Use Of eHealth Research Articles

Health promotion interventions for children and adolescents using e-health: a systematic review

Abstract Background The utilization of e-health in healthcare interventions has become increasingly prevalent due to its cost-effectiveness. Nevertheless, there is a paucity of evidence regarding the use of e-health in children, as the majority of e-health interventions are focused on adults. This study aimed to identify the components and effects of e-health intervention for the promotion of children’s health and to suggest strategies for their implementation. Methods A systematic review was conducted in accordance with the PRISMA guidelines. A literature review of relevant studies published between January 2013 and November 2023 was conducted. A search of databases including PubMed, EMBASE, CINAHL, MEDLINE, and Cochrane Review Library was conducted using a combination of medical subject headings (MeSH) and keywords. A qualitative appraisal of the studies was conducted using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). Results Sixteen studies were selected. Most studies showed good methodological quality. The majority of studies (n = 15) focused on improving children’s physical health, while only one study focused on mental health. There were a variety of components to the intervention, including internet education, web-based home-exercise, serious games, mobile apps, email counseling, and active video games, and only one type of intervention was provided, or a combination with additional methods such as phone calls and counseling. A review of the literature indicates that e-health interventions have been effective in increasing children’s physical activity, reducing weight, relieving stress, and reducing depression. Conclusions This study identified the effectiveness of e-health interventions for improving children’s physical and mental health. The use of e-health to promote children’s health should be actively developed and implemented in a variety of clinical and community settings. Key messages • E-health interventions have been demonstrated to be an effective means of improving the physical and mental health of children and adolescents. • It is recommended that health promotion interventions utilizing e-health be developed and tested in a variety of communities and settings for children and adolescents.

Short- and Long-Term Outcomes of e-Health and Internet-Based Psychological Interventions for Chronic Tinnitus: A Systematic Review and Meta-Analysis.

Objective: e-Health or web-based systems in the field of tinnitus have gained increasing interest. Cognitive behavioral therapy (CBT) delivered via the internet is currently witnessing a surge in both attention and offerings. This systematic review analyzed the efficacy and sustainability of internet-based therapies aimed at reducing tinnitus distress and comorbidities such as anxiety, depression, and sleep disorders. The review exclusively considered randomized controlled trials (RCTs) in which trained personnel were actively involved during intervention. Methods: Utilizing search terms such as tinnitus, internet-based therapy, and e-Health therapy, we identified 155 studies, from which 37 RCTs were carefully examined for data availability. Primary outcome measures included treatment effects for tinnitus distress (Tinnitus Questionnaire and other questionnaires) and handicap (Tinnitus Handicap Inventory), while secondary outcomes encompassed depression, anxiety, and sleep problems. Meta-analyses were conducted employing random-effect models. A study effect model was applied, yielding a singular effect size for each sample. The effect sizes were examined for influences of various moderators. Results: We found a statistically significant large effect size for improvement in tinnitus distress (d = 0.83; [confidence interval 0.61-1.06] with total n = 450 for the experimental group and total n = 504 or the controls), while the reduction of tinnitus handicap was smaller (moderate effect size d = 0.59; [0.44-0.73]). Less strong but still significant effects resulted for depression, anxiety, and insomnia. Most of the long-term outcomes remained stable. As moderators, the risk of bias (RoB) and the severity of tinnitus manifestations were identified. Conclusions: Internet-based therapy provides a valuable avenue for initial therapeutic contact, as supporting component in tinnitus treatment if accompanied by therapists. The heterogeneous quality with high drop-out rates or partly high RoB and the wide range of interventions (counseling, eCBT, mindfulness) might be considered as a limiting factor for a first-line management in tinnitus. So far, the use of e-Health is dependent on availability or user preferences.

