.49-1.67), were associated with medication adherence in rural areas. The results of this study suggest that there is an association between eHealth literacy and medication adherence among older people with frailty and prefrailty. To promote medication adherence, eHealth literacy can be helpful in tailoring interventions.

Associations of eHealth Literacy with Social Activity among Community-Dwelling Older Adults: A Cross-Sectional Study.

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.

Associations of eHealth literacy and knowledge with preventive behaviours and psychological distress during the COVID-19 pandemic: a population-based online survey

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...

Association of eHealth Literacy with Health Promotion Behaviors of Community-Dwelling Older People: The Chain Mediating Role of Self-Efficacy and Self-Care Ability.

In the digital age, electronic health literacy (eHealth literacy) of community-dwelling older people plays a potentially important role in their health behaviors which are critical for health outcomes. Researchers have documented that self-efficacy and self-care ability are related to this relationship. This study aimed to assess the relationship between eHealth literacy and health promotion behaviors among older people living in communities and explore the chain mediating role of self-efficacy and self-care ability. For this cross-sectional study, we used data from 425 older adults at 3 communities in Qingdao, Shandong Province in Northeastern China, from June to September 2021. Path analysis using the structural equation model was performed. We found that eHealth literacy was significantly associated with health promotion behaviors in older people. Additionally, eHealth literacy indirectly affected health promotion behaviors through self-efficacy and self-care ability, respectively. In addition, the chain mediation effect was identified in the relationship of eHealth literacy and health promotion behaviors: eHealth literacy→ self-efficacy→ self-care ability→ health promotion behaviors. These findings offer promising directions for developing interventions to modify older adults’ health behaviors through enhancing their eHealth literacy. These interventions should integrate components that target improving the self-efficacy and self-care ability of older people.

Associations of e-health literacy with life satisfaction and quality of life among the elderly in Tai′an city

Objective To explore the correlation of e-health literacy with life satisfaction and quality of life among the elderly in Tai′an city, Shandong province, and to provide references for improving the quality of life of the elderly. Methods Using multistage random cluster sampling, we conducted a face-to-face questionnaire survey among 3 870 urban and rural residents aged ≥ 60 years in 6 prefectures/counties/districts of Tai′an municipality during August 2020. A self-designed general questionnaire, the E-Health Literacy Scale (e-HEALS) – Chinese Version, the Satisfaction with Life Scale (SWLS), the European Quality of Life-5 Dimensions (EQ-5D), and the European Quality of Visual Analogue Scale (EQ-VAS) were adopted in the study. A structural equation model (SEM) was constructed based on the data collected to analyze relationships between e-health literature and life satisfaction and quality of life among the elderly. Results For all the elderly, the overall score of e-HEALS was 10.20 ± 8.53 and the dimension scores were 6.27 ± 4.16, 2.62 ± 1.76, and 1.31 ± 0.89 for e-health literacy-related application, judgment, and decision-making ability; the overall score of SWLS was 27.84 ± 5.32; the utility score of EQ-5D was 0.93 ± 0.12; and the score of EQ-VAS was 78.41 ± 15.68, respectively. The results of correlation analysis showed that the overall score of e-HEALS was positively correlated significantly with the overall score of SWLS (r = 0.079) and the EQ-VAS score (r = 0.088) (both P Conclusion E-health literacy can affect the quality of life directly and indirectly via influencing life satisfaction among community elderly residents in Tai′an city.

Association of eHealth Literacy With Lifestyle Behaviors in University Students: Questionnaire-Based Cross-Sectional Study.

BackgroundMaintenance 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.ObjectiveThe 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.MethodsA 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.ResultsThe 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).ConclusionsThe 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.

Association of e-health literacy and social support with depressive symptoms among female nursing students

