Readability Of Health Information Research Articles

Who is most at risk of digital exclusion within healthcare?

Abstract Introduction There has been a rapid growth in the use of digital technologies in healthcare to improve population health. However, due to digital exclusion (DE) (the unfair differences in motivation, access and use of these technologies), some demographic groups are unable to harness the health benefits of these technologies. Various frameworks have been designed to highlight groups vulnerable to health inequities, but none focus on DE. To provide better support for digitally excluded individuals, we must start by identifying demographic groups most at risk of DE. Aim Review the literature to identify demographic groups most at risk of DE within healthcare. Methods PubMed, Google Scholar and Scopus were searched on 22nd October 2022 in a non-systematic way to scope and examine emerging evidence surrounding groups at risk of DE within healthcare. English-language peer-reviewed articles and grey literature (e.g., government reports and regulatory organisation documents) identifying demographic groups at risk of DE and possible factors influencing exclusion were included. Search terms included words associated with DE and health inequity. Data extracted from the included articles included the different demographic groups highlighted and reasons for DE. Results Analysis of twenty-two included articles highlighted six common sociodemographic factors associated with DE that we compiled into six groups. These groups include Culture (ethnicity, language, religion), Limiting conditions (visual and hearing impairments), Education, Age, Residence (rural, deprived areas, homeless), and Socioeconomic status, forming the CLEARS framework. Cultural factors associated with DE included bias in artificial intelligence models used in healthcare technologies, low sensitivity in sensors when used across different ethnic backgrounds, and lack of consideration for different religious groups. Limiting conditions may make it difficult to use the technology, such as reading health information on small screens if visually impaired. Low educational attainment and old age (over 65) were frequently associated with poor digital literacy skills and poor understanding of the benefit of health technologies, thus reducing motivation and use of health technologies. Residential factors centred around barriers to accessing infrastructure to support connectivity (e.g. WiFi) and socioeconomic factors, including financial barriers to compatible devices and connectivity. Individuals who identify with two or more of these groups (intersectionality) are at even greater risk of DE. Conclusion This review identified six groups at risk of DE, the contributing reasons for exclusion, and the role of intersectionality. The CLEARS framework generated from this review can guide researchers and health technology developers in identifying groups that need to be involved in the co-design of digital health technologies to support inclusion. During the development of the CLEARS framework, groups in previous health inequities frameworks, such as the LGBTQ+ community, were considered, but later excluded due to the lack of representation within the literature. However, it is also important to recognise underserved groups are less likely to appear in the literature. Further work is needed to design tailored guidelines to support the development of inclusive digital health technologies that meet the needs of underserved groups.

An Investigation into Health Literacy and Extracurricular Reading Habits: The Case of Students at Abadan University of Medical Sciences in Iran

Background: The process of developing health literacy (HL) begins in childhood and embraces several skills and experiences. Individuals need these skills to properly manage their health and interact with healthcare systems. Although studies considering HL and its related variables are extensive in volume and informative in results, it seems necessary to add more to the field by addressing the issue among students of medicine. Objectives: The present study aimed to check the level of HL and extracurricular reading habits among students of medicine, how they obtain health information, the relationship between their HL and their extracurricular reading habits, and the relationship between extracurricular reading habits and each of the five aspects of HL. Methods: The participants (N = 220) were studying at Abadan University of Medical Sciences, Abadan, Iran. The data were collected using the Health Literacy for Iranian Adults (HELIA) questionnaire (Montazeri et al., 2015) and a questionnaire developed by the researchers. Results: The findings suggest that extracurricular studying positively correlated with reading health information, reaching health information, and using health information for the respondents of the present study. There was also a significant difference between the extracurricular reading habits and the HL of respondents. However, extracurricular studying and their appraisal of health information did not positively correlate. Furthermore, the Internet was the first source of information for the respondents. Conclusions: The aforementioned results might direct health policymakers’ attention to the HL concerns that medical students need and the ways that they immediately hang on to reach information (i.e., the Internet).