ICardioMonitor Digital Monitoring System for People with Heart Failure: Development and Evaluation of Its Accessibility and Usability

Background/Objectives: The use of eHealth as a monitoring system in people with heart failure (HF) has been shown to be effective in promoting self-care and reducing re-admissions and mortality. The present study develops and evaluates the accessibility and usability of the web app iCardioMonitor HF monitoring system. Methods: This study consisted of two stages. The first stage (co-design) comprised two phases: (1) analysis of the scientific literature and expert opinions and (2) co-design of the iCardioMonitor (web app plus a knowledge-base algorithm) and definition of alert criteria. The second stage (cross-sectional descriptive study) analyzed system accessibility (% of people using the iCardioMonitor and % of parameters recorded) and usability, employing the Spanish version of the System Usability Scale for the Assessment of Electronic Tools. Results: The iCardioMonitor was configured by a web app and an algorithm with the capacity to detect decompensated HF automatically. A total of 45 patients with an average age of 55.8 years (standard deviation [SD] = 10.582) and an average time since diagnosis of 7.1 years (SD = 7.471) participated in the second stage. The percentage of iCardioMonitor use was 83.2%. The average usability score was 77.2 points (SD = 21.828), higher in women than men (89.2; SD = 1.443–76.0; SD = 1.443) (p = 0.004). The usability score was higher the shorter the time since diagnosis (r = 0.402; p = 0.025) and the higher the number of responses (r = 0.377; p = 0.031). Conclusions: The results obtained show that iCardioMonitor is a tool accepted by patients and has obtained a remarkable score on the usability scale. iCardioMonitor was configured by a web app and an algorithm with the capacity to detect decompensated HF automatically.

The impact of eHealth use on general practice workload in the pre-COVID-19 era: a systematic review

BackgroundIn recent years, eHealth has received much attention as an opportunity to increase efficiency within healthcare organizations. Adoption of eHealth might consequently help to solve perceived health workforce challenges, including labor shortages and increasing workloads among primary care professionals, who serve as the first point of contact for healthcare in many countries.The purpose of this systematic review was to investigate the impact of general eHealth use and specific eHealth services use on general practice workload in the pre-COVID-19 era.MethodsThe databases of CINAHL, Cochrane, Embase, IEEE Xplore, Medline ALL, PsycINFO, Web of Science, and Google Scholar were searched, using combinations of keywords including ‘eHealth’, ‘workload’, and ‘general practice’. Data extraction and quality assessment of the included studies were independently performed by at least two reviewers. Publications were included for the period 2010 – 2020, before the start of the COVID-19 pandemic.ResultsIn total, 208 studies describing the impact of eHealth services use on general practice workload were identified. We found that two eHealth services were mainly investigated within this context, namely electronic health records and digital communication services, and that the largest share of the included studies used a qualitative study design. Overall, a small majority of the studies found that eHealth led to an increase in general practice workload. However, results differed between the various types of eHealth services, as a large share of the studies also reported a reduction or no change in workload.ConclusionsThe impact of eHealth services use on general practice workload is ambiguous. While a small majority of the effects indicated that eHealth increased workload in general practice, a large share of the effects also showed that eHealth use reduced workload or had no impact. These results do not imply a definitive conclusion, which underscores the need for further explanatory research. Various factors, including the study setting, system design, and the phase of implementation, may influence this impact and should be taken into account when general practices adopt new eHealth services.Study registration numberPROSPERO (International Prospective Register of Systematic Reviews) CRD42020199897; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=199897.

Support needs of gout patients and suitability of eHealth to address these needs.

