eHealth Literacy Scale Research Articles

EHealth Literacy and Patient Portal Use and Attitudes: Cross-sectional Observational Study.

Throughout the COVID-19 pandemic, patient portals have become more widely used tools of patient care delivery. However, not all individuals have equivalent access or ability to use patient portals. The aim of this study is to evaluate the relationships between eHealth literacy (eHL) and patient portal awareness, use, and attitudes among hospitalized patients. Inpatients completed patient portal surveys; eHL was assessed (eHealth Literacy Scale). Multivariable logistic regression analyses adjusted for age, self-reported race, gender, and educational attainment were completed with significance at P<.006 (Bonferroni correction). Among 274 participants, most identified as Black (n=166, 61%) and female (n=140, 51%), mean age was 56.5 (SD 16.7) years, and 178 (65%) reported some college or higher educational attainment. One-quarter (n=79, 28%) had low eHL (mean 27, SD 9.5), which was associated with lower odds of portal access awareness (odds ratio 0.11, 95% CI 0.05-0.23; P<.001), having ever used portals (odds ratio 0.19, 95% CI 0.10-0.36; P<.001), less perceived usefulness of portals (odds ratio 0.20, 95% CI 0.10-0.38; P=.001), and lower likelihood of planning to use portals in the coming years (odds ratio 0.12, 95% CI 0.06-0.25; P<.001). As time through the COVID-19 pandemic passed, there was a trend toward increased perceived usefulness of patient portals (53% vs 62%, P=.08), but average eHL did not increase through time (P=.81). Low eHL was associated with less awareness, use, and perceived usefulness of portals. Perceived usefulness of portals likely increased through the COVID-19 pandemic, but patients' eHL did not. Interventions tailored for patients with low eHL could ensure greater equity in health care delivery through the COVID-19 pandemic.

Patients’ Perspectives, Factors, and Patterns of eHealth Use in Kidney Transplant Recipients

eHealth supports the delivery of relevant health information and management of chronic disease. However, little is known about patients' perspectives and the determinants of eHealth use among kidney transplant recipients. Kidney transplant recipients aged 18 years and older from 3 transplant units in Australia and the Better Evidence and Translation in Chronic Kidney Disease consumer network completed a survey with free-text responses relating to eHealth uptake. Multivariable regression modeling was used to determine the factors associated with eHealth use. Free-text responses were thematically analyzed. Of the 117 participants who were invited in person and who responded to the email, 91 completed the survey. Sixty-three participants (69%) were current eHealth users (active use of eHealth tools), and 91% had access to eHealth devices, including smartphones (81%) and computers (59%). Most (98%) reported that eHealth improves posttransplant care. Factors associated with increased eHealth use (odds ratio [95% confidence interval]) were higher eHealth literacy scale (eHEALS) score (1.21 [1.06-1.38]) and tertiary education (7.78 [2.19-27.7]). We identified the following 3 themes on eHealth determinants: (i) empowering self-management, (ii) enhancing health services, and (iii) technology burden. Transplant recipients believe that eHealth interventions have the potential to improve their posttransplant care. eHealth interventions should meet the needs of all transplant recipients and be accessible to those with lower educational attainment.

EHealth literacy, internet use and health-related behaviour among health sciences students: a cross sectional study

Background Health sciences students should have the necessary skills required to find health information from online resources. Objective To assess the eHealth Literacy Scale (eHEALS) and its association with internet use for health-related purposes, self-perceived health and health-related behaviour. Methods A cross-sectional study was conducted in a sample of 528 health sciences students. Sociodemographic data, questions related to internet use for health-related purposes, self-perceived health and health-related behaviour, and the eHEALS tool were collected. Results The overall mean eHEALS score was 3.19 ± 0.78. Students who consider access to health resources on the internet to be very important had the highest eHEALS scores (p = 0.015). There were significant differences between the participants’ perceptions of the usefulness of the internet with regard to making health decisions (p < 0.001), the accuracy of information on the internet (p = 0.001) and the eHEALS scores. Conclusions Health sciences students have a moderate level of eHealth literacy. Positive attitude towards internet use and positive self-perception of health are the most relevant factors associated with eHealth literacy. Impact statement As future healthcare providers, students need to develop eHealth literacy skills in order to find reliable health information. A positive attitude towards internet use and a positive self-perception of health are factors associated with eHealth literacy. Educators should promote training programmes that ensure students are acquiring suitable skills in eHealth literacy.