WHAT DO OLDER ADULTS THINK ABOUT ELECTRONIC PAIN APPS? USING A HEALTH LITERACY FRAMEWORK TO MEASURE QUALITY

Abstract Mobile pain applications (apps) may improve health communication. Mobile health apps do not always consider the needs of older adults. This project examines perceptions of pain apps on smartphones among older adults. The sample consisted of 23 older adults (M age = 64 years), with majority female (83%), predominantly Caucasian (91%), and majority some college education (65%). Respondents answered questions about 5 free pain apps using the Mobile Application Rating Scale (MARS). The MARS assesses descriptive and technical aspects of an eHealth apps using five categories including four quality scales: engagement, functionality, aesthetics, and information and one subjective quality scale. Participants currently had pain with range of 3 months to 12 years. The Single Item Health Literacy Screener identified 17 people have never asked for help reading health information; all participants scored 100% on the Rapid Estimate of Adult Literacy in Medicine Short Form. Participants self-reported an average of 2.6 comorbidities on the Functional Comorbidity Scale. The participants overall MARS rating ranged from 1-5; 11 participants rated pain apps very high (4-5). Important app characteristics identified by the older adults as critical for useable app included: Clear instructions, good navigation, and easy functionality. The elders reported that difficulty with loading the app and slow times would deter their use of the app. In terms of frequency of use, participants felt using the app was important weekly only if they experienced pain. These are important considerations in designing age-friendly technology for use with the frequent condition of pain among older adults.

A multimethods randomized trial found that plain language versions improved adults understanding of health recommendations

ObjectivesTo make informed decisions, the general population should have access to accessible and understandable health recommendations. To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of adults provided with a digital “Plain Language Recommendation” (PLR) format vs. the original “Standard Language Version” (SLV). Study Design and SettingAn allocation-concealed, blinded, controlled superiority trial and a qualitative study to understand participant preferences. An international on-line survey. 488 adults with some English proficiency. 67.8% of participants identified as female, 62.3% were from the Americas, 70.1% identified as white, 32.2% had a bachelor's degree as their highest completed education, and 42% said they were very comfortable reading health information. In collaboration with patient partners, advisors, and the Cochrane Consumer Network, we developed a plain language format of guideline recommendations (PLRs) to compare their effectiveness vs. the original standard language versions (SLVs) as published in the source guideline. We selected two recommendations about COVID-19 vaccine, similar in their content, to compare our versions, one from the World Health Organization (WHO) and one from Centers for Disease Control and Prevention (CDC). The primary outcome was understanding, measured as the proportion of correct responses to seven comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior, measured on a 1-7 scale. ResultsParticipants randomized to the PLR group had a higher proportion of correct responses to the understanding questions for the WHO recommendation (mean difference [MD] of 19.8%, 95% confidence interval [CI] 14.7–24.9%; P < 0.001) but this difference was smaller and not statistically significant for the CDC recommendation (MD of 3.9%, 95% CI −0.7% to 8.3%; P = 0.096). However, regardless of the recommendation, participants found the PLRs more accessible, (MD of 1.2 on the seven-point scale, 95% CI 0.9–1.4%; P < 0.001) and more satisfying (MD of 1.2, 95% CI 0.9–1.4%; P < 0.001). They were also more likely to follow the recommendation if they had not already followed it (MD of 1.2, 95% CI 0.7–1.8%; P < 0.001) and share it with other people they know (MD of 1.9, 95% CI 0.5–1.2%; P < 0.001). There was no significant difference in the preference between the two formats (MD of −0.3, 95% CI −0.5% to 0.03%; P = 0.078). The qualitative interviews supported and contextualized these findings. ConclusionHealth information provided in a PLR format improved understanding, accessibility, usability, and satisfaction and thereby has the potential to shape public decision-making behavior.

No Dramas: Using applied theatre to explore youth health issues in regional Central Queensland.

Young people in a regional Central Queensland community identified concerns related to their health and health behaviours, but have limited access to health information. To explore the youth health perspectives and priorities of young people in regional Queensland and identify how young people prefer to access health information. A participatory action research approach, using applied theatre methods and technology. The key challenges to youth health in regional Queensland identified by participants were substance use, in particular vaping, and bullying. Short-form social media videos are an effective channel for communicating youth health information, but to do so must closely align with the predominant formats and trends on social media platforms. Young people are not likely to read health information in printed form. Effective communication is the key to empowering young people to make decisions regarding their health behaviours. Our research shows that young people tend to share with other young people, and they are less likely to listen to older people and those in positions of authority. Health concerns raised ranged from cyberbullying and peer pressure to vaping, alcohol and chroming. Young people are more likely to engage with information that reflects their lived experience. The research concludes that we need to reconsider how information is provided for young people. Ways to empower young people and their voices via their preferred genre and format, not only to inform their health behaviours but also other aspects of their lives, is imperative.