To investigate the support needs of patients with gout regarding information, communication, treatment and disease monitoring, and patients' views on and preferences for eHealth applications to address these needs. A focus group study using purposive sampling was conducted. Three focus group sessions with a duration of 2 h per group were held with in total of 23 patients using urate-lowering therapy, recruited from primary and secondary care. Audio recordings were transcribed, and data were analysed using thematic analysis. Eight themes were identified. Five themes addressed support needs of gout patients and suitability of eHealth in addressing those needs: (1) Timely access to healthcare, especially during flares; (2) (personalized) information regarding diagnosis, medication, and diet; (3) insight into uric acid levels and medication side effects through blood monitoring; (4) better coordination across primary and secondary care; and (5) self-management and shared responsibility over care for maintaining health. Three themes addressed eHealth in general: (1) receptive towards eHealth in gout care; (2) the preference for eHealth to have a complementary role (i.e. not replacing face-to-face) contact with healthcare providers; and (3) preferences on eHealth use and functionalities. Patients expressed various needs regarding their disease management and projected a supporting role for eHealth in (self)management of gout. Addressing the needs and preferences of patients could enhance their understanding of the disease and treatment, self-management, and possibly health outcomes.

Short-Term Effects of an eHealth Care Experiential Learning Program Among Patients With Type 2 Diabetes: Randomized Controlled Trial.

Type 2 diabetes is a chronic disease with a significant medical burden. eHealth care integrates medicine and technology to enhance the outcomes of such patients; however, adequate eHealth literacy (eHL) is necessary for that to happen. Fostering eHL is crucial for patients with diabetes to engage with eHealth care and receive quality care and timely support. Experiential learning theory can enhance patients' eHL and skills to use eHealth care technology in their daily care. This study explored the effectiveness of an eHealth care experiential learning program in improving eHL, patient health engagement, and eHealth care use status among patients with type 2 diabetes in 3 months. In this randomized controlled trial, patients under case management services from various clinics in Taiwan were randomly assigned to either the intervention group receiving the 6-session eHealth care experiential learning program or the control group receiving the usual care. Data were collected using structured questionnaires at 3 time points: pretest, postintervention, and 3 months after the intervention. Descriptive data were presented using frequency distribution, percentage, mean, and SD. The outcomes were analyzed using a generalized estimating equation method by intention-to-treat analysis. A total of 92 participants (46 in each group) were recruited in this study. Of these, 86 completed the course and follow-up evaluations with a mean age of 62.38 (SD 12.91) years. After completing the intervention, the intervention group had significantly higher posttest scores in eHL (β=19.94, SE 3.52; P<.001), patient health engagement (β=.28, SE 0.13; P=.04), and eHealth use (β=3.96, SE 0.42; P<.001) than the control group. Furthermore, the intervention group maintained these significant improvements in eHL (β=18.19, SE 3.82; P<.001) and eHealth use (β=3.87, SE 0.49; P<.001) after 3 months. Participating in the eHealth care experiential learning program resulted in significant improvements in eHL, patient health engagement, and eHealth use among patients with type 2 diabetes. Our interventional program can inform future clinical practice and policies to strengthen self-management skills and facilitate the use of health technology in caring for patients with chronic diseases. ClinicalTrials.gov NCT05180604; https://clinicaltrials.gov/ct2/show/NCT05180604.

Sociodemographic Factors Associated With Using eHealth for Information Seeking in the United States: Cross-Sectional Population-Based Study With 3 Time Points Using Health Information National Trends Survey Data.

