eHealth Literacy Research Articles

The Relationship Between Neonatal Nurses' e-Health Literacy Levels and Care Behaviours: A Cross-Sectional Study.

The study aims to determine the relationship between e-health literacy level and the care behaviour of neonatal nurses. E-health literacy is becoming increasingly important, as health-related information can be obtained easily and quickly from electronic sources. A cross-sectional design was adopted in the survey. The STROBE checklist for cross-sectional studies was used in reporting this study (Data S1). The study was conducted between July and November 2023. The sample of the study consists of 384 neonatal nurses working in different hospitals in Türkiye. An introductory form, the E-Health Literacy Scale (eHEALS), and the Care Behaviours Inventory-24 (CBI-24) were used for data collection. The data collection forms were created using Google Forms. eHEALS 4.32 ± 0.551, CBI-24 5.58 ± 0.567, CBS-24 sub-dimension: Assurance 5.58 ± 0.591, CBS-24 sub-dimension: Knowledge-Skills 5.64 ± 0.561, CBI-24 sub-dimension: Respect 5.56 ± 0.565, CBI-24 sub-dimension: Connectedness 5.52 ± 0.637 was found. It was determined that there was a very weak positive relationship between eHEALS, CBI-24 and sub-dimension scores (p < 0.001). A significant relationship was found between the eHEALS and the independent variables age, female, living in the Southeastern Anatolia region, working in a public hospital, using the internet for their profession, and CBI-24 sub-dimension: assurance (F = 6.111; p < 0.001). The relationship between e-health literacy and care behaviours of neonatal nurses was examined. Neonatal nurses' was found eHEALS, CBI-24, and sub-dimension scores had a high and very weak positive relationship. A significant relationship was found between the eHEALS level and age, female, Southeastern Anatolia region, state hospital, using the internet for their profession, and assurance sub-dimension. Study determines the eHEALS of neonatal nurses and provides information about this field. Interventions aimed at eHEALS should be developed and implemented at both the institutional and individual levels. STROBE, No Patient or Public Contribution.

Explore barriers to using the internet for health information access in African countries: A systematic review.

The Internet is a crucial source of health information, providing access to vast volumes of high-quality, up-to-date, and relevant healthcare information. Its impact extends beyond information access, influencing medical practice through the widespread adoption of telemedicine and evidence-based medicine. Despite the significant global increase in internet usage, Africa lags in internet penetration, particularly in utilizing the internet for health information. This study aims to systematically review the literature to explore barriers to accessing health information on the Internet in African countries. The study was conducted from January 1 to February 28, 2023. It followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to systematically review published studies investigating the utilization of the Internet for health information in African countries. A comprehensive search was conducted across various databases, including Google Scholar, PubMed, Cochrane Library, Hinari, CINAHL, and Global Health. The inclusion criteria were applied, resulting in the selection of six studies that formed the basis for our analysis. This systematic review identifies eleven barriers to accessing health information on the internet. These include a lack of ownership of smart electronic devices, infrequent internet use, limited internet access, low E-health and computer literacy, slow internet connection, high cost of internet access, insufficient information search skills, residing in rural areas, dealing with diverse fields, and having low perceptions. Improving our understanding of barriers to accessing health information online is essential for policymakers, governments, academics, and healthcare professionals. To enhance the use of the Internet for health information and strengthen the overall health system, policymakers should prioritize increasing Internet accessibility, reducing costs, improving connections, offering basic computer skills training, and ensuring the availability of electronic devices in all institutions.

Development and validation of the eHealth Literacy and Use Scale (eHLUS) to measure medical app literacy.

This study aimed to develop and validate the eHealth Literacy and Use Scale (eHLUS), a German assessment tool designed to measure health literacy in the context of using medical apps. This scale enhances traditional eHealth literacy tools by focusing on the unique requirements of medical app use, such as integration into everyday life, and self-efficacy. This study employed a mixed-method design. The development of the eHLUS involved a thorough literature review, expert interviews, and psychometric evaluation in a real-world environment. The eHLUS, consisting of 14 items across three dimensions, was designed for a nuanced assessment of eHealth literacy in medical apps. Psychometric evaluation data were gathered from 127 participants at two time points (nt1=117; nt2=62). The scale demonstrated excellent internal consistency, with a Cronbach's alpha of 0.913 and a McDonald's omega of 0.911. A mean completion time of 2.2min underscores its practical applicability. Retest reliability was confirmed in 52 matched cases, affirming the scale's stability. Principal component analysis revealed three dimensions: autonomous use and technical access, eHealth engagement, and eHealth literacy. The findings demonstrate the suitability of eHLUS for assessing individuals' abilities to effectively use medical apps, highlighting its importance in research and healthcare. The evaluation of the scale, along with expert interviews, underscores both its necessity and feasibility. The eHLUS captures eHealth literacy and its associated determinants within the context of medical app use, contributing to the optimization of patient care.