Associations between health literacy, digital skill, and eHealth literacy among older Chinese adults: A cross-sectional study.

Digital divide in health-related technology use is a prominent issue for older adults. Improving eHealth literacy may be an important solution to this problem. This study aimed to explore the associations between health literacy, digital skills, and eHealth literacy among older Chinese adults. A total of 2,144 older adults (mean age, 72.01 ± 6.96 years) from Jinan City, China participated in this study. The eHealth Literacy Scale was used to measure eHealth literacy in older adults. A linear regression model was used to analyze the associations among health literacy, digital skills, and eHealth literacy in older Chinese adults. The mean eHealth literacy score of the older adults was 17.56 ± 9.61. After adjusting for sociodemographic characteristics and experience of Internet usage, the results of the linear regression showed that health literacy (B = 0.258, 95% confidence interval (CI) = 0.215-0.302, P< 0.001) and digital skills (B = 0.654, 95% CI = 0.587-0.720, P < 0.001) were positively associated with eHealth literacy. Sensitivity analyses revealed that this association remained robust. The level of eHealth literacy in older Chinese adults is low. Health literacy and digital skills are associated with eHealth literacy in older adults. In the future, eHealth literacy intervention research should be considered from the perspective of health literacy and digital skills.

Do elders care about eHealth? A correlational study between eHealth consumption and literacy

As digital tools become more prevalent in medicine, the ability for individuals to understand and take actions based on what they read on the internet is crucial. eHealth literacy is defined as as the ability to seek, find, understand, and evaluate health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. In general, Americans have low eHealth literacy rates. However, limited research has been conducted to understand the eHealth literacy level among older Chinese adult immigrants in the U.S. To determine the eHealth literacy of elderly Chinese immigrants, we sent out an eHealth survey and relevant computer skills survey using a modified version of the eHEALS (eHealth Literacy Scale) health literacy test. We hypothesized that elders who consumed more electronic health content would have a higher eHealth literacy score. The results of this survey showed that there was a positive correlation between the frequency of electronic health information consumption and the participant's eHealth literacy rate. In addition, the results of our computer literacy test show that the frequency of consumption and computer literacy are positively correlated as well. There is a strong positive correlation between the level of computer skills and eHealth literacy of participants. These results reveal possible steps individuals can take to reduce health misinformation and improve their own health by attaining, understanding, and taking action on health material on the internet.

Assessment of eHealth literacy to reduce financial toxicity and improve shared decision-making in cancer patients: A cross-sectional study.

This study aimed to investigate the associations between eHealth literacy, preferences for financial decision-making, and financial toxicity (FT) in a sample of Chinese cancer patients. Eligible cancer patients were invited to participate in a cross-sectional survey from January to April 2021. Three measures (eHealth literacy scale, control preference scale, and COST) were used to analyze patients' eHealth literacy, decisional preferences, and FT, respectively. Wilcoxon signed-rank test and Kruskal-Wallis H test assessed the differences between population subgroups. Binary logistic and multivariate linear regression models were used to assess the relationships between eHealth literacy, decisional preferences, and FT. A total of 590 cancer patients completed the questionnaire. We found that high FT was associated with poor ECOG performance, severe cancer stage, and longer cancer duration. Patients who preferred to adopt collaborative attitude toward decision-making showed a significantly higher eHealth literacy. However, there was an inverse relationship between eHealth literacy and a patient-driven attitude toward decision-making in female cancer patients. Regression analysis indicated that patients who were highly educated and actively employed might report a higher eHealth literacy. A significant relationship was found between high eHealth literacy and low FT. However, this relationship became insignificant when the background characteristics of cancer patients were taken into account. A relationship between enhanced eHealth literacy, preference for collaborative decision-making, and low risk of FT is identified. Interventions to improve patients' ability to use quality and reliable web-based information on cancer care should be encouraged.