Despite the potential benefits of using eHealth, sociodemographic disparities exist in eHealth use, which threatens to further widen health equity gaps. The literature has consistently shown age and education to be associated with eHealth use, while the findings for racial and ethnic disparities are mixed. However, previous disparities may have narrowed as health care interactions shifted to web-based modalities for everyone because of the COVID-19 pandemic. This study aims to provide an updated examination of sociodemographic disparities that contribute to the health equity gap related to using eHealth for information seeking using 3 time points. Data for this study came from the nationally representative 2018 (n=3504), 2020 (n=3865), and 2022 (n=6252) time points of the Health Information National Trends Survey. Logistic regression was used to regress the use of eHealth for information seeking on race and ethnicity, sex, age, education, income, health status, and year of survey. Given the consistent association of age with the dependent variable, analyses were stratified by age cohort (millennials, Generation X, baby boomers, and silent generation) to compare individuals of similar age. For millennials, being female, attaining some college or a college degree, and reporting an annual income of US $50,000-$74,999 or >US $75,000 were associated with the use of eHealth for information seeking. For Generation X, being female, having attained some college or a college degree, reporting an annual income of US $50,000-$74,999 or >US $75,000, better self-reported health, and completing the survey in 2022 (vs 2018; odds ratio [OR] 1.80, 95% CI 1.11-2.91) were associated with the use of eHealth for information seeking. For baby boomers, being female, being older, attaining a high school degree, attaining some college or a college degree, reporting an annual income of US $50,000-$74,999 or >US $75,000, and completing the survey in 2020 (OR 1.56, 95% CI 1.15-2.12) and 2022 (OR 4.04, 95% CI 2.77-5.87) were associated with the use of eHealth for information seeking. Among the silent generation, being older, attaining some college or a college degree, reporting an annual income of US $50,000-$74,999 or >US $75,000, and completing the survey in 2022 (OR 5.76, 95% CI 3.05-10.89) were associated with the use of eHealth for information seeking. Baby boomers may have made the most gains in using eHealth for information seeking over time. The race and ethnicity findings, or lack thereof, may indicate a reduction in racial and ethnic disparities. Disparities based on sex, education, and income remained consistent across all age groups. This aligns with health disparities literature focused on individuals with lower socioeconomic status, and more recently on men who are less likely to seek health care compared to women.

Sociodigital Determinants of eHealth Literacy and Related Impact on Health Outcomes and eHealth Use in Korean Older Adults: Community-Based Cross-Sectional Survey.

eHealth literacy is an essential skill for pursuing electronic health information, particularly for older people whose health needs increase with age. South Korea is now at the intersection of a rapidly digitalizing society and an increasingly aged population. eHealth literacy enables older people to maximize the effective use of emerging digital technology for their health and quality of life. Understanding the eHealth literacy of Korean older adults is critical to eliminating the gray digital divide and inequity in health information access. This study aims to investigate factors influencing eHealth literacy in older Korean adults and its impact on health outcomes and eHealth use. This was a cross-sectional survey. Community-dwelling older adults 65 years and older in 2 urban cities in South Korea were included. eHealth literacy was measured by the eHealth Literacy Scale. Ordinal logistic regression was used to analyze factors associated with eHealth literacy and multivariate ANOVA for the impact of eHealth literacy on health outcomes and eHealth use. In total, 434 participants were analyzed. A total of 22.3% (97/434) of participants had high eHealth literacy skills. Increasing age, higher monthly income, and time spent on the internet were significantly associated with eHealth literacy (P<.001), and social media users were 3.97 times (adjusted odds ratio 3.97, 95% CI 1.02-15.43; P=.04) more likely to have higher skill. Higher eHealth literacy was associated with better self-perceived health and frequent use of digital technologies for accessing health and care services (P<.001). Disparity in socioeconomic status and engagement on the internet and social media can result in different levels of eHealth literacy skills, which can have consequential impacts on health outcomes and eHealth use. Tailored eHealth interventions, grounded on the social and digital determinants of eHealth literacy, could facilitate eHealth information access among older adults and foster a digitally inclusive healthy aging community.

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.

Digitalized social and emotional learning and better wellbeing among displaced Syrian adolescents in Lebanon

Syrian adolescent refugees are one of the largest forced displaced populations in the world. Displaced adolescents experience significant stressors on their mental health, including high poverty and severely limited access to mental health services. Studies show that game-based learning interventions offer the potential for increasing access to mental health supports. We employed a mixed-method pilot and feasibility study to explore how the Happy Helping Hand (HH) game app contributed to improved well-being and emotional problem-solving skills in displaced Syrian adolescents in Lebanon. A 5-week, 10-session digital learning HH psychosocial program was administered by teachers. Adolescent and teacher focus groups were used to assess how emotional problem-solving skills were applied in-depth. A single group pre-post design measured well-being using the World Health Organization’s Well-Being Index (WHO-5). Thematic analysis was used for qualitative analysis. Descriptive and bivariate t-tests were used for quantitative analyses. Qualitatively, adolescents´ demonstrated increased emotional problem-solving skills and well-being, and attributed the changes to the usefulness of the app. Quantitative findings show well-being significantly increased at post-test compared to pretest. The study supports the use of e-health and role-playing games for Syrian adolescents. Future research should examine an up-scaled implementation of the app with displaced adolescents.