P0907 Health literacy and digital health literacy in Inflammatory Bowel Disease as conditions for individualized adapted digital health information

Abstract Background Digital health information appears inadequate of providing medical expertise and clinical guidelines in IBD, including optimized accessibility, relevance and understandability for effective self-management. This study examines IBD patients’ health literacy (HL) and digital health literacy (DHL) and their covariance with various patient characteristics as implications for a digital health information platform. Methods IBD patients at a Norwegian university hospital underwent a cross-sectional survey. Clinical data were extracted from EHR. Other data were reported via questionnaire with the following instruments: HL – Health Literacy Questionnaire; DHL – eHealth Literacy Questionnaire; Quality of Life (QoL) – EQ-5D-5L; Self-efficacy (GSE) - General Self-Efficacy Scale; Illness perception (IP) – Brief Illness Perception Questionnaire; Medication adherence (MA) – The OsloMet Adherence to medication Survey tool. Data underwent a canonical correlation analysis (CCA) followed by hierarchical clustering. Variables omitted from CCA underwent bivariate analyses and logistic regression to assess cluster affiliation. Results Of 380 patients, 173 had UC and 53 % were male. Mean age was 43.6 years. No diagnose-specific PROM differences were found. CCA demonstrated positive associations for GSE, IP and health status against having sufficient capability to understand, assess and act upon health information and digital health services (p &amp;lt; .001). CCA also proved a negative association for age and actively engaging with digital health services (p &amp;lt; .001). Two clusters were identified (p &amp;lt;. 05). Cluster 1 embodied the oldest patients, lowest levels of HL, DHL, GSE, health status, IP and longest disease duration. Compared to Cluster 2, Cluster 1 significantly demonstrated lower MA (p &amp;lt;.05), higher shares of unemployment (p &amp;lt;.05), active disease (p &amp;lt;.001), and more severe QoL problems in terms of mobility (p &amp;lt; .05), usual activities (p &amp;lt; .001), pain/discomfort (p &amp;lt; .001) and anxiety/depression (p &amp;lt; .001). Disease activity (p &amp;lt;. 01) and biological treatment (p &amp;lt; .001) proved to be the strongest factors for cluster affiliation in a logistic model. Conclusion Our results imply a relation between health status, age, self-efficacy, biological treatment, disease perception and disease activity for IBD patients with low HL and DHL. The findings are implicative for a targeted intervention addressing digital health information dissemination for IBD patients.

Validation of the eHealth literacy scales: comparison between the shorter and longer versions

ABSTRACT Digital service provision became necessary during and after the COVID-19 pandemic highlighting the technological disparity experienced by healthcare professionals and healthcare users. eHealth Literacy skills are mostly measured with the use of the eHeals, but recently more instruments have been developed to meet this need. The aim of the study was to validate and compare the two scales in Greek: the eHeals and the revised eHeals-Extended. In total, 401 participants replied to the eHeals, the revised eHeals-Extended, and the HLS-EU-Q16. The eHeals scales provided good psychometric properties. The validation of the eHeals confirmed the two dimensions with high internal consistency (total score α = .91, eHeals1 α = .88, eHeals2 α = .78). The revised eHeals-Extended exploratory analysis extracted five factors with satisfactory internal consistency (Cronbach’s α = .62–.89): awareness and quality of resources online, understanding online information, smart on the net, accessing and validating online information and perceived efficiency. The use of the revised eHeals-Extended and eHeals validated in Greek, could be valuable tools in clinical and research settings. The eHeals could be used as an additional tool when eHealth Literacy is not the core concept measured and the revised eHeals-Extended can be used when researchers wish to measure eHealth Literacy concept more thoroughly.