The effect of document source trustworthiness on the evaluation and strategic use of embedded sources when reading health information online

The organization of sources into layers may have an impact on the way readers evaluate conflicting documents online. Two experiments (n = 131) examined whether undergraduates use metadata from the document to evaluate the contents and embedded sources included in that document. Participants read two texts about treatments for a rare disease put forward by two neutral characters (the embedded sources). Each text was manipulated so that it was published by a trustworthy or untrustworthy document source. In Experiment 1, participants performed the task using their own criteria. In Experiment 2, they received a pre-training on how to evaluate sources. Participants used more information (cited more sources and preferred the treatment) and rated the embedded source as more trustworthy when associated to a trustworthy document, but only in Experiment 2. In conclusion, readers can strategically use multiple source layers, suggesting a networked source representation, but contingent to task specifications.

Understanding Tourists’ Attitude Toward Online Travel Health Information During and Post-COVID-19: A Health Belief Model Application

Due to people’s anxieties about COVID-19, it may take years before international tourism returns to pre-pandemic levels. Thus, it is crucial to understand how tourists’ health beliefs influence their travel decision-making processes during and after the SARS-COV2 pandemic, and to develop new strategies to support and meet tourists’ current needs and concerns. The current study employs a Health Belief Model (HBM) perspective to examine the influence on tourists’ health risk prevention – and subsequently on their travel intention – of reading travel health information online, while considering tourists’ perceptions of threat susceptibility and severity, and usefulness of travel health information. As risk perception is influenced by individual differences such as gender and previous experience, the study model includes the demographic factors of age, gender, and health status. The model was tested using a survey questionnaire completed by 261 respondents in Saudi Arabia who were considering travelling abroad for tourism. Results were analyzed using PLS-SEM. The study found that perceived susceptibility and perceived usefulness each significantly and positively influenced the perception of importance of reading health information, and the perception of importance of reading travel health information online significantly and positively influenced travel intention. The discussion includes additional findings as well as implications for industry practice and policy regarding online pandemic-related information, in order to improve protection efficacy and enhance information content and style to adequately serve the needs of tourists from a health belief perspective.

Impact of health literacy and self-care behaviors on health-related quality of life in Iranians with type 2 diabetes: a cross-sectional study

BackgroundRegarding the importance of health literacy as a key factor in self-care, appropriate understanding of health information by patients with type 2 diabetes mellitus (T2DM) is fundamental for better management of risk factors, which can also benefit their quality of life. This study aimed to describe the relationship between health literacy (HL), and self-care behaviors with health-related quality of life (HRQL) in patients with T2DM.MethodsA cross-sectional survey was done in Iran in 2019. Patients were recruited randomly from health centers by medical records (n = 192, 55.2% male, mean age 58.12 years). The data collection included demographic form, health literacy questionnaire, diabetes self-care behavior questionnaire, and world health organization’s Quality of Life-BREF (WHOQOL-BREF). Analyses were adjusted for confounders using hierarchical regression analysis.ResultsHL as predictor variables explained 47.5% of variance in overall HRQL (p value < 0.001), reading health information was the strongest HL dimension (β = 0.478). Self-care behaviors explained an additional 13.6% of the HRQL variance. In total, 65.5% of the variation in the HRQL is explained by the HL, self-care behavior, and the demographic variables.ConclusionWe found that more almost two-third of the HRQL explained by the HL and self-care behaviors. Given the importance of health literacy and self-care behaviors in the quality of life in patients with T2DM, adoption of health-promoting behaviors and increasing health literacy can be beneficial for promoting quality of life among these patients.

Changes in electronic cigarette use and label awareness among smokers before and after the European Tobacco Products Directive implementation in six European countries: findings from the EUREST-PLUS ITC Europe Surveys.

