Digital Health Information Research Articles

Relationships Among eHealth Literacy, Physical Literacy, and Physical Activity in Chinese University Students: Cross-Sectional Study.

eHealth literacy is critical for evaluating abilities in locating, accessing, and applying digital health information to enhance one's understanding, skills, and attitudes toward a healthy lifestyle. Prior research indicates that enhancing eHealth literacy can improve health behaviors such as physical activity (PA). Physical literacy (PL) refers to the ability to develop sustainable PA habits, taking into account various aspects of an individual. Notably, university students have shown a decline in PA and possess low PL levels. However, the connection between eHealth literacy and PL in this demographic has not been extensively studied, and it remains uncertain whether PA acts as a mediator between eHealth literacy and PL. This study examines the extent to which PA mediates the link between eHealth literacy and PL in Chinese university students and explores gender differences in these variables. In February 2022, a cross-sectional survey was administered to 1210 students across 3 universities in China. The instruments used were the Perceived PL Instrument, the International Physical Activity Questionnaire, and the Chinese version of the eHealth Literacy Scale. Correlations between eHealth literacy, PA, and PL were analyzed using Pearson product-moment correlation and multiple linear regression, while mediation models helped elucidate the interactions among the 3 variables. The response rate for the study was 92.9% (1124/1210). In the mediation analysis, eHealth literacy showed a significant direct effect on PL, with a coefficient of 0.78 (β .75, SE 0.02; P<.001). Moderate to vigorous physical activity (MVPA) accounted for 2.16% of the total effect, suggesting that MVPA partially mediates the relationship between eHealth literacy and PL. Additionally, male students outperformed female students in terms of MVPA (t636=4.94; P<.001) and PL (t636=3.18; P<.001), but no significant differences were found in eHealth literacy (t636=1.23; P=.22). The findings indicate that MVPA serves as a mediator in the link between eHealth literacy and PL among university students. Students with low eHealth literacy or limited PA are less likely to be physically literate. Thus, eHealth literacy plays a crucial role in enhancing PL and PA, especially when interventions targeting PL are implemented. Our results also suggest a need for targeted health education interventions aimed at improving MVPA and PL among female students, while also recognizing that eHealth literacy is comparable across genders at universities.

“Design of a Trustworthy Cloud-Native National Digital Health Information Infrastructure for Secure Data Management and Use”

Abstract Since 2022, Malawi Ministry of Health (MoH) designated the development of a National Digital Health Information System (NDHIS) as one of the most important pillars of its national health strategy. This system is built upon a distributed computing infrastructure employing the following state-of-art technologies: (1) digital healthcare devices to capture medical data; (2) Kubernetes-based Cloud-Native Computing architecture to simplify system management and service deployment; (3) Zero-Trust Secure Communication to protect confidentiality, integrity and access rights of medical data transported over the Internet; (4) Trusted Computing to allow medical data to be processed by certified software without compromising data privacy and sovereignty. Trustworthiness, including reliability, security, privacy and business integrity, of this system was ensured by a peer-to-peer network of trusted medical information guards deployed as the gatekeepers of every computing node on this system. This NDHIS shall facilitate Malawi to attain universal health coverage by 2030 through its scalability and operation efficiency. It shall improve medical data quality and security by adopting a paperless approach. It will also enable MoH to offer data rental services to healthcare researchers and AI model developers around the world. This project is spearheaded by the Digital Health Division (DHD) under MoH. The trustworthy computing infrastructure was designed by a taskforce assembled by the DHD in collaboration with Luke International in Norway, and a consortium of hardware and software solution providers in Taiwan. A prototype that can connect community clinics with a district hospital has been tested at the Taiwan Pingtung Christian Hospital.

Partnering With Nurse Inventors and Entrepreneurs: A Guide for Nursing Professional Development Leaders.

Health care innovation and entrepreneurship are key drivers of transformation in health care, re-shaping the way care is delivered, managed, and experienced. Innovation in health care spans a range of areas, including digital health, bio-technology, medical devices, tele-health, and health information systems. Entrepreneurs are leveraging technology to create solutions to improve patient outcomes, reduce costs, and address inefficiencies. Nurse inventors and entrepreneurs are blazing new trails that require nursing professional development leaders to consider new opportunities for collaboration. For nursing professional development leaders, fostering relationships with nurse entrepreneurs can unlock numerous benefits, from improving patient safety to enhancing nursing practice and facilitating advisory board appointments. [J Contin Educ Nurs. 2024;55(11):517-519.].