EHealth literacy in the general population: a cross-sectional study in China

BackgroundeHealth literacy (eHL) is positively associated with health-related behaviors and outcomes. Previous eHL studies primarily collected data from online users and seldom focused on the general population in low- and middle-income countries (LMIC). Additionally, knowledge about factors that affect eHL is limited. Chronic lung disease (CLD) has brought a large burden in LMIC, making it a relevant example for studying eHL. This study aims to explore eHL and its associated factors within the general population of China, encompassing sociodemographic characteristics, CLD knowledge, digital access, eHealth use and attitudes towards eHealth.MethodData were collected from November 2023 to January 2024 via online and hard-copy questionnaires among the general population in China. Descriptive analyses were performed to explore eHL, CLD knowledge, digital access, and attitudes towards eHealth at different sociodemographic levels. Univariable and multivariable regression analyses were performed to identify factors associated with eHL.Results439 valid questionnaires were collected. Participants demonstrated a mean eHL of 24.7 ± 8.2 and CLD knowledge of 5.9 ± 3.7, obtained a score of 6.9 ± 1.8 in attitudes towards eHealth. A notable percentage of participants (45/439, 10.3%) reported no digital access, especially those aged 66+, the unemployed, retired, those with a primary school or below degree and earning ≤ 1500 RMB monthly. Multivariable hierarchical regression analysis showed higher eHL was uniquely associated with younger age (b=-0.10, P < .001), higher educational level (b = 2.02, P < .001), higher income (b = 1.10, P < .001), having digital access (b = 6.35, P < .001), more frequent eHealth use (b = 1.14, P < .001), and more positive attitudes towards eHealth (b = 0.47, P = .003).ConclusionOur sample from the general population in China had a relatively low eHL and CLD knowledge level, but held a positive attitudes towards eHealth. A digital divide was noticed between the elderly, low socioeconomic population and other groups. Younger age, higher educational and income level, having digital access, more frequent eHealth use and more positive attitudes towards eHealth were significantly associated with higher eHL. Efforts at both individual and systematic levels should be made to improve eHL, and promote CLD knowledge and digital access, especially in disadvantaged populations. Moreover, there is a pressing need to develop and refine national and international standards for eHL.

Swedish Version of the System Usability Scale: Translation, Adaption, and Psychometric Evaluation.

The Swedish health care system is undergoing a transformation. eHealth technologies are increasingly being used. The System Usability Scale is a widely used tool, offering a standardized and reliable measure for assessing the usability of digital health solutions. However, despite the existence of several translations of the System Usability Scale into Swedish, none have undergone psychometric validation. This highlights the urgent need for a validated and standardized Swedish version of the System Usability Scale to ensure accurate and reliable usability evaluations. The aim of the study was to translate and psychometrically evaluate a Swedish version of the System Usability Scale. The study utilized a 2-phase design. The first phase translated the System Usability Scale into Swedish and the second phase tested the scale's psychometric properties. A total of 62 participants generated a total of 82 measurements. Descriptive statistics were used to visualize participants' characteristics. The psychometric evaluation consisted of data quality, scaling assumptions, and acceptability. Construct validity was evaluated by convergent validity, and reliability was evaluated by internal consistency. The Swedish version of the System Usability Scale demonstrated high conformity with the original version. The scale showed high internal consistency with a Cronbach α of .852 and corrected item-total correlations ranging from 0.454 to 0.731. The construct validity was supported by a significant positive correlation between the System Usability Scale and domain 5 of the eHealth Literacy Questionnaire (P=.001). The Swedish version of the System Usability Scale demonstrated satisfactory psychometric properties. It can be recommended for use in a Swedish context. The positive correlation with domain 5 of the eHealth Literacy Questionnaire further supports the construct validity of the Swedish version of the System Usability Scale, affirming its suitability for evaluating digital health solutions. Additional tests of the Swedish version of the System Usability Scale, for example, in the evaluation of more complex eHealth technology, would further validate the scale.

Research Progress on E-health Literacy in Patients with Chronic Obstructive Pulmonary Disease

The development and theoretical model of the concept of e-health literacy, the current status of e-health literacy in patients with chronic obstructive pulmonary disease (COPD), the influencing factors and interventions are reviewed, with a view to providing references for studies related to e-health literacy in COPD patients.

Factors Influencing Telehealth Satisfaction Among Liver and Kidney Transplant Recipients.