Objective To explore the relationship between eHealth literacy and social support and depressive symptoms in female nursing students, and to provide a reference for improving the mental health of female nursing students. Methods In November 2019, 1 115 female nursing students from freshmen to junior years in four medical colleges in Changsha were investigated eHealth Literacy Scale, Perceived Social Support Scale, Center for Epidemiological Studies Depression Scales and demographic information questionnaire. Results The detection rate of depressive symptoms in female nursing students was 20.1%(224/1 115), and the qualification rate of eHealth literacy was 29.2%(326/1 115). The incidence of depressive symptoms were higher in female nursing students with urban household registration and their parents with high school education and above and poor family economic status (χ 2 = 9.46, 20.02, 7.16, 12.40, P <0.05). Multivariate Logistic regression analysis showed that poor eHealth literacy and low social support were positively correlated with depressive symptoms in female nursing students ( OR = 3.16, 3.65, P <0.05). There was a correlation between the interaction of eHealth literacy and social support with depressive symptoms. In the same type of social support, the lower eHealth literacy level, the greater the risk of depressive symptoms was for female nursing students ( P <0.05). Conclusion Health literacy and social support are the influencing factors of depressive symptoms in female nursing students. The occurrence of depressive symptoms can be reduced by improving the level of electronic health literacy and social support. 【摘要】 目的 探讨护理专业女生电子健康素养和社会支持与抑郁症状的关联, 为提高护理专业女生心理健康水平 提供参考。 方法 2019 年 11月, 采用电子健康素养量表、领悟社会支持量表、流调中心抑郁量表、社会人口学信息调查 表, 对多阶段整群抽取的长沙市 4 所医学院校大一至大三年级 1 115 名护理专业女生进行调查。 结果 护理专业女生抑 郁症状的检出率为 20.1% (224/1 115), 电子健康素养合格率为29.2% (326/1 115)。生源地为城镇、父/母受教育程度为高 中及以上、家庭经济状况较差的护理专业女生抑郁症状检出率较高 (χ 2 值分别为 9.46, 20.02, 7.16, 12.40, P 值均<0.05)。 多因素 Logistic 回归分析显示, 电子健康素养不合格和低社会支持均与护理专业女生抑郁症状呈正关联 ( OR 值分别为 3.16, 3.65, P 值均<0.05)。电子健康素养和社会支持的交互作用与抑郁症状之间的相关有统计学意义, 相同社会支持情况 下, 电子健康素养不合格, 护理专业女生抑郁症状发生风险大 ( P 值均<0.05)。 结论 电子健康素养和社会支持是护理专 业女生抑郁症状的影响因素。提高电子健康素养水平和社会支持有助于降低抑郁症状的发生。

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.

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. 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. 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). 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.

Associations of eHealth Literacy With Health Services Utilization Among College Students: Cross-Sectional Study.

BackgroundElectronic health (eHealth) literacy has become an important topic in health fields. Studies have found that individuals with higher eHealth literacy are more likely to use preventive care services and to have effective interactions with their physicians. In addition, previous studies have revealed a gender difference in the utilization of physician access and outpatient services. Nevertheless, few studies have explored the effect of the three levels of eHealth literacy (functional, interactive, and critical levels) on the four aspects of health services utilization (type, site, purpose, and time interval). It is unclear whether the associations between these three levels of eHealth literacy and the four aspects of health services utilization among college students are positive or negative.ObjectiveThe objective of this study was to investigate the associations among gender, eHealth literacy, and health services utilization.MethodsWe used the eHealth Literacy Scale, a 12-item instrument designed to measure college students’ functional, interactive, and critical eHealth literacy, and the Health Services Utilization Scale, which is a 10-item instrument developed to measure the four aspects of health services utilization by college students. A nationally representative sample of 489 college students in Taiwan was surveyed. We conducted multiple regression analysis to examine the associations among gender, eHealth literacy, and health services utilization.ResultsThe study found that being female was negatively related to the purpose aspect of health services utilization (t487=−2.85, P<.01). However, the R2 value of gender on the purpose aspect was low enough to be ignored. Critical (t484=2.98-4.23, P<.01) and interactive eHealth literacy (t484=2.43-2.89, P<.05) were related to three aspects of the health services utilization, and functional eHealth literacy was related to the purpose aspect (t484=−4.99, P<.001).ConclusionsThis study showed that Taiwanese college students with interactive eHealth literacy were more likely to have a higher rate of outpatient care use. Moreover, Taiwanese college students with critical eHealth literacy were more likely to make full use of health services than those with functional eHealth literacy. Finally, the educated and age-restricted sample may attenuate gender disparities in health services utilization among Taiwanese college students.

Associations of eHealth Literacy With Health Behavior Among Adult Internet Users.

BackgroundIn the rapidly developing use of the Internet in society, eHealth literacy—having the skills to utilize health information on the Internet—has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users.ObjectiveThe aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan.MethodsThe participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses.ResultsWe analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth literacy were significantly more likely to exhibit the good health behaviors of physical exercise (adjusted odds ratio [AOR] 1.377, 95% CI 1.131-1.678) and eating a balanced diet (AOR 1.572, 95% CI 1.274-1.940) than individuals with low eHealth literacy.ConclusionsWe found that some health behaviors, including exercise and balanced nutrition, were independently associated with eHealth literacy among Japanese adult Internet users.