Associations Among Online Health Information Seeking Behaviors, Electronic Health Literacy and Food Neophobia: A Cross-Sectional Study.

Few studies have investigated whether improve electronic health (eHealth) literacy can alleviate food neophobia in university students. We explored the associations among online health information (OHI)-seeking behaviors, eHealth literacy and food neophobia. A questionnaire-based, cross-sectional study of 5151 university students in China was conducted from October to December 2022. The study used Chinese versions of the eHealth literacy scale (C-eHEALS), and the food neophobia scale (FNS-C), as well as the OHI-seeking behaviors scale. Data were collected through Wenjuanxing software. Analysis of variance, t-tests, the Pearson correlation coefficient and chi-square tests were performed for data analysis. The average (SD) scores of C-eHEALS and FNS-C were 26.81 (5.83) and 38.86 (6.93), respectively. University students in China had a low C-eHEALS and a high FNS-C level, and there were significant differences between the high and low groups of C-eHEALS (P < .001) and FNS-C (P < .001). There was also a significant correlation between eHealth literacy and food neophobia (P < .001), and a lower eHealth literacy level indicated a higher probability of food neophobia occurrence. University students with high FNS-C and low C-eHEALS show more OHI-seeking behaviors. When schools, communities, and parents want to alleviate students' food neophobia, OHI-seeking training to improve eHealth literacy may be a good intervention.

Psychometric properties of the German revised version of the eHealth literacy scale in individuals with cardiac diseases: Validation and test of measurement invariance.

The internet is most people's primary source of (health) information. However, no validated instrument exists to assess eHealth literacy in the group of patient with cardiac diseases. The objective of this study was the evaluation of the psychometric properties of the German revised version of the eHealth literacy scale (GR-eHEALS) in individuals with coronary artery disease (CAD) and congestive heart failure (CHF). A cross-sectional study was conducted. N = 455 were included in the statistical analyses. The assessment compromised the GR-eHEALS, medical history, sociodemographic data, and technology-related data. Confirmatory factor analyses, correlational analyses, and tests of measurement invariance were performed. The two-factorial model reached a good model fit. The sub-scales information seeking and information appraisal, as well as the eHealth literacy total score, reached high reliability coefficients. Construct and criterion validity was fully confirmed For the two-factorial model, measurement invariance up to the scalar level could be confirmed regarding the sociodemographic characteristics sex, age, and educational level. This study confirmed the two-factor structure, construct, and criterion validity as well as measurement invariance at the scalar level for sex, age, and educational level of the GR-eHEALS scale in a sample of individuals with CAD and CHF.

The association between Electronic Health Literacy and Self-care Management in Adults with Type-2 Diabetes

Purpose: E-health illiteracy has disadvantages including misevaluation of medical information displayed on the internet. Both effective self care management and e-health literacy are important terms in order to control of the chronic diseases. The aim of this study is to determine the relationship between e-health literacy and the self-care management of patients with Type-2 diabetes. Materials and Methods: The type of the study is descriptive. A questionnaire was applied to individuals who have been diagnosed with Type-2 diabetes in the endocrine policlinic of the internal medicine clinic of a tertiary state hospital in Istanbul, Turkey. The sample size was calculated as 384 by accepting the adequate e-health literacy rate among Type-2 diabetes patients as 50%, the margin of error 5%, and the confidence level as 95%. In addition to sociodemographical questions; our questionnaire contains two scales: Self-Care Management Protection scale and the E-health Literacy Scale. Number (n) and percentage (%) values were used in the expression of descriptive data. Mean, standard deviation, median and minimum, maximum values were given. For data comparison; Mann-Whitney U test was used for non-normally distributed variables. The Spearman correlation used to measure the linear relation between two numeric variables. Significance level has been accepted as p&lt;0.05. Results: Totally 330 patients were included our study by a participation rate of 85.9 %. The mean age of the participants was 57.74±13.83 and 52.4% were female. A positive correlation was observed between scores of e-health literacy scale and self-care management scale (r=0.235, p&lt;0.001) and self- protection subscale of self-care management scale (r= 0.345, p&lt;0.001). A negative correlation exists between age and e-health literacy (r= -0.419, p&lt;0.001). Conclusions: The results support the claim that individuals with a higher e-health literacy can better able to control their disease through self- management.