Use of eHealth and remote patient monitoring: a tool to support home dialysis patients, with an emphasis on peritoneal dialysis

ABSTRACT Implementing eHealth requires technological advancement, universal broadband and internet access, and devices to conduct telemedicine and remote patient monitoring in end-stage kidney disease patients receiving home dialysis. Although eHealth was beginning to make inroads in this patient population, the COVID-19 pandemic spurred telemedicine usage when many regulations were waived during the Public Health Emergency to limit the spread of infection by endorsing social distancing. At the same time, two-way communication automatic peritoneal dialysis cyclers were introduced to advance remote patient monitoring. Despite the numerous advantages and potential benefits afforded by both procedures, challenges and untapped resources remain to be addressed. Continuing research to assess the use of eHealth and technological innovation can make eHealth a powerful tool in home dialysis. We review the past, present and future of eHealth and remote patient monitoring in supporting home dialysis.

Adherence to Antihypertensive Therapy and Its Determinants: A Systematic Review.

Hypertension is a globally prevalent condition, and low adherence to antihypertensive therapy is considered one of the main causes of poor blood pressure (BP) control. Non-adherence to antihypertensive treatment is a complex issue that can arise from various factors; however, gaining an understanding of this provides key targets for intervention strategies. This study aimed to provide an overview of the current status and recent developments regarding our understanding of the determinants of patients' adherence to antihypertensives. A systematic review was performed using the electronic databases MEDLINE/PubMed, Web of Science, Scientific Electronic Library Online (SciELO), and "Índex das Revistas Médicas Portuguesas", which included studies published between 2017 and 2021 following the PICOS model: (P) Adult patients with the diagnosis of primary hypertension, using at least one antihypertensive agent; (I) all interventions on both pharmacological and non-pharmacological level; (C) patient's adherence against their non-adherence; (O) changes in adherence to the therapeutic plan; and (S) any study design (except review articles) written in English, French, Spanish or Portuguese. Articles were reviewed by two researchers and their quality was assessed. Subsequently, determinants were classified according to their consistent or inconsistent association with adherence or non-adherence. Only 45 of the 635 reports identified met the inclusion criteria. Adherence was consistently associated with patient satisfaction with communication, patient-provider relationship, their treatment, and use of eHealth and mHealth strategies; a patient's mental and physical health, including depression, cognitive impairment, frailty, and disability, previous hospitalization, occurrence of vital events; drug treatment type and appearance; and unwillingness due to health literacy, self-efficacy, and both implicit and explicit attitudes towards treatment. There were discrepancies regarding the association of other factors to adherence, but these inconsistent factors should also be taken into account. In conclusion, the barriers to adherence are varied and often interconnected between socioeconomic, patient, therapy, condition, and healthcare system levels. Healthcare teams should invest in studying patients' non-adherence motives and tailoring interventions toindividual levels, by using a multifaceted approach to assess adherence. Further research is needed to analyze the impact of implicit attitudes, the use of new technological approaches, and the influence of factors that are inconsistently associated with non-adherence, to understand their potential in implementing adherence strategies.