Digital health literacy of adults with low reading and writing skills: A mixed-methods study

Abstract Background Around 12% of the adult population living in Germany have low reading and writing skills. Little is known about their digital health literacy and use of digital health technologies. The objectives of the Liter@te study were to assess the digital health literacy of adults with low reading and writing skills and to explore which digital tools they used in everyday life. Methods A cross-sectional survey (n = 96) and five focus groups (n = 39) were conducted with adults aged 18-64 years with low reading and writing skills. Digital health literacy was measured using the eHEALS scale and compared with results from a nationwide sample. Focus group participants completed a task course on digital health information and then discussed their experiences. Survey data were analyzed using descriptive statistics and logistic regression. Qualitative content analysis was applied to analyze the focus group data. Results Survey participants were on average 44 years old, 72% were female and 92% were not born in Germany. Compared to the nationwide survey, use of digital health technologies and digital health literacy were lower. In addition, use of digital health technologies was associated with higher digital health literacy. Lack of technical skills, language problems, and searching and finding health information online were most challenging for focus group participants (mean age 43 years, 87% female). Focus group participants reported that they prefer videos when searching for health information online and seek support from family members or local organizations if they cannot find a solution to their health issue. Conclusions Adults with low reading and writing skills search for health information online, but have difficulties to find the appropriate information. Interventions to promote digital health literacy are needed to ensure that persons with low reading and writing skills are not further left behind. Key messages • Adults with low language skills have a low digital health literacy. • Reading and writing requirements and lack of technical skills make it difficult for them to search health information online.

Enhance physical, mental and academic wellbeing of pupils in Germany through digital health literacy

Abstract Background Digital health literacy (DHL) involves the ability to find, understand, appraise, and apply health information from digital sources. It serves as the foundation for informed decision-making about one’s health and well-being using digital technology and online health information sources and services. Despite its significance, the role of DHL in relation to schoolchildren’s wellbeing remains underexplored. Therefore, this study aims to investigate how schoolchildren’s DHL influences their physical, mental, and academic well-being. Methods The cross-sectional survey comprised a representative sample of N = 1448 school-aged children (9-18 years) living in Germany. DHL was assessed via a translated and adapted version of the DHL instrument. The assessment of physical, mental, and academic well-being relied on the KINDL questionnaire. Linear regression analyses were conducted, with the scale score of physical, mental, and academic well-being serving as dependent variables and DHL as predictor. Additionally, potential confounding variables such as sex, age, migration background, subjective family wealth, chronic illness, and subjective health status were included in the analyses. Results All three regression models were significant (physical: F(9,1325) = 34.99, p &amp;lt; .001; R2 = 0.19; mental: F(9,1320) = 27.43, p &amp;lt; .001; R2 = 0.16; academic: F(9,1336) = 15.19, p &amp;lt; .001; R2 = 0.09). DHL significantly predicted physical (B=.08, p=.01), mental (B=.17, p&amp;lt;.001), and academic (B=.21, p&amp;lt;.001) wellbeing. Conclusions This study provides the first evidence of the predictive power of DHL for schoolchildren’s physical, mental, and academic well-being. It emphasizes the importance of promoting DHL in schoolchildren to empower them to find, understand, appraise, and apply digital health information effectively. Key messages • Digital health literacy significantly predicts schoolchildren’s physical, mental, and academic well-being. • Promoting digital health literacy can empower schoolchildren to make informed decisions about their well-being.

Digital health literacy and associated socio-demographic characteristics in the French population