Testing reliability and validity of the Vietnamese version of the eHealth literacy scale (eHEALS) among medical students in Vietnam

BackgroundIn the context of COVID-19 pandemic, eHealth Literacy is important and essential for healthcare workers, especially medical students; eHealth Literacy Scale (eHEALS) was developed to measured eHealth literacy of individuals, with higher eHEALS scores indicated greater ehealth literacy. ObjectivesThe study evaluates the reliability and validity of Vietnamese version of eHEALS and analyzed some factors affecting on eHEALS score among Hanoi Medical University students in Vietnam. MethodsA cross-sectional study design was adopted, and data were elicited from 494 medical students. Exploratory Factor Analysis (EFA); Cronbach’s alpha and correlation coefficients; split-half assessment; Poisson regression analysis were applied. ResultsThe total score of our subjects in the eHEALS was 30.34 ± 4.57. The results from Bartlett’s test, Kaiser-Meyer-Olkin (KMO) test, calculated Cronbach’s alpha coefficient and test–retest reliability were high. Poisson regression identified that eHEALS scores of participants was significantly associated with device, ongoing medical condition and trustworthiness of health information source (p < 0.05). DiscussionOur study helps researchers who conduct studies in eHealth develop optimal applied and intervention researches in subjects with medical knowledge. Additional studies need to be required with numerous different groups of people in Vietnam. ConclusionThe Vietnamese version of eHEALS is a reliable and valid measure. Device, medical condition and trustworthiness of health information source are factors affecting on eHEALS score of students in Hanoi Medical University.

Exploration of the health needs of patients with poorly controlled type 2 diabetes using a user-centred co-production approach in the area of mHealth: an exploratory sequential mixed-method protocol

IntroductionResearch on the needs and preferences of patients with poorly controlled type 2 diabetes mellitus (T2DM) with mobile health (mHealth) service is limited. With the principles of co-production, this study...

The Relationship of Perceived Health Literacy and Vaccination Hesitancy in People with Dementia Associated Disorders

AbstractBackgroundDementia associated disorders (DAD) refers to clinical conditions that are typically characterized by progressive cognitive impairment (CI) that interferes with an individual’s ability to function independently. In routine care CI in DAD may be poorly recognized and can vary considerably in degree and combination across multiple cognitive domains. Therefore, clinical judgement may be insufficient alone to identify CI across these varied types/degrees, and how CI may directly affect both patient quality of life and decision‐making. Patient reported outcomes (PRO) are used to survey patient perception of their disease across varied real world impact. The BRIEF Health Literacy (HL) survey (BHL), Electronic health literacy (eHealth Literacy Scale, EHL) and the psychological antecedents of vaccinations (Vaccine 5C, V5C), vaccine hesitancy, have not been explored across these areas in people with DAD (PwDAD).MethodRetrospective cross‐sectional analysis of PwDAD who completed the following PRO’s V5C, EHL, and BHL in routine care.Results146 PwDAD, average age of 72+/‐15 years. Linear regression statistics were used to analyze trends between individual V5C questions with the BHL and EHL. Significant correlations were found as follows (p&lt;0.01): V5C‐2 (the need for vaccination)vs BHL (r = .2), V5C‐3 (everyday stress interfering with vaccination) vs BHL (r = .2), V5C‐4 (I personally weight risks/benefits of vaccination) vs BHL (r = .3), V5C‐2 vs EHL (r = .2), V5C‐3 vs EHL (r = .1), V5C‐4 vs EHL (r = .2).ConclusionLower perception health literacy ability (BHL) and lower ability to use electronic sources to gain information regarding their health literacy (EHL)in PwDAD impact decision and feelings regarding vaccination (i.e. the necessity of vaccination, stress as a barrier to vaccination, and risk‐benefit analysis respectively). Further investigation beyond perceptions to quantitative measures of CI across multiple cognitive domains (degrees/combinations) between the V5C, BHL, and EHL would prove useful in exploring these relationships and defining a path to enhance education to reduce vaccine hesitancy.