Solid organ transplant (SOT) recipients now have widespread access to telehealth, but the factors influencing their satisfaction still need to be understood. This cross-sectional study explored potential contributors to telehealth satisfaction among SOT recipients, including liver, kidney, and simultaneous liver-kidney recipients. A total of 136 adult SOT recipients completed an online survey. The survey assessed telehealth satisfaction, previous telehealth experiences, including confidence levels and the need for assistance from others, electronic health literacy (eHealth literacy), perceived physical and mental health status, and cognitive function, along with demographic and clinical characteristics. The multivariate regression backward selection method was used to identify potential factors contributing to telehealth satisfaction. Participants had a mean age of 60.1 years (standard deviation [SD] = 10.5) and were, on average, 92 months post-transplant (SD = 99.9). The mean telehealth satisfaction score was 5.3 out of 7 (SD = 1.2), indicating positive satisfaction with telehealth. However, lower telehealth satisfaction was associated with poor confidence in communicating with providers via telehealth, lower eHealth literacy, better perceived cognitive function, and a prolonged time since SOT (adjusted R2 = 0.49). SOT recipients who perceive vulnerability in online technology, report better perceived cognitive function, and are farther out from their SOT may exhibit lower satisfaction with telehealth. When considering telehealth for transplant care, clinicians should prioritize addressing the specific concerns and challenges of SOT recipients who may perceive telehealth unfavorably.

Developing a Framework to Measure Health Literacy Demands of Consumer-Facing Healthcare Organization Websites

Many consumer-facing healthcare organization websites are challenging for people with low e-health literacy skills to navigate and use the information to make informed decisions. Though searchers may be familiar with how to use the Internet, navigating website designs, often referred to as eHealth literacy, can make finding health information confusing. Health literacy demands, related to eHealth literacy skills concerning the content and design, can make the difference between consumers’ frustration and success. In this study, we aimed to create a framework to measure the accessibility and usability of healthcare organization consumer-facing websites using this question, “How can the information offered, and navigation of consumer-facing healthcare organization websites be improved to increase accessibility and usability?” We scored select healthcare organizations’ consumer-facing websites including their home page and two patient education pages, using Social Cognitive Theory and Health Literacy constructs both of which promote better accessibility and usability of health information. In addition, we analyzed how the health literacy demands of these pages support or obstruct the eHealth literacy skills of consumers. Results indicated that only 50% of Social Cognitive Theory constructs and 47% of Health Literacy constructs were observed. However, by examining the missing constructs healthcare organizations can assess where to focus consumer-facing website improvement efforts. Therefore, we concluded that Social Cognitive Theory combined with Health Literacy constructs offer a viable framework for measuring and potentially improving consumer-facing healthcare websites.

Return to work in young and middle-aged colorectal cancer survivors: Factors influencing self-efficacy, fear, resilience, and financial toxicity

BACKGROUND Return to work (RTW) serves as an indication for young and middle-aged colorectal cancer (CRC) survivors to resume their normal social lives. However, these survivors encounter significant challenges during their RTW process. Hence, scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors. AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy (RTW-SE), fear of progression (FoP), eHealth literacy (eHL), family resilience (FR), and financial toxicity (FT) on their RTW outcomes. METHODS A cross-sectional investigation was adopted in this study. From September 2022 to February 2023, a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing. The investigation utilized a general information questionnaire alongside scales assessing RTW-SE, FoP, eHL, FR, and FT. To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors, Cox regression modeling and Kaplan-Meier survival analysis were used. RESULTS A total of 43.54% of the participants successfully returned to work, with an average RTW time of 100 days. Cox regression univariate analysis revealed that RTW-SE, FoP, eHL, FR, and FT were significantly different between the non-RTW and RTW groups (P &lt; 0.05). Furthermore, Cox regression multivariate analysis identified per capita family monthly income, job type, RTW-SE, and FR as independent influencing factors for RTW (P &lt; 0.05). CONCLUSION The RTW rate requires further improvement. Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors. Health professionals should focus on modifiable factors, such as RTW-SE and FR, to design targeted RTW support programs, thereby facilitating their timely reintegration into mainstream society.

Return to work in young and middle-aged colorectal cancer survivors: Factors influencing self-efficacy, fear, resilience, and financial toxicity.