Abstract Background With the development of digital devices in the health field, digital health literacy has become an important issue in promoting and protecting people’s health. Digital health literacy was measured in a representative sample of the French adult population in order to assess its level and to identify the socio-demographic characteristics of individuals with the lowest literacy levels. Comparisons with works carried out in other European countries as well as implications for the implementation of digital interventions will be discussed. Methods Digital health literacy was assed using the HLS19-DIGI-HI Instrument. This 8-item scale measuring the skills related to dealing with digital health information was introduced in the 2023 Health Barometer survey, conducted by the French national public health agency. The survey included French-speaking individuals living in France, aged 18-85, selected through randomly generated phone numbers. 3007 persons were interviewed using a computer assisted telephone interview. A continuous score and categories were calculated to determine the level of Digital Health Literacy. Their associations with sociodemographic characteristics were studied using univariate and multivariate analysis. Results 1902 persons declared they used internet to search information or advice on health on internet in the last 12 months and completed the Digital health literacy questionnaire. 61 % of these individuals have a low level of digital health literacy (29 % “inadequate” and 32% “problematic”). Multiple sociodemographic characteristics were associated with lower levels of literacy in univariate and multivariate analysis. Conclusions These results are useful to better understand and assess the digital health literacy of the population according to their socio-demographic characteristics. They will provide a knowledge base to implement web-based interventions for promoting targeted digital health interventions, according to targeted audiences. Key messages • This study in large random sample of the French population showed frequent difficulties to deal with online health information. • Multiple sociodemographic characteristics were associated with digital health literacy and can help to support implementation of targeted digital health interventions.

Measuring digital health literacy in Europe – developing a new tool to capture innovation

Abstract Background Rapid advancement of digital resources for health and healthcare in Europe has widened the scope of opportunities to promote health, but also raises concerns about accessibility and health equity. Measuring digital health literacy (DHL) in populations is critical for assessing digital resource appropriateness in general and specifically among vulnerable populations. The DHL measure used in the M-POHL Health Literacy Survey 2019-2021 (HLS19) in 13 countries showed inadequate DHL in large parts of the population, reflecting a social gradient. As digital resources become increasingly interactive, potentially widening the digital divide, a need to refine the DHL HLS19 tool was evident. Methods Building on the HLS19 tool, an additional measure was developed to assess interactive aspects of DHL by representatives from 16 countries in a co-productive way, based on discussions about the diverse digital challenges. The additional scale was to be generic enough to be relevant for all countries, yet specific enough to discern the diverse needs regarding various public health/healthcare service formats across Europe. Results The new tool is divided into 2 parts: a scale measuring the skills to access, understand, appraise, and apply digital health information as applied and validated in HLS19, and a new set of items assessing the use and ease of use of interactive digital resources including health promotion apps, digital tools for managing health/medical conditions, navigating the healthcare system, and communicating online with health professionals. The tool has been translated into several languages and is currently undergoing piloting/cognitive testing. Conclusions Collaborative work among countries is essential for developing relevant measurement tools on the European level. Just as the technology undergoes rapid change, likewise tools for assessing DHL must be updated acknowledging the diversity of digital resources and needs on country levels.

InfoQ: Certifying credible providers of digital health information

Abstract Background Access to accurate health information is crucial. Despite the abundance of information online, sorting through it can be overwhelming, especially with the spread of misinformation. This poses a threat to public health and challenges health literacy. Efforts to combat misinformation are struggling due to the rapid growth of available information. We need complementary strategies, such as promoting trustworthy information sources. An initiative by Bertelsmann Stiftung, aims to counter misinformation by promoting health information from credible sources. Methods In 2021, the U.S. National Academy of Medicine outlined principles for identifying credible health information sources, endorsed globally by the WHO and embraced by the social media industry. However, these principles lack operationalization, leaving indicators for credibility undefined. To address this gap, Bertelsmann Stiftung, in collaboration with German experts, conducted workshops in 2023 to draft evaluation criteria. Their ongoing work, alongside initiatives by the Careum Foundation and Gesundheit Österreich GmbH will be presented. Results The criteria focus on structure (e.g., the expertise of providers) and process (e.g., methods for identifying relevant evidence) rather than outcome (i.e., the quality of each piece of information), and are based on the domains science-basis, transparency and legitimacy. Mandatory and complementary criteria allow a two-step approach to identify health information providers of good quality (meeting all mandatory criteria) and excellent quality (meeting all criteria). Conclusions These criteria build the basis of the establishment of an international certification system and represent a crucial measure to combat misinformation and promote population health literacy. Various international partners and social platforms have already reached a strong consensus on the relevance of the project goals and expressed their willingness to deepen their efforts in this regard.

An integrative systematic review on interventions to improve layperson's ability to identify trustworthy digital health information.