EHealth Literacy and Health Information Seeking Behaviours Among People with Stroke: A Cross-Sectional Study

<h3>Research Objectives</h3> To describe the ehealth literacy and online health information seeking behaviour in self-management of medical and emotional conditions, as well as life roles, health, and occupation, among people with stroke; and to explore the associations between demographics and ehealth literacy. <h3>Design</h3> A cross-sectional study. <h3>Setting</h3> Community. <h3>Participants</h3> Forty community-dwelling individuals with stroke (average 68 years) were recruited. Most were male (68%), used English as their primary language (83%) and were from urban communities (78%). <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Quantitative survey data was collected online on participants' sociodemographic characteristics, ehealth literacy using the eHealth Literacy Scale (eHEALS), and online health information seeking behaviour. <h3>Results</h3> Most respondents (78%) used the internet to find health information, however, the level of trust for using the internet ranged between "a little" to "some" (75%). The internet was used to find information pertaining to medical management, emotional management, and life roles, health, and occupation by approximately 60%, 20%, and 15% of respondents, respectively. Respondents showed a moderate level of ehealth literacy (eHEALS score: 29 ± 7 out of 40). Significant negative correlations were found between eHEALS and age (rs = -0.362, p = 0.022). There were significant negative correlations with age in subdomains of eHEALS: (i) knowing how to use the internet (rs = -0.364, p = 0.021), (ii) knowing how to use health information from the internet (rs = -0.346, p = 0.029), (iii) having the skills to evaluate online resources (rs = -0.331, p = 0.037), and (iv) differentiating between high and low quality online HI (rs = -0.336, p = 0.034). <h3>Conclusions</h3> This novel study investigated ehealth literacy and health information seeking behaviour among people with stroke. Overall, individuals living with stroke recorded low to moderate trust levels with online health information, which was lower in older respondents. Further studies are warranted to determine how best to improve online resource access and support people to build confidence when using the internet to find health resources, especially for emotional management, health, life roles and occupation. <h3>Author(s) Disclosures</h3> None.

Insight into global research on health literacy and heart diseases: A bibliometric analysis.

Health literacy (HL) has shown its important role on reducing the burden of heart diseases. However, no study has provided a comprehensive worldwide view of the data regarding HL and heart diseases. The study aimed to provide insight into: (1) the intellectual structure, (2) research trends, and (3) research gaps on HL and heart diseases; and (4) to explore HL scales commonly utilized in heart studies. Studies related to HL and heart diseases were retrieved from Web of Science, Scopus, and PubMed. All publications published between 2000 and 2021 were included after conducting keyword searches on "heart diseases" in general or on specific types of heart diseases (e.g., "heart failure") and "health literacy". Bibliometric analyses were carried out using the Bibliometrix R package and VOSviewer 1.6.14. A total of 388 original research articles and reviews on HL and heart diseases were included in our study. The studies were primarily conducted in the United States and developed countries. A total of 337 studies (86.9%) focused on heart failure (200 studies, 51.5%) and ischemic heart diseases (137 studies, 35.3%). Sixty-two studies (16.0%) focused on other heart diseases (e.g., valvular diseases and rheumatic heart diseases). The number of interventional studies was limited (52 studies, 13.4%) and fluctuated from 2000 to 2021. The most common questionnaires measuring health literacy among patients with heart diseases were the Test of Functional Health Literacy in Adults (TOFHLA), Short Test of Functional Health Literacy in Adults (STOFHLA), and Brief Health Literacy Screen (BHLS). Use of the eHealth Literacy Scale (eHEALS) has become the latest trend among patients with heart diseases. Health literacy and heart diseases were most often studied in the United States and developed countries. Several HL tools were used; eHEALS has been lately used in this field. These findings suggest the need to conduct more empirical studies on HL and heart diseases in different settings (e.g., developing or poor countries) and with different types of heart diseases (e.g., valvular and rheumatic disorders). Additionally, it is necessary to develop heart disease-specified HL scales for research and practice.