Association of eHealth Literacy With Cancer Information Seeking and Prior Experience With Cancer Screening

Cancer is a critical disease with a high mortality rate in the US. Although useful information exists on the Internet, many people experience difficulty finding information about cancer prevention because they have limited eHealth literacy. This study aimed to identify relationships between the level of eHealth literacy and cancer information seeking experience or prior experience with cancer screening tests. A total of 108 adults participated in this study through questionnaires. Data covering demographics, eHealth literacy, cancer information seeking experience, educational needs for cancer information searching, and previous cancer screening tests were obtained. Study findings show that the level of eHealth literacy influences cancer information seeking. Individuals with low eHealth literacy are likely to be less confident about finding cancer information. In addition, people who have a low level of eHealth literacy need more education about seeking information than do those with a higher level of eHealth literacy. However, there is no significant relationship between eHealth literacy and cancer screening tests. More people today are using the Internet for access to information to maintain good health. It is therefore critical to educate those with low eHealth literacy so they can better self-manage their health.

Association of eHealth Literacy With Colorectal Cancer Knowledge and Screening Practice Among Internet Users in Japan

BackgroundIn rapidly developing Internet-user societies, eHealth literacy has become important in promoting wellness. Although previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC), little is known about whether eHealth literacy is associated with these variables.ObjectiveThe present study examined associations between eHealth literacy, knowledge of CRC, and CRC screening practices.MethodsData were analyzed for 2970 Japanese adults (men, 49.9%; mean age ± SD, 39.7 ± 10.9 years) who responded to an Internet-based cross-sectional survey. Knowledge of the definition of CRC, its risk factors and screening practice, previous experience of CRC screening, score on the Japanese version of the eHEALS (J-eHEALS), sociodemographic attributes (sex, age, marital status, educational attainment, and household income level), and frequency of Internet usage were obtained. Sociodemographic attributes and frequency of Internet usage were used as control variables in the multiple regression and logistic regression models.ResultseHealth literacy was positively associated with CRC knowledge (β = .116, < .001), when the covariables of both eHealth literacy and CRC knowledge were used in the multiple regression model. Moreover, after controlling for sociodemographic factors, which were significantly associated with eHealth literacy and CRC screening practice, an increase of 1 point in the eHEALS score signified that participants were 1.03 times (95% CI = 1.01–1.05) more likely to undergo CRC screening.ConclusionsInternet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy.

EHealth literacy: a marker for "digital divide" in health information

eHealth literacy is defined as the use of emerging information and communications technology to improve or enable health and health care. The study examined whether literacy disparities are diminished or enhanced in the search for health information on the Internet.We used a countrywide representative random-digital-dial telephone household survey of the Israeli adult population (18 years and older, N = 4286).Respondents who were highly eHealth literate tended to be younger and more educated than their less eHealth-literate counterparts. They were also more active consumers of all types of information on the Internet, used more search strategies, and scrutinized information more carefully than did the less eHealth-literate respondents. Finally, respondents who were highly eHealth literate gained more positive outcomes from the information search in terms of cognitive, instrumental (self-management of health care needs, health behaviors, and better use of health insurance), and interpersonal (interacting with their physician) gains.The association of eHealth literacy with background attributes indicates that the Internet reinforces existing social differences. The more comprehensive and sophisticated use of the Internet and the subsequent increased gains among the high eHealth literate create new inequalities in the domain of digital health information.

EHealth literacy: a marker for "digital divide" in health information

eHealth literacy is defined as the use of emerging information and communications technology to improve or enable health and health care. The study examined whether literacy disparities are diminished or enhanced in the search for health information on the Internet.We used a countrywide representative random-digital-dial telephone household survey of the Israeli adult population (18 years and older, N = 4286).Respondents who were highly eHealth literate tended to be younger and more educated than their less eHealth-literate counterparts. They were also more active consumers of all types of information on the Internet, used more search strategies, and scrutinized information more carefully than did the less eHealth-literate respondents. Finally, respondents who were highly eHealth literate gained more positive outcomes from the information search in terms of cognitive, instrumental (self-management of health care needs, health behaviors, and better use of health insurance), and interpersonal (interacting with their physician) gains.The association of eHealth literacy with background attributes indicates that the Internet reinforces existing social differences. The more comprehensive and sophisticated use of the Internet and the subsequent increased gains among the high eHealth literate create new inequalities in the domain of digital health information.http://dx.doi.org/10.7175/rhc.v3i3.281