Health information on the Internet has a ubiquitous influence on health consumers' behaviour. Searching and evaluating online health information poses a real challenge for many health consumers. To our knowledge, our systematic review paper is the first to explore the interventions targeting lay people to improve their e-health literacy skills. Our paper aims to explore interventions to improve laypeople ability to identify trustworthy online health information. The search was conducted on Ovid Medline, Embase, Cochrane database, Academic Search Complete, and APA psych info. Publications were selected by screening title, abstract, and full text, then manual review of reference lists of selected publications. Data was extracted from eligible studies on an excel sheet about the types of interventions, the outcomes of the interventions and whether they are effective, and the barriers and facilitators for using the interventions by consumers. A mixed-methods appraisal tool was used to appraise evidence from quantitative, qualitative, and mixed-methods studies. Whittemore and Knafl's integrative review approach was used as a guidance for narrative synthesis. The total number of included studies is twelve. Media literacy interventions are the most common type of interventions. Few studies measured the effect of the interventions on patient health outcomes. All the procedural and navigation/ evaluation skills-building interventions are significantly effective. Computer/internet illiteracy and the absence of guidance/facilitators are significant barriers to web-based intervention use. Few interventions are distinguished by its implementation in a context tailored to consumers, using a human-centred design approach, and delivery through multiple health stakeholders' partnership. There is potential for further research to understand how to improve consumers health information use focusing on collaborative learning, using human-centred approaches, and addressing the social determinants of health.

The Relationship Between Nurses' Digital Health Literacy and Their Educational Levels, Professional Roles, and Digital Attitudes: A Cluster Analysis Based on a Cross-Sectional Study.

The current study aimed to identify digital health literacy levels among nurses with respect to their education, role and attitude towards digital technologies. Cross-sectional study. Through convenience sampling, all Registered Nurses, managers/leaders and nurse researchers employed in Hospitals, University Hospitals and Districts were recruited and surveyed using an online questionnaire. The data collection tool assessed: (I) demographics, (II) Digital Health Literacy (DHL) with the Health Literacy Survey19 Digital (HLS19-DIGI) instrument including DHL dealing with digital health information (HL-DIGI), interaction with digital resources for health (HL-DIGI-INT) and use of digital devices for health (HL-DIGI-DD); (III) attitudes on the use of digital technologies in clinical practice. The multiple correspondence analysis was applied to identify three clusters for the education/professional role (A, B, C) and three for digital technologies' use (1, 2, 3). The one-way nonparametric analysis of variance (Kruskal-Wallis test) was applied to compare HL-DIGI, HL-DIGI-INT and the HL-DIGI-DD scores among clusters. Among 551 participants, the median scores of the HL-DIGI, the HL-DIGI-INT and the HL-DIGI-DD questionnaires were 70.2, 72 and 2.00, respectively. The distribution in the clusters 'educational/professional role' was A, (58.8%); B, (16.5%); and C, (24.7%). Nurses in a managerial or coordinator role and with a postgraduate degree used digital resources with greater frequency. The distribution in the clusters 'use of digital technologies' was: 1, (54.6%); 2, (12.2%); and 3, (33.2%). The HL-DIGI-DD and HL-DIGI scores of clusters 1, 2 and 3 differed significantly. DHL among nurses is strongly influenced by the education level, professional role, habits and attitude towards digital technologies. Nurses with coordinator roles used digital technologies with greater frequency and had a higher level of DHL. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were used for reporting. No Patient or Public Contribution. Local Ethical Committee of the Polyclinic of Bari (code: DHL7454, date: 21/09/22).

Preventive health-care behavior: a serial multiple mediation analysis

Purpose Preventive health-care behavior (PHB) adoption as a primordial prevention to stay healthy and avoid lifestyle disease risk is a global trend. This paper aims to use the PHB model and stimulus-organism-response theory to empirically examine the role of individual and technological factors in influencing primordial PHB. Design/methodology/approach A sequential mixed-method was adopted to identify the primordial PHB adoption and propose a conceptual framework. The identified determinants and the hypothesized relationships were empirically tested using a convenience sample of 406 urban Indians. Partial least square structural equation modeling is used for data analysis. Findings The derived conceptual framework was empirically tested to assess the role of health literacy (HL), health value (HV) and digital health information seeking (DHIS) on primordial PHB. Findings confirmed the significant influence of DHIS on HL, HL on HV and PHB and HV on PHB. The direct effects of DHIS on PHB and HV were insignificant. HL solely mediated the indirect effect of DHIS on PHB, while the mediation of HV was insignificant. HL and HV fully mediated the relationship between DHIS and PHB. Research limitations/implications The impact of DHIS on PHB adoption and the serial multiple mediating roles of HL and HV are significant in understanding primordial PHB adoption for both academic theory and practice. However, the cross-sectional study on urban Indians needs further validation across geographies. Originality/value To the best of the authors’ knowledge, this pioneering study is among the first to propose and validate a comprehensive model of primordial PHB adoption.