Perceptions of Quality of Care Among Users of a Web-Based Patient Portal: Cross-sectional Survey Analysis.

Web-based patient portals enable patients access to, and interaction with, their personal electronic health records. However, little is known about the impact of patient portals on quality of care. Users of patient portals can contribute important insights toward addressing this knowledge gap. We aimed to describe perceived changes in the quality of care among users of a web-based patient portal and to identify the characteristics of patients who perceive the greatest benefit of portal use. A cross-sectional web-based survey study was conducted to understand patients' experiences with the Care Information Exchange (CIE) portal. Patient sociodemographic data were collected, including age, sex, ethnicity, educational level, health status, geographic location, motivation to self-manage, and digital health literacy (measured by the eHealth Literacy Scale). Patients with experience using CIE, who specified both age and sex, were included in these analyses. Relevant survey items (closed-ended questions) were mapped to the Institute of Medicine's 6 domains of quality of care. Users' responses were examined to understand their perceptions of how portal use has changed the overall quality of their care, different aspects of care related to the 6 domains of care quality, and patient's satisfaction with care. Multinomial logistic regression analyses were performed to identify patient characteristics associated with perceived improvements in overall care quality and greater satisfaction with care. Of 445 CIE users, 38.7% (n=172) reported that the overall quality of their care was better; 3.2% (n=14) said their care was worse. In the patient centeredness domain, 61.2% (273/445) of patients felt more in control of their health care, and 53.9% (240/445) felt able to play a greater role in decision-making. Regarding timeliness, 40.2% (179/445) of patients reported they could access appointments, diagnoses, and treatment more quickly. Approximately 30% of CIE users reported better care related to the domains of effectiveness (123/445, 27.6%), safety (138/445, 31%), and efficiency (174/445, 28.6%). Regarding equity, patients self-reporting higher digital health literacy (odds ratio 2.40, 95% CI 1.07-5.42; P=.03) and those belonging to ethnic minority groups (odds ratio 2.27, 95% CI 1.26-3.73; P<.005) were more likely to perceive improvements in care quality. Across ethnic groups, Asian and British Asian patients perceived the greatest benefits. Increased frequency of CIE use also predicted perceived better care quality and greater satisfaction with care. A large proportion of CIE users perceived better care quality and greater satisfaction with care, although many portal users reported no change. The most favorable perceived improvements related to the domain of patient centeredness. With national policy directed toward addressing health disparities, patient portals could be valuable in improving care quality for ethnic minority groups. Future research should test the causal relationship between patient portal use and care quality.

EHealth literacy among online health consumers in Jordan

PurposeThis study aims to examine the eHealth literacy level among online health consumers (OHC) in Jordan and identified variables predicting their eHealth literacy level as well.Design/methodology/approachA quantitative study was conducted to achieve the study objectives. A purposeful sample of 262 OHC completed an electronic version of the eHealth literacy scale (eHEALS). eHEALS is the most cited scale in the literature, which includes eight items (measured on a 5-point Likert scale, ranging from strongly disagree to strongly agree).FindingsResults showed that OHC in Jordan had a moderate level of overall eHealth literacy. Specifically, the eHEALS formed two conceptually sound factors. Gender, occupation, perceived usefulness and perceived importance of the internet, and more frequent online health information seeking were significant positive predictors of overall eHealth literacy and/or its two identified dimensions.Research limitations/implicationsThis study represents a humble contribution to the field. Several recommendations were suggested to maintain and improve eHealth literacy among OHC in Jordan.Originality/valueThe internet has changed the landscape of health information. There is an increase in the provision and availability of health information to all users. OHC should be skillful in locating, using and evaluating online health information. Although many researchers have increasingly studied the concept of eHealth literacy among various groups in the past decade, little research has been devoted to focus on eHealth literacy among OHC, particularly in Jordan.