Article 20 of the European Tobacco Product Directive (TPD), which went into effect in May 2016, regulates electronic cigarettes (e-cigarettes) in the European Union (EU). The aim of this study was to evaluate changes in e-cigarette use, design attributes of the products used and awareness of e-cigarette labelling and packaging among smokers from six EU Member States (MS) before and after TPD implementation. Data come from Wave 1 (2016, pre-TPD) and Wave 2 (2018, post-TPD) of the ITC Six European Country Survey among a sample of smokers and recent quitters who use e-cigarettes from six EU MS. Weighted logistic generalized estimating equations regression models were estimated to test the change in binary outcomes between Waves 1 and 2 using SAS-callable SUDAAN. In 2018, current daily/weekly e-cigarette use among adult smokers was just over 2%, but this varied from the highest in Greece (4%) to lowest in Poland (1.2%). From Waves 1 to 2, there was a significant increase in respondents reporting noticing and reading health and product safety information on leaflets inside e-cigarette packaging (8.39-11.62%, P < 0.001). There were no significant changes between waves of respondents reporting noticing or reading warning labels on e-cigarette packages/vials. e-cigarette use among smokers in these six EU countries is low. Although reported noticing and reading leaflets included in the packaging of e-cigarettes increased significantly from before to after the TPD, there was no significant change in reported noticing and reading of warning labels. Findings indicate the importance of continued monitoring of TPD provisions around e-cigarettes.

Occupational Health Needs and Predicted Well-Being in Office Workers Undergoing Web-Based Health Promotion Training: Cross-Sectional Study.

BackgroundOffice workers face workplace-related health issues, including stress and back pain, resulting in considerable cost to businesses and health care systems. Workplace health promotion attempts to prevent these health issues, and the internet can be used to deliver workplace health promotion interventions to office workers. Data were provided by Fitbase GmbH, a German company, which specializes in workplace health promotion via the internet (Web-based health). The Web-based health intervention allowed workers to focus on different health categories by using information modules (reading health information) and/or completing practical exercises (guided, interactive health tutorials).ObjectiveThis study aimed to identify the extent to which office workers have workplace-related health issues, assess whether office workers who differ in their health focus also differ in their improved well-being, and assess whether completing practical exercises is associated with improved well-being compared with reading information modules.MethodsFitbase GmbH collected data for the period of February 2016 to May 2017 from health insurance employees undergoing Web-based health training in Hamburg, Germany. The data consisted of a needs assessment examining health issues faced by office workers, a wellness questionnaire regarding one’s perception of the Web-based health intervention, and activity logs of information modules and practical exercises completed. Through logistic regression, we determined associations between improved well-being from Web-based health training and differences in a worker’s health focus and a worker’s preferred intervention method.ResultsNearly half of the office workers had chronic back pain (1532/3354) and felt tense or irritated (1680/3348). Over four-fifth (645/766) of the office workers indicated that the Web-based health training improved their well-being (P<.001). Office workers who preferred practical exercises compared with information modules had 2.22 times greater odds of reporting improved well-being from the Web-based health intervention (P=.01; 95% CI 1.20-4.11). Office workers with a focus on practical exercises for back health had higher odds of improved well-being compared with other health foci. Office workers focused on practical exercises for back pain had at least two times the odds of having their well-being improved from the Web-based health intervention compared with those focused on stress management (P<.001), mindfulness (P=.02), stress management/mindfulness (P=.005), and eye health (P=.003). No particular health focus was associated with improved well-being for the information modules.ConclusionsOffice workers frequently report having back pain and stress. A focus on Web-based health training via practical exercises and practical exercises for back health predict an improvement in office workers’ reported well-being.

The role of Health Literacy in Hypertension Control: a cross-sectional study in Iran.

Health literacy is peoples' capacity to receive, process, and utilize basic health information which is necessary for proper decisions. Assessing the Health Literacy level on controlling systolic and diastolic hypertension is the main goal of this study. A cross-sectional study. In this cross-sectional study, multistage cluster sampling was used to recruit 210 people affected by hypertension in Tabriz City, Iran. The data collection tool was a Health Literacy questionnaire. Among the Health Literacy dimension, such as the ability to access health information, reading health information, understanding health information, appraisal of health information, and decision making the SEM model has been utilized as a mediator variable in order to verify these variables on controlling the size of blood pressure to address the specific aims of study based on the Health Litercy. Significant correlations were found between all Health Literacy dimensions and systolic hypertension (p < 0.05). Also, the ability to access health information was the statistically significant predictor of decision making (R=0.335; p-value=0.012) and of systolic hypertension (R=-0.275; p-value=0.025). None of the Health Literacy dimensions revealed significant correlations with diastolic hypertension (p < 0.05). Adequate Health Literacy is a helpful factor to control hypertension in hypertensive patients. Therefore, improving Health Literacy, especially, facilitating the patients' access to health information, should be considered as an important factor of hypertension management.