Enhancing Healthcare Information Systems in Ethiopian Hospitals: Exploring Challenges and Prospects of a Cloud-based Model for Smart and Sustainable Information Services

Hospitals are the primary hubs for healthcare service providers in Ethiopia; however, hospitals face significant challenges in adopting digital health information systems solutions due to disparate, non-interoperable systems and limited access. Information technology, especially via cloud computing, is crucial in healthcare for efficient data management, secure storage, real-time access to critical information, seamless provider communication, enhanced collaboration, and scalable IT infrastructure. This study investigated the challenges to standardizing smart and green healthcare information services and proposed a cloud-based model for overcoming them. We conducted a mixed-methods study in 11 public hospitals, employing quantitative and qualitative approaches with diverse stakeholders (N = 103). The data was collected through surveys, interviews, and technical observations by purposive quota sampling with the Raosoft platform and analyzed using IBM SPSS. Findings revealed several shortcomings in existing information systems, including limited storage, scalability, and security; impaired data sharing and collaboration; accessibility issues; no interoperability; ownership ambiguity; unreliable data recovery; environmental concerns; affordability challenges; and inadequate policy enforcement. Notably, hospitals lacked a centralized data management system, cloud-enabled systems for remote access, and modern data recovery strategies. Despite these challenges, 90.3% of respondents expressed interest in adopting cloud-enabled data recovery systems. However, infrastructure limitations, inadequate cloud computing/IT knowledge, lack of top management support, digital illiteracy, limited innovation, and data security concerns were identified as challenges to cloud adoption. The study further identified three existing healthcare information systems: paper-based methods, electronic medical catalog systems, and district health information systems2. Limitations of the paper-based method include error-proneness, significant cost, data fragmentation, and restricted remote access. Growing hospital congestion and carbon footprint highlighted the need for sustainable solutions. Based on these findings, we proposed a cloud-based model tailored to the Ethiopian context. This six-layered model, delivered as a Software-as-a-Service within a community cloud deployment, aims to improve healthcare services through instant access, unified data management, and evidence-based medical practices. The model demonstrates high acceptability and potential for improving healthcare delivery, and implementation recommendations are suggested based on the proposed model.

Expectant mothers' social media emotional support-seeking behavior

In developing countries, the use of digital media for health information by expectant mothers is a relatively new phenomenon, in contrast to developed countries. This study explores whether emotional support and satisfaction are linked and how they affect the use of social media for healthcare information. A non-experimental survey design was employed in this study. Expectant mothers were surveyed in five hospitals in Ghana's capital from May to August 2022 using a questionnaire. After reviewing and cleaning the data, 580 usable responses were obtained. The collected data were analyzed using SmartPLS 4 structural equation modeling. The findings of the study indicate that expectant mothers' decision to adopt digital media for health information is influenced by emotional support on social media (ESPSM) and satisfaction with social media (SATSM). Furthermore, satisfaction with social media partially mediated the effect between ESPSM and social media health information usage (SMHIU). These findings highlight the importance of emotional support and satisfaction with social media platforms in promoting digital health information usage. In particular, emotional support plays a crucial role for women, especially during pregnancy. These discoveries provide valuable insights for healthcare professionals on how best to assist expectant mothers.

Developing an Educational Resource Aimed at Improving Adolescent Digital Health Literacy: Using Co-Design as Research Methodology.

Adolescence is a key developmental period that affects lifelong health and is impacted by adolescents regularly engaging with digital health information. Adolescents need digital health literacy (DHL) to effectively evaluate the quality and credibility of such information, and to navigate an increasingly complex digital health environment. Few educational resources exist to improve DHL, and few have involved adolescents during design. The co-design approach may hold utility through developing interventions with participants as design partners. This project aimed to explore the co-design approach in developing an educational resource to improve adolescents' DHL. Adolescents (12-17 years old) attended 4 interactive co-design workshops (June 2021-April 2022). Participant perspectives were gathered on DHL and the design of educational resources to improve it. Data generated were analyzed through content analysis to inform educational resource development. In total, 27 participants from diverse backgrounds attended the workshops. Insight was gained into participants' relationship with digital health information, including acceptance of its benefits and relevance, coupled with awareness of misinformation issues, revealing areas of DHL need. Participants provided suggestions for educational resource development that incorporated the most useful aspects of digital formats to develop skills across these domains. The following 4 themes were derived from participant perspectives: ease of access to digital health information, personal and social factors that impacted use, impacts of the plethora of digital information, and anonymity offered by digital sources. Initial participant evaluation of the developed educational resource was largely positive, including useful suggestions for improvement. Co-design elicited and translated authentic adolescent perspectives and design ideas into a functional educational resource. Insight into adolescents' DHL needs generated targeted educational resource content, with engaging formats, designs, and storylines. Co-design holds promise as an important and empowering tool for developing interventions to improve adolescents' DHL.