Return to work (RTW) serves as an indication for young and middle-aged colorectal cancer (CRC) survivors to resume their normal social lives. However, these survivors encounter significant challenges during their RTW process. Hence, scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors. To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy (RTW-SE), fear of progression (FoP), eHealth literacy (eHL), family resilience (FR), and financial toxicity (FT) on their RTW outcomes. A cross-sectional investigation was adopted in this study. From September 2022 to February 2023, a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing. The investigation utilized a general information questionnaire alongside scales assessing RTW-SE, FoP, eHL, FR, and FT. To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors, Cox regression modeling and Kaplan-Meier survival analysis were used. A total of 43.54% of the participants successfully returned to work, with an average RTW time of 100 days. Cox regression univariate analysis revealed that RTW-SE, FoP, eHL, FR, and FT were significantly different between the non-RTW and RTW groups (P < 0.05). Furthermore, Cox regression multivariate analysis identified per capita family monthly income, job type, RTW-SE, and FR as independent influencing factors for RTW (P < 0.05). The RTW rate requires further improvement. Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors. Health professionals should focus on modifiable factors, such as RTW-SE and FR, to design targeted RTW support programs, thereby facilitating their timely reintegration into mainstream society.

Multi‐Level Factors Influencing eHealth Literacy Among Chinese Older Adults: A Longitudinal Study

ABSTRACTAimsBased on the socio‐ecological model, the present study examined influencing factors of eHealth literacy among Chinese older adults at individual‐level (e.g., socio‐demographics, Internet use, and health status), interpersonal (e.g., informational support and instrumental support), and community‐level (e.g., available public facilities).DesignA longitudinal study was conducted among 611 Chinese older adults aged 55 or over.MethodsFrom February to December 2022, older people's eHealth literacy was collected at baseline, 3‐month and 6‐month follow‐up surveys and other variables were collected only at baseline, using online questionnaires.ResultsAmong 611 participants, 464 (75.9%) completed both follow‐up surveys. At the individual level, participants who were older, female gender, rural residents, living alone, had lower education, occupational levels and income, and had chronic conditions and long‐term medication showed lower eHealth literacy. Older adults with longer Internet use history, online health information seeking, more frequent health‐related Internet use, higher self‐rated Internet skills and positive perceptions towards online health information exhibited higher eHealth literacy over time. In terms of interpersonal and community‐level factors, perceiving informational and instrumental support when using digital health, and having access to health facilities (e.g., health education) and technological training provided by the community could predict older individuals' higher eHealth literacy over time, after adjusting for covariates.ConclusionOlder people's eHealth literacy can be influenced by factors at individual, interpersonal, and community levels.Implications and ImpactThis longitudinal study identified significant factors influencing older individuals' eHealth literacy at different levels. Understanding unmodifiable factors at the individual level can help identify the subgroups that may need targeted support and interventions for promoting eHealth literacy. Furthermore, findings can guide tailored interventions to improve eHealth literacy through modifiable factors at the technological, interpersonal and community levels.Reporting MethodAdhered to the STROBE guidelines.Patient or Public ContributionNo patient or public contribution.

Prospective relationship between Electronic Health Literacy and Health-promoting Lifestyle among Chinese Older Adults: A Three-wave Longitudinal Study

BackgroundImproving older people’s health-promoting lifestyle (HPL) may slow the progression of health conditions and improve quality of life. Electronic health (eHealth) literacy is increasingly important for individuals managing health in the digital age. Previous cross-sectional studies have shown a positive association between eHealth literacy and HPL among older adults. However, no longitudinal studies have examined the association over time, their temporal relationship, and the potential underlying mechanisms. ObjectivesTo examine the longitudinal association and temporal relationship between eHealth literacy and HPL among older adults, and to explore their underlying mechanism based on the Integrated Model of eHealth Use (iMeHU). MethodsThis longitudinal study was conducted among older adults in Jiangxi Province, China, from February to November 2022. Data were collected at baseline (T1) and 3-month (T2) and 6-month follow-up (T3), using online self-reported questionnaires. Older people’s eHealth literacy and HPL were measured using the Digital Health Literacy Instrument and Health-Promoting Lifestyle Profile-II. Statistical analyses included Linear mixed model (LMM), cross-lagged panel model (CLPM), longitudinal mediation analysis, and multi-group analysis. Results611 participants were included at T1; 464 (75.9%) completed the follow-ups at T2 and T3. The LMM results suggested that older individuals with higher eHealth literacy levels showed better HPL over time (adjusted β = 0.31, 95%CI: 0.27∼0.35, p<.001), after adjusting for covariates. CLPMs supported that eHealth literacy could predict older people’s improved HPL subsequently, but not the reverse. Attitude towards eHealth mediated the relationship from eHealth literacy to improved HPL, with a mediated proportion of 17.2%. In addition, the prospective relationships were stronger and only significant in older patients. ConclusionsFrom a longitudinal perspective, this study highlighted the important roles of eHealth literacy and attitude towards eHealth in improving older people’s HPL, especially for the patients. The findings provide robust evidence and practical implications to develop targeted interventions.