An empirical examination of the use of Easy Read health information in health consultations involving patients with intellectual disabilities.

Easy Read health information (ERHI) has the potential to promote engagement in health care for people with intellectual disabilities. This study examined how ERHI was actually employed by clinicians and received by patients. Video recordings were made of 32 patients with intellectual disabilities attending a health check with primary care clinicians who had been given access to a range of ERHI, and 9 attending a health appointment with a specialist intellectual disability nurse. The recordings were analysed using conversation analysis. Easy Read health information was visible in only 7 (22%) of the primary care health checks (though not always shared with the patients). Easy Read health information was used in sequences where clinicians offered unsolicited health advice and met with degrees of resistance from patients, though its potential for shared decision making was also evident. Easy Read health information can aid patient understanding and decision making, but attention should be paid to the interactional practices accompanying their use.

Orofacial granulomatosis and dietary interventions: health information on the internet

To assess the content, quality, and readability of health information on the internet for patients with orofacial granulomatosis, including material on benzoate and cinnamon-free diets. The first 100 websites drawn from searches using 8 key terms (2400 websites) across 3 search engines (Yahoo, Google, and Bing) were analysed. Duplicates or websites with unrelated information were excluded, which brought the number of websites included in the study to 12. To assess the quality of the information, we used the DISCERN questionnaire, Journal of the American Medical Association (JAMA) Benchmark Criteria, and Health on Net Seal. The readability was then analysed by applying the Flesch-Kincaid Reading Ease and Grade Level tests, the Automated Readability Index, and global traffic ranking (ALEXA). Separate assessment for both orofacial granulomatosis, and its management with a benzoate and cinnamon-free diet, showed that most websites (75%) were either ‘very poor’ or ‘poor’ in quality, with a mean DISCERN score of 31.4 out of 80. No website met all four JAMA benchmarks. Only two websites displayed the HONcode seal. Generally, health information was considered difficult to read, with a FRES ranging from 21.5 to 68, with a mean score of 48 (±13.2). To comprehend this information, readers would need to have, on average, a 10th grade US level education. The quality and readability of online information on orofacial granulomatosis is poor and difficult to read.

Talking to producers of Easy Read health information for people with intellectual disability: Production practices, textual features, and imagined audiences

ABSTRACT Background: Concerns about health inequalities experienced by people with intellectual disability (ID) have led to many health information materials being created in an “Easy Read” format. This study aimed to understand the practices involved in making information accessible. Methods: Individual, pair and group interviews were conducted involving people with and without ID based in non-profit organisations, academic, and health service settings. Thematic analysis addressed the creation of Easy Read health resources, the format and content of the texts, and how producers imagine the texts are received by potential audiences. Results: Little consensus emerged of the best way to produce Easy Read health information. Lacking systematic feedback, participants described imagined audiences and contexts for their reception. Conclusions: Production of Easy Read resources has become widespread despite current limited evidence of impact. Interactions between social groups involved in the production process and the wider policy and legislative context contribute to this situation.

Quality and Readability of English-Language Internet Information for Tinnitus.

Because of the wealth of information available on the internet and increasing numbers of individuals relying on websites as a primary source of information for health-related questions, it is important that the readability of their content is within the comprehension level of most readers. The study evaluated the quality and readability of English-language Internet information for tinnitus. Analysis of Internet websites on tinnitus. A total of 134 websites with tinnitus information. Three key words (i.e., tinnitus, ringing in the ear, and buzzing in the ear) were entered in five country-specific versions of the most commonly used internet search engine in August 2016. For each of the 15 searches, the first 20 relevant websites were examined. After removing duplicates, a total of 134 websites were assessed. Their origin (commercial, nonprofit organization, government, personal, or university), quality (Health On the Net [HON] certification and DISCERN scores), and readability (Flesch Reading Ease score, Flesch-Kincaid Reading Grade Level Formula, and Simple Measure of Gobbledygook) were assessed. Most websites were of commercial (49.3%) or nonprofit organization (38.8%) origin. Their quality and readability was highly variable. Only 13.5% of websites had HON certification. χ² analysis showed that there was significant association between website origin and HON certification [χ²(4) = 132.9, p < 0.0001]. The mean DISCERN scores were 2.39. No association between DISCERN scores and website origin was found. Readability measures showed that on average, only people with at least 10-12 yr of education could read and understand the internet information for tinnitus in websites. Almost all the websites exceeded the most stringent reading level recommended for health information. The results highlight great variability in the quality and readability of health information, specifically for tinnitus in the internet. These findings underscores the need for stakeholders (e.g., web-developers, clinicians) to be aware of this and to develop more user-friendly health information on websites to make it more accessible for people with low literacy.