The digital readiness of future physicians: nurturing the post-pandemic medical education

BackgroundThe COVID-19 pandemic has accelerated the integration of digital technologies in the healthcare sector. Telemedicine has notably emerged as a significant tool, offering a range of benefits. However, various barriers, such as healthcare professionals’ insufficient technological skills and competencies, can hinder its effective implementation. Scholars have examined the readiness of future physicians, with some studies exploring their readiness before or during the COVID-19 crisis. There is, however, a noteable gap in the literature concerning the post-pandemic period. This study aims to identify gaps in current medical education programs by examining two primary aspects: (1) technical readiness (encompassing general and health-related digital competencies) and (2) behavioural readiness, which includes prior experiences and future intentions related to telemedicine education and implementation among medical students and residents.MethodsA cross-sectional study was conducted using a web-based questionnaire administered to medical students and residents at a major Northern Italian university. The survey responses were analyzed to ascertain whether their distributions varied across demographic variables such as gender and level of education.ResultsThe most commonly owned technologies were laptops and smartphones, with smartphones perceived as the easiest to use, while desktop computers presented more challenges. Approximately 38% of respondents expressed apprehension about applying digital health information in decision-making processes. There was a significant lack of both personal and academic experience, with only 16% of students and residents having used telemedicine in a university setting. Despite this, 83% of participants expressed a desire for training in telemedicine, and 81% were open to experimenting with it during their academic journey. Moreover, 76% of respondents expressed interest in incorporating telemedicine into their future clinical practice.ConclusionsThis study highlights the need for medical students and residents to receive specific education in digital health and telemedicine. Introducing curricula and courses in this domain is critical to addressing the challenges of digital healthcare.

Associations between digital health literacy and health system navigating abilities among Norwegian adolescents: validating the HLS19-DIGI scale using Rasch modeling

BackgroundDespite increasing global attention to health literacy and adolescents’ digital health information seeking, no unidimensional instruments measuring digital health literacy (DHL) in adolescents have reportedly been validated using Rasch modeling. Moreover, the evidence of adolescents’ abilities to navigate the health system (NAV-HL) in light of their DHL proficiency is still scarce. Therefore, our study aims to evaluate the psychometric properties of a DHL instrument (HLS19-DIGI scale) in order to investigate DHL in adolescents and young adults aged 16–25 and associations with abilities to navigate the health system.MethodsA population-based cross-sectional survey among 890 Norwegian adolescents was conducted during April–October 2020 using computer-assisted telephone interviewing. Rasch modeling, independent samples t-test, chi-square test, and binary regression models were used to analyze the data.ResultsThe HLS19-DIGI scale was sufficiently unidimensional, whereas no differential item functioning or disordered response categories were observed. However, relatively poor targeting was revealed indicating too many easy items for the target population. Yet, a high proportion (54%) of low DHL proficiency in adolescents was observed, as well as DHL was positively associated with the abilities to navigate the health system.ConclusionsThe HLS19-DIGI scale is considered a sufficiently unidimensional and valid instrument for measuring DHL in adolescents, which may be a useful tool for health authorities, public health workers, and health service providers. While DHL affects adolescents’ abilities to navigate the health system, future research should measure and examine their ability to utilize digital health services, separately.

Gender Harmony: A Case for Nursing Informatics.

The design of digital health information systems around a conflated gender/sex binary contributes to health inequities. Lack of specific information that supports affirming communication lead to inappropriate care, disrespectful encounters with healthcare staff, and avoidance of health services by clients who have been harmed by misgendering, deadnaming and being outed. The HL7 International Gender Harmony Model (HL7 GHM) supports the design, implementation and use of DHIS that enable affirming clinical interactions and care. This case study will demonstrate how applying the HL7 GHM can address the harms reported in a recently published account of one patient in Canada.