The population-based Tromsø 8 study and e-mental health

IntroductionAgeing populations with increased needs, rising costs of traditional services, and new technologies are some factors driving the use of e-health services. A Norwegian study with data from 2015-2016 found that 13.5% had used apps, 7.3% had used social media, and 5% had used video services for health purposes. Little is known about the effects of many online health services, but in general they seem to increase knowledge and make most people feel reassured, although some users feel more anxious or confused after using such tools. Recent technological developments have resulted in new online health services, including AI-based technologies. More updated knowledge regarding the population’s use of e-health services in general and e-mental health services in particular, is needed.ObjectivesThe objective here is to provide information about an upcoming large population-based epidemiological study and how it addresses e-health and e-mental health.MethodsWe introduce the upcoming 8th version of the epidemiological Tromsø Study and discuss its importance to the field of e-mental health.Results The Tromsø epidemiological study has since 1974 taken place in the Norwegian municipality of Tromsø. It contains information on a range of topics within health and illness, including topics from many medical specialities, psychiatry and substance use. In the upcoming 8th version of the study (2025-2026), more than 33,000 people aged above 40 will be invited to participate. The main questionnaire will include questions relating to a wide variety of topics, including on e-health use. We suspect the importance of e-health and e-mental health have increased lately, and we will examine how the use of e-health may impact mental health.ConclusionsCommunity-based studies, such as the Tromsø Study, allow researchers to study associations between many different variables, including mental health and e-health. The upcoming Tromsø 8 study will enable us to study e-health use and its relationship to mental health in a large sample representative of the Norwegian population.Disclosure of InterestNone Declared

The use of eHealth and health coaching in postnatal diabetes prevention, in women with history of gestational diabetes

This literature review explores the role of eHealth and health coaching in assisting prevention of type 2 diabetes in women with history of gestational diabetes mellitus (GDM). The integration of electronic health (eHealth) and mobile health (mHealth) technologies, including telemedicine, smartphone apps, and mixed-method approaches, has emerged as a crucial strategy in healthcare delivery. These technologies address postnatal barriers such as lack of support, time constraints, and childcare issues, enhancing accessibility to diabetes prevention interventions. The review presents evidence from various studies, including randomized controlled trials and ongoing research projects, indicating positive impacts on engagement, adherence, and follow-up rates when utilizing remote interventions through smartphone apps and health coaching. Notably, the use of telemedicine during the COVID-19 pandemic has further underscored the potential benefits of delivering care remotely. The focus on postnatal diabetes prevention in women with a history of GDM is particularly pertinent, given the increased risk of developing type 2 diabetes. The inclusion of partners and families in interventions, highlights a holistic approach to promoting a healthy lifestyle. While the results are promising, the review acknowledges the inconclusive nature of current evidence, emphasizing the need for further research to establish the long-term efficacy and acceptance of these interventions. Continued efforts to refine these strategies and expand research will contribute to a better understanding of their impact, ultimately paving the way for targeted and effective diabetes prevention in this high-risk population of women with a history of GDM.

Pengembangan Layanan Baru dan Penggunaan Teknologi dalam Strategi Inovasi pada Masa Pandemi Covid-19

This research aims to analyze the development of new services and the use of technology in innovation strategies at Hospital X during the COVID-19 pandemic. The research method uses a case study approach with interviews, document review, and observation, as well as Focus Group Discussions (FGD). The research results show that health service innovation strategies at Hospital hospital services such as registration, payment transactions, service outreach, or online consultations. Apart from that, increasing the use of e-health or IT, such as telemedicine, drive-thru vaccination, drive-thru PCR/antigen/antibody swabs, MCU on site, and home care, etc. can provide speed and accuracy in service delivery. In conclusion, in the digital era, the pace of change has become very fast. Hospital X applies these strategic, creative, execution and organizational factors in innovation. Keywords: COVID-19, Innovation, Service Development, Strategy, Technology.