OC-2-KB: integrating crowdsourcing into an obesity and cancer knowledge base curation system

BackgroundThere is strong scientific evidence linking obesity and overweight to the risk of various cancers and to cancer survivorship. Nevertheless, the existing online information about the relationship between obesity and cancer is poorly organized, not evidenced-based, of poor quality, and confusing to health information consumers. A formal knowledge representation such as a Semantic Web knowledge base (KB) can help better organize and deliver quality health information. We previously presented the OC-2-KB (Obesity and Cancer to Knowledge Base), a software pipeline that can automatically build an obesity and cancer KB from scientific literature. In this work, we investigated crowdsourcing strategies to increase the number of ground truth annotations and improve the quality of the KB.MethodsWe developed a new release of the OC-2-KB system addressing key challenges in automatic KB construction. OC-2-KB automatically extracts semantic triples in the form of subject-predicate-object expressions from PubMed abstracts related to the obesity and cancer literature. The accuracy of the facts extracted from scientific literature heavily relies on both the quantity and quality of the available ground truth triples. Thus, we incorporated a crowdsourcing process to improve the quality of the KB.ResultsWe conducted two rounds of crowdsourcing experiments using a new corpus with 82 obesity and cancer-related PubMed abstracts. We demonstrated that crowdsourcing is indeed a low-cost mechanism to collect labeled data from non-expert laypeople. Even though individual layperson might not offer reliable answers, the collective wisdom of the crowd is comparable to expert opinions. We also retrained the relation detection machine learning models in OC-2-KB using the crowd annotated data and evaluated the content of the curated KB with a set of competency questions. Our evaluation showed improved performance of the underlying relation detection model in comparison to the baseline OC-2-KB.ConclusionsWe presented a new version of OC-2-KB, a system that automatically builds an evidence-based obesity and cancer KB from scientific literature. Our KB construction framework integrated automatic information extraction with crowdsourcing techniques to verify the extracted knowledge. Our ultimate goal is a paradigm shift in how the general public access, read, digest, and use online health information.

Perceived importance and difficulty of online activities among visually impaired persons in Nigeria

ABSTRACTThis study investigated perceived relevance of and difficulties in access to day-to-day online activities among visually impaired computer users who used screen readers. The 98 participants in the study were grouped into visually impaired adults (aged 20–59, n = 60) and visually impaired older adults (aged 60 and over, n = 38). Data were collected in structured interview questionnaires with Likert scales exploring ratings of perceived importance and difficulty of access to 11 online platforms of various internet activities. Analyses revealed that the two groups did not differ significantly in ratings of perceived importance of four major online activities, namely sending or reading email (p = 0.5224), online banking (p = 0.2833), online shopping (p = 0.1829), and health information seeking (p = 0.1414). The topmost rated activity of priority among both groups was sending and reading emails. Findings also show that, apart from sending and reading emails, activities rated as important were mostly perceived as difficult to access. The implications of the study for inclusive design and strategies and/or interventions to encourage uptake of internet use among the visually impaired population are discussed.

Feasibility of e-Health Interventions on Smoking Cessation among Vietnamese Active Internet Users.