Family guidance regarding internet mitigates older adults' ehealth literacy inequality due to educational attainment through internet use.

To explore whether family guidance regarding Internet (FGI) mitigates the effect of educational attainment on older adults' eHealth literacy through different Internet uses and identify which types of FGI improve eHealth literacy among low-educated older adults effectively. A total of 490 Chinese adults aged 60 and above completed the eHealth Literacy Scale, an Internet use checklist, and self-reported their educational attainment and FGI frequency. With adequate FGI, educational attainment was not related to informational Internet use, recreational Internet use, and eHealth literacy. Instrumental, informational, and recreational FGI predicted low-educated older adults' Internet uses and eHealth literacy positively. FGI mitigates older adults' eHealth literacy inequality due to educational attainment and indirectly narrows this gap through the mediations of informational and recreational Internet use. Informational, instrumental, and recreational FGI play key roles in improving eHealth literacy among low-educated older adults.

How does mHealth benefit older Chinese adults' quality of life? Examining the roles of eHealth literacy, health motivation, and patient activation.

China is experiencing a rapid increase in its aging population, leading to the emergence of significant challenges to improve the quality of life (QoL) of older adults. The study aims to explore the potential benefits of using mobile health technology in improving the QoL for older Chinese adults. This study utilized a subsample of adults aged 60 and above from a cross-sectional, population-based national survey conducted among Chinese adults (N = 852). A moderated mediation analysis was conducted to investigate the impact of mHealth use on older Chinese adults' QoL, focusing on the mediating roles of eHealth literacy and patient activation and the moderating effect of motivation for health promotion and prevention. The results indicate that mHealth use directly enhances the QoL of older Chinese adults (β = .061, p < .001), and this effect is mediated by eHealth literacy and patient activation (β = .057, Boots 95% CI [.044, .072]). Furthermore, motivation for health promotion and prevention moderates the relationship between eHealth literacy and patient activation (β = .133, p < .001). These results demonstrate the positive impact of mHealth use on the QoL of older Chinese adults and reveal the underlying mechanisms involving mental and physical factors. These findings underscore the significance of increased attention to promoting mHealth use among older Chinese adults and provide a new way to enhance eHealth literacy and patient activation by encouraging the adoption of mHealth products.

Examining internet use for health information seeking and influencing factors among undergraduate health science students in Southwest Ethiopia.

The Internet has become a pivotal resource for accessing health information globally, offering unprecedented convenience and breadth of resources. This cross-sectional study examines the implications of Internet use for health information seeking and the influencing factors among undergraduate health science students in Southwest Ethiopia. An institutional-based cross-sectional study was conducted from November 10 to December 10, 2023. The study enrolled 423 students. Data were collected using a pretested and structured self-administered questionnaire. Data entry and analysis were performed using EpiData V4.6 and STATA V17, respectively. Bi-variable and multivariable logistic regression analyses were conducted to identify factors associated with the outcome variable. Statistical significance was determined using a P-value of less than 0.05. A total of 423 respondents participated in this study, resulting in a 100% response rate. Among them, 67.4% (95% CI: 63.0%-72.0%) reported using the Internet for health purposes. Factors significantly associated with this usage included being a third-year student or above (AOR=2.33, 95% CI: 1.36-3.99), owning a smartphone (AOR=2.41, 95% CI: 1.14-5.10), having good awareness (AOR=2.81, 95% CI: 1.55-5.09), holding a favorable attitude (AOR=9.58, 95% CI: 5.10-18.00), and possessing adequate e-health literacy (AOR=5.25, 95% CI: 2.89-9.46). This study underscores the internet's primary role in accessing information on diseases, treatments, healthy lifestyles, and prevention. Key factors such as e-health literacy, attitude, awareness, smartphone usage, and study timing significantly influence this trend. Understanding these factors is vital for optimizing internet resources for health information dissemination.

Attitudes, Awareness, and Willingness of Iranians Toward Using Telemedicine in Post-COVID Era: A Cross-Sectional Study.