Age Differences in Electronic Mental Health Literacy: Qualitative Study.

Electronic mental health literacy (eMHL) is critical for accessing and effectively using digital mental health resources. However, there is a paucity of research on how eMHL varies across age groups. This study aimed to investigate differences in eMHL among young, middle-aged, and older adults; provide insights into the needs, behaviors, and attitudes of different age groups in relation to digital mental health resources; and ultimately, inform the improvement of mental health services. A qualitative investigation was conducted to examine the differences in eMHL across different age demographics in the Chinese population in 2023. The study sample comprised 3 distinct age groups: 18-34 years, 35-64 years, and 65 years and older. Participants were recruited through purposive sampling to ensure a diverse representation of the population. Data were collected through semistructured one-on-one interviews, which allowed for in-depth exploration of individual experiences and perceptions. The gathered data were subsequently subjected to rigorous thematic analysis to enable the identification and interpretation of recurring patterns and themes. The principal outcomes derived from these interviews were synthesized into 5 distinct dimensions: emotional needs, use of digital mental health resources, assessment of digital mental health information, engagement with social media to regulate emotions, and coping strategies. These dimensions were uniformly observed across the 3 age groups. We identified differences in knowledge, skills, and attitudes regarding the use of web-based information for managing mental health problems between the 3 age groups. The findings highlight the importance of age-specific strategies for improving eMHL.

Global Perspective on EMR and eHealth

A goal of this exploratory study was to uncover the attitudes of the public towards health information technology (HIT) during a health crisis (COVID-19 pandemic). A socio-technical network formed by EMR/eHealth, COVID-19, and the tweeters was investigated using the Actor-Network-Theory (ANT) to understand global perspectives on healthcare technology, taking into account the human dimension and social reality in technology. Social Media (SM) analytics was used to mine HIT-related tweets from the early phases of the COVID-19 pandemic. Results show that positivity, trust, and anticipation are the three most significant emotions associated with electronic medical records (EMR) and eHealth from the tweets. Our analysis found an acceptance of HIT by the global public and optimism for its role in information dissemination, control and containment, and public health improvement. The ANT analysis reveals a virtual coalition building that occurred through discussions among notable network actors, and the role of crowdsourcing in disseminating digital health information.

Understanding the Perspectives of Hail City Population on the Confidentiality and Privacy of Digital Health and Medical Information.

Background In the era of rapid digital advancement, the confidentiality and privacy of digital health and medical data have become paramount concerns. This study investigates the perspectives of individuals residing in Hail City regarding these critical issues, with a particular emphasis on the influence of demographic factors such as age, gender, and computer proficiency on individuals' discomfort with health professionals using computers and their trust in researchers.Gaining a deeper understanding of these factors is vital for the development of targeted interventions aimed at enhancing patient comfort and trust in digital health/medical technologies. Methodology This study employed a descriptive cross-sectional design, involving a survey of 775 individuals aged 18 and above in Hail City. The questionnaire was designed to gather information on participants' demographic characteristics, computer proficiency, experiences with digital health and medical information, and perceptions of health information safety and privacy. To examine the associations and predictive relationships between variables, chi-square tests, correlation analyses, and logistic regression were performed. Results Significant associations were found between gender and discomfort with health professionals using computers (chi-square = 60.29, p < 0.0001), and between age and trust in researchers regarding the privacy of medical information (chi-square = 50.14, p < 0.0001). Positive correlations were observed between computer proficiency and perception of health information safety (r = 0.12, p = 0.0002), while a negative correlation was found between computer ownership and avoidance of medical tests due to privacy concerns (r = -0.08, p = 0.03). Logistic regression analysis identified age, gender, and computer proficiency as significant predictors of discomfort with health professionals using computers. The findings highlight the crucial role that demographic factors play in shaping attitudes toward the privacy and security of digital health and medical information. Conclusions The findings of this study highlight the crucial role that demographic factors play in shaping attitudes toward the privacy and security of digital health and medical information. Gender and age were found to significantly influence individuals' levels of discomfort and trust, while computer proficiency was shown to enhance perceptions of safety. Based on these findings, the researchers recommend implementing targeted interventions, such as gender-sensitive training programs and initiatives, to enhance digital literacy and improve patient comfort and trust in digital health technologies.