Introduction: Although e-health interventions are widely implemented as a supportive measure to smoking cessation, there is a lack of evidence in the feasibility of its application among Vietnamese youths, which is considered to be one of the most frequent internet using populations. This study assessed the quitting attempts among smokers and their preference and willingness to pay for smartphone-based cessation supporting applications in a sample of active internet users approached. Methods: A total of 1082 participants were recruited for the online-based survey from August to October 2015 in Vietnam. Information on sociodemographic characteristics, health information seeking behaviors on the internet, smoking status, quitting attempts and willingness to pay for smartphone-based cessation supporting applications were collected. Multivariate logistic regression was used to determine the associated factors with current smoking and willingness to pay for the smoking cessation application. Results: About 11% of participants were current smokers while 73.4% had attempted to quit smoking. Only 26.8% of the individuals indicated that they were willing to utilize a smartphone application to assist them in quitting. Participants who were male, had partners/spouse and lived at other places were more likely to smoke cigarette. Meanwhile, people who spent 50–70% of their online time to read health information were less likely to smoke. Results also show that living with family and never sharing health information on the internet were negatively associated with a participant’s willingness to pay for the smartphone application. Meanwhile, people who highly trusted health information were more likely to be willing to pay for the application. Conclusions: This prevalence of smoking and associated factors can provide potential indicators for creating several public health interventions in the new environment with the increasing development of information technology. This study implies that in order to expand the coverage of smoking cessation interventions, we recommend the integration of e-health interventions with clinical- or telephone-based conventional models by providing smartphone applications and information on the internet from reliable sources.

How the public uses social media wechat to obtain health information in china: a survey study

BackgroundOn average, 570 million users, 93% in China’s first-tier cities, log on to WeChat every day. WeChat has become the most widely and frequently used social media in China, and has been profoundly integrated into the daily life of many Chinese people. A variety of health-related information may be found on WeChat. The objective of this study is to understand how the general public views the impact of the rapidly emerging social media on health information acquisition.MethodsA self-administered questionnaire was designed, distributed, collected, and analyzed utilizing the online survey tool Sojump. WeChat was adopted to randomly release the questionnaires using convenience sampling and collect the results after a certain amount of time.Results(1) A total of 1636 questionnaires (WeChat customers) were collected from 32 provinces. (2) The primary means by which respondents received health education was via the Internet (71.79%). Baidu and WeChat were the top 2 search tools utilized (90.71% and 28.30%, respectively). Only 12.41% of respondents were satisfied with their online health information search. (3) Almost all had seen (98.35%) or read (97.68%) health information; however, only 14.43% believed that WeChat health information could improve health. Nearly one-third frequently received and read health information through WeChat. WeChat was selected (63.26%) as the most expected means for obtaining health information. (4) The major concerns regarding health information through WeChat included the following: excessively homogeneous information, the lack of a guarantee of professionalism, and the presence of advertisements. (5) Finally, the general public was most interested in individualized and interactive health information by managing clinicians, they will highly benefit from using social media rather than Internet search tools.ConclusionsThe current state of health acquisition proves worrisome. The public has a high chance to access health information via WeChat. The growing popularity of interactive social platforms (e.g. WeChat) presents a variety of challenges and opportunities with respect to public health acquisition.

Health literacy and logical inconsistencies in valuations of hypothetical health states: results from the Canadian EQ-5D-5L valuation study.

To examine the association of health literacy with logical inconsistencies in time trade-off valuations of hypothetical health states described by the EQ-5D-5L classification system. Data from the EQ-5D-5L Canadian Valuation study were used. Health literacy was assessed using the Brief Health Literacy Screen. A health state valuation was considered logically inconsistent if a respondent gave the same or lower value for a very mild health state compared to the value given to 55555, or gave the same or lower value for a very mild health state compared to value assigned to the majority of the health states that are dominated by the very mild health state. Average age of respondents (N = 1209) was 48 (SD = 17) years, 45% were male, 7% reported inadequate health literacy, and 11% had a logical inconsistency. In adjusted analysis, participants with inadequate health literacy were 2.2 (95%CI: 1.2, 4.0; p = 0.014) times more likely to provide an inconsistent valuation compared to those with adequate health literacy. More specifically, those who had problems in "understanding written information" and "reading health information" were more likely to have a logical inconsistency compared to those who did not. However, lacking "confidence in completing medical forms" was not associated with logical inconsistencies. Health literacy was associated with logical inconsistencies in valuations of hypothetical health states described by the EQ-5D-5L classification system. Valuations studies should consider assessing health literacy, and explore better ways to introduce the valuation tasks or use simpler approaches of health preferences elicitation for individuals with inadequate health literacy.