Digital technology and intentions to adopt digital e-health practices among health-care professionals

Purpose In the present era, digital technology can be used responsibly to provide developed and developing countries with high-quality health-care services to nations. This study aims to explore Saudi Arabia’s intentions to adopt digital health-care practices. Design/methodology/approach To be consistent with previous studies, this study used a quantitative methodology to collect the data from health-care professionals working in Saudi Arabia’s public and private health institutes. Consequently, this study’s findings are based on 306 valid samples. Findings On the one hand, the path analysis reveals that health-care professionals believe in perceptions relating to the use of e-health and technology (PEHT) and experiences regarding internet use (ERIU) and that these have positive and significant effects on attitudes toward the use of e-health and technology (ATEHT) and intentions to use e-health services (ITUES). On the other hand, barriers to using e-health (BUEH) negatively impact ATEHT and ITUES. Finally, ATEHT also has a positive and significant effect on ITUES. Practical implications This study’s findings will help Saudi Arabia’s policymakers and the country’s health ministry to develop policies to provide e-services that health-care professionals can use to improve the quality of the country’s health care, patients’ human rights and social care. Furthermore, this study’s findings are helpful in developing attitudes and intentions toward either e-health or digital health to provide better health facilities to serve Saudi Arabia’s citizens. Originality/value This study empirically confirms among Saudi Arabia’s health-care professionals the PEHT, ERIU and BUEH toward ATEHT and ITUES.

Prospective association of eHealth literacy and health literacy with physical activity among Chinese college students: a multiple mediation analysis.

The COVID-19 pandemic has decreased physical activity (PA) while increasing demand for electronic health resources. eHealth literacy (EHL) is expected to aid eHealth use and health promotion. EHL was raised on the grounds of health literacy (HL). This study explored the associations among EHL, HL, and PA in Chinese college students and identified mediating mechanisms in the EHL/HL-PA relationship. An integrated social-cognitive model was proposed. A total of 947 Chinese college students (52.8% women, age = 19.87 ± 1.68 years) completed the three-wave data collection. Path analysis was performed. An adequate good-to-fit model was indicated. Perceived EHL (PEHL) was significantly associated with perceived HL (PHL) and HL performance (HLP); PHL was negatively related to HLP; PEHL was significantly associated with self-efficacy (SE) and social support (SS); PHL had a significant effect on SS but not SE; HLP significantly affected SS but not SE; SS and SE positively predicted intention (INT), which then predicted PA. SS mediated PEHL/PHL-INT links; SE mediated the PEHL-INT link; SS and INT jointly mediated PEHL/PHL/HLP-PA; SE and INT jointly mediated PEHL-PA. Relationships among EHL, HL, and PA were explored with multiple mediating mechanisms identified. Differential SE and SS roles in EHL/HL-PA links suggest new mechanisms to inform EHL/HL intervention development.

Nurses' and physicians' perceptions of the impact of eHealth and information systems on the roles of health care professionals: A qualitative descriptive study.

The increased use of eHealth and information systems impacts health care work broadly, including cultural and social aspects of work such as the roles of health care professionals. This qualitative descriptive study examined the perceptions of health care professionals in terms of how eHealth and information systems have changed their roles. The data was collected via 15 semi-structured thematic interviews and analysed using content analysis with an inductive approach. The analysis indicated mainly unconscious changes in the roles of professional groups. The professionals perceived that the role of digitally competent professionals in the working community was important. Moreover, high digital competency was seen to have led to an increase or change in work tasks. Professionals' own working environments and job opportunities were seen to have affected to their roles when using information systems. eHealth was perceived to have created inequalities in work tasks, increased skills gaps and complicated work. However, eHealth made cooperation between professionals easier than before. Organisations should pay more attention to equal opportunities to increase professional's digital competency, even out workloads between professionals, and provide equal access to eHealth and information systems.

Descriptive Norms and eHealth Use Among Older Adults: A Cross-Country Comparative Study

ABSTRACT eHealth use enables older adults to access and manage healthcare resources, and benefits their health; however, older adults’ uptake of eHealth remains low across societies. Social influences such as descriptive norms may be of critical importance in promoting the elderly’s usage of eHealth. Based on the Integrative Model of Behavioral Prediction, this study investigates how descriptive norms relate to eHealth use among the elderly in China and the United States. Analysis of the combined