With the increased use of telemedicine during the pandemic, understanding patients' attitudes and readiness to adopt telemedicine is crucial. This study investigates the attitudes, willingness, and usage behaviors of Iranian patients toward telemedicine. This cross-sectional study took place in Iran from October 2021 to January 2023. Participants received a web-based questionnaire consisting of five sections. The study aimed to assess Iranians' attitudes toward telemedicine following the COVID-19 pandemic and their readiness to utilize telemedicine services in the post-pandemic period by analyzing the gathered data. A total of 569 Iranian patients participated in the questionnaire, resulting in a 95% response rate. While 80% of respondents were familiar with telemedicine terms, only 30% had utilized telemedicine services before the COVID-19 outbreak. Overall, Iranians displayed positive attitudes toward telemedicine, with over two-thirds expressing a strong willingness to continue using telemedicine post-pandemic. The analysis revealed a positive correlation between higher e-health literacy scores and favorable attitudes toward telemedicine. Additionally, a significant relationship was observed between having a positive attitude toward telemedicine and prior usage of telemedicine services before the pandemic. The findings indicated a positive attitude toward telemedicine among public patients. The results highlight a willingness to utilize remote medical services if the required infrastructure is in place to address trust issues among patients. These outcomes can be utilized to assess the feasibility of implementing telemedicine services in Iran.

Development of a perceived eHealth literacy scale for individuals with serious mental illness: A cross-sectional study.

The development of an electronic health literacy scale for the population with serious mental illness (SMI) is needed due to individuals' characteristics. Develop a graphic-based perceived electronic health literacy scale for SMI (GP-eHLS-SMI). A cross-section study. This study was conducted from May 2023 to February 2024. The GP-eHLS-SMI was constructed based on qualitative interviews. Experts reviewed the items, and a pilot questionnaire was developed. A total of 436 community-dwelling participants with SMI from 20 medical facilities were recruited for psychometric analysis. Ten questionnaires were invalid, and 426 questionnaires were used for analysis. We used the first 220 questionnaires to perform the item and exploratory factor analyses. The last 206 questionnaires were used for confirmatory factor analysis. All valid questionnaires were used to examine test-retest reliability and criterion validity. Research tools included a demographic data questionnaire, the GP-eHLS-SMI, and the Chinese eHealth Literacy Scale (C-eHEALS). The C-eHEALS was used as the gold standard to explore the area under the receiver operating characteristic (ROC) curve (AUC) and cut-off point of the GP-eHLS-SMI. The Cronbach's alpha for the 16-item GP-eHLS-SMI was 0.882. The GP-eHLS-SMI score was significantly correlated with the C-eHEALS score (r=0.733, p<.001). The AUC was 0.863 (95% CI: 0.828, 0.897), and the cut-off point was 41. The test-retest reliability was r=0.929 (p<.001), and the intraclass correlation coefficient (ICC) was 0.961. The GP-eHLS-SMI is a valuable tool.

Health literacy in pediatric thrombosis: a landscape analysis.

Health literacy can influence self-management, leading to improved health outcomes in pediatric patients with venous thrombotic events (VTEs). To assess general health literacy in adolescents and parents/caregivers of children diagnosed with VTE, and their perception and satisfaction with overall thrombosis-related knowledge, thrombosis knowledge compared to that of other conditions, and beliefs regarding thrombosis knowledge importance. Patients aged 10 to 18 years with VTE history and parents/caregivers of patients aged 0 to 18 years with VTE attending clinic were recruited in this cross-sectional study. Health literacy was measured using the Rapid Estimate of Literacy in Medicine Short Forms (Adolescent and Adult), the Health Literacy Assessment Scale for Adolescents, and the e-Health Literacy Scale. Self-reported perception, satisfaction, comparative knowledge, and beliefs regarding thrombosis knowledge were assessed using researcher-generated questions. In total, 101 participants (50 adolescents, 51 parents/caregivers) were recruited at a median of 27 months (25th-75th percentile; 12-62 months) post-VTE diagnosis. Overall, 74% of adolescents and 59% of parents/caregivers had ≥1 measure indicating low general health literacy. Only half the participants thought their thrombosis knowledge was similar to that of other diseases. Satisfaction with thrombosis-related knowledge was 44%; 96% agreed that learning about thrombosis was important. Adolescents reported higher satisfaction with their knowledge than parents/caregivers, but satisfaction was not associated with demonstrated thrombosis knowledge. Most participants had low general health literacy levels, and more than half were not satisfied with their thrombosis-related knowledge. Adolescents tended to overestimate their knowledge. Effective strategies to support health literacy in this population are needed.