Development and psychometric evaluation of a new brief scale to measure eHealth literacy in people with type 2 diabetes

BackgroundThe internet has become a major source of health information, and obtaining appropriate information requires various abilities and skills, labeled as electronic health literacy (eHealth literacy). The existing instruments for measuring eHealth literacy are outdated because they were developed during the Web 1.0 era, or not sufficiently sensitive for people with a specific condition or disease because they were designed to assess eHealth literacy over a broad range for a general population. Approximately one in ten adults worldwide live with diabetes. Health professionals have a responsibility to identify patients with low eHealth literacy to prevent them from obtaining misleading internet diabetes information.AimsThe aims were to develop a condition-specific eHealth literacy scale for diabetes and to evaluate its psychometric properties among people with type 2 diabetes.MethodsAn instrument development design was used. This study recruited 453 people diagnosed with type 2 diabetes at the outpatient clinics of hospitals in 2021. Psychometric properties (internal consistency, measurement invariance, and content, structural, convergent, and known-groups validities) were analyzed.ResultsAn expert panel assessed content validity. Exploratory factor analysis, exploratory graph analysis, and confirmatory factor analysis (CFA) for structural validity yielded a two-factor solution (CFI = 0.977, SRMR = 0.029, RMSEA = 0.077). Cronbach’s alpha and omega values were excellent for each factor (0.87–0.94). Multigroup CFA yielded configural and metric measurement invariance across the gender, age, and glycemic control status groups. Convergent validity with a comparator instrument to measure health literacy was supported by a moderate correlation, and known-groups validity determined using groups with different internet-use frequencies was satisfied with a high effect size.ConclusionA new condition-specific eHealth literacy scale for people with type 2 diabetes was developed, comprising 10 items. The scale exhibited good psychometric properties; however, test–retest reliability must be determined for the stability of the scale and cross-cultural validity is required among different languages. The brief scale has the merits of being feasible to use in busy clinical practice and being less burdensome to respondents. The scale can be applied in clinical trials of internet-based diabetes interventions for assessing the eHealth literacy of respondents.

The relationship between eHealth literacy, social media self-efficacy and health communication intention among Chinese nursing undergraduates: A cross-sectional study.

With the popularization of the Internet, it has become possible to widely disseminate health information via social media. Medical staff's health communication through social media can improve the public's health literacy, and improving the intention of health communication among nursing undergraduates is of great significance for them to actively carry out health communication after entering clinical practice. To explore the relationship among eHealth literacy, social media self-efficacy, and health communication intention and to determine the mediating role of social media self-efficacy in the relationship between eHealth literacy and health communication intention. A cross-sectional descriptive correlation design was used in this study. Stratified cluster sampling was used to select 958 nursing students from four nursing colleges in Jiangsu Province, China, from June to July 2021. Data were collected using the eHealth Literacy Scale, the Social Media Self-efficacy Scale, and the Health Communication Intention Questionnaire. Sociodemographic data were also collected. Correlation analysis and regression analysis were used to determine the relationship between eHealth literacy, social media self-efficacy, and health communication intention. Health communication intention is positively correlated with eHealth literacy and social media self-efficacy. There is a significant positive correlation between eHealth literacy and health communication intention (β = 0.57, p < 0.001), and social media self-efficacy played a mediating role in the influence of eHealth literacy on health communication intention (the mediating effect accounted for 37.2% of the total effect). The study found that eHealth literacy and social media self-efficacy had an impact on health communication intention. Because there is a correlation between eHealth literacy and social media self-efficacy and health communication intention, in order to promote health communication intention of nursing students, it is also important to cultivate eHealth literacy and social media self-efficacy of nursing students. In view of these results, targeted educational programs must be developed to improve eHealth literacy and social media self-efficacy among nursing undergraduates, thereby promoting their health information transmission.

194 CONNECTED HEALTH SUSTAINING HOME STAY IN DEMENTIA (CHESS): SMART HEALTH TECHNOLOGY ACCEPTABILITY BY INFORMAL CAREGIVERS OF PEOPLE WITH DEMENTIA

Abstract Background The prevalence of dementia is increasing worldwide, and innovative strategies are required to meet increasing demands on health services. The Connected HEalth Sustaining home Stay in Dementia (CHESS) Study aimed to provide support to People with Dementia (PwD) and their caregivers in their homes. We aimed to quantitatively assess the acceptance of smart connected health technology by caregivers of PwD through use of standardised questionnaires. Methods Fifty-two PwD and their informal caregivers were recruited by convenience sampling to the intervention arm of the CHESS Study. An additional 25 dyads acted as control participants. Questionnaire data were collected following completion of the CHESS study from 27 informal caregivers from the CHESS Technology group and 16 informal caregivers from the Control group. Measures of health technology acceptability included the System Usability Scale (SUS), the eHealth Literacy Scale (eHEALS), the Technology Readiness Index 2.0 (TRI), and the Unified Theory of Acceptance and Use of Technology Scale (UTAUT). Univariate analyses of variance were used to explore differences between groups. Results Internal consistency (Cronbach’s alpha) was high for all measures (range 0.68 – 0.96). The SUS score for the technology group was high (M=70.07, SD=17.69), indicating that the CHESS technology had a high level of usability. All participants had a high level of eHealth literacy (M=33.61, SD=10.51). Both groups performed similarly on the TRI and UTAUT, however the control group indicated greater discomfort with health technology and felt less secure in providing their personal information electronically to healthcare professionals than the technology group. Conclusion Caregivers across the technology and control groups had high levels of eHealth literacy and found health technology to be generally acceptable. The CHESS technology in particular was rated as highly usable on the SUS by those who used it. These findings offer support for a Connected Health model of care.

A Community-Based Participatory Research Approach to Developing and Testing Social and Behavioural Interventions to Reduce the Spread of SARS-CoV-2: A Protocol for the 'COPAR for COVID' Programme of Research with Five Interconnected Studies in the Hong Kong Context.

Background: While a number of population preventive measures for COVID-19 exist that help to decrease the spread of the virus in the community, there are still many areas in preventative efforts that need improvement or refinement, particularly as new strains of the virus develop. Some of the key issues currently include incorrect and/or inconsistent use of face masks, low acceptance of early screening or vaccination for COVID-19, vaccine hesitance, and misinformation. This is particularly the case in some vulnerable populations, such as older people with chronic illnesses, ethnic minorities who may not speak the mainstream language well and children. The current protocol introduces a large programme of research through five interrelated studies that all focus on social and behavioural interventions to improve different aspects of community-related preventative indicators. Hence, the specific objectives of the overall programme are to (1) increase early testing for COVID-19 and promote the uptake of COVID-19 vaccines in the community (Study 1); (2) increase COVID-19-related health literacy and vaccine literacy and promote improved preventative measures in minority ethnic groups, chronically ill populations and caregivers (Study 2); (3) strengthen the public’s motivation to stay at home and avoid nonessential high-risk activities (Study 3); (4) decrease COVID-19 vaccine hesitancy (Study 4); and (5) enhance the adherence to COVID-19-related hygiene practices and the uptake of early testing in school children (Study 5). Methods: We will utilise a community-based participatory research (CBPR) approach in the proposed studies. All studies will incorporate an intervention development phase in conjunction with key community stakeholders, a feasibility study and an execution stage. A variety of self-reported and objective-based measures will be used to assess various outcomes, based on the focus of each study, in both the short- and long-term, including, for example, the 8-item self-reported eHealth Literacy Scale (eHEAL) and objective measures such as vaccine uptake. Discussion: Theory-driven interventions will address each study’s focus (e.g., social distancing, promotion of vaccine uptake, eHealth education, preventive measures and early detection). Improvements are expected to be seen in the outcomes of vulnerable and high-risk groups. Decreased infection rates are expected due to improved preventative behaviours and increased vaccine uptake. Long-term sustainability of the approach will be achieved through the CBPR model. The publication of this protocol can assist not only in sharing a large-scale and complex community-based design, but will also allow all to learn from this, so that we will have better insight in the future whether sharing of study designs can elicit timely research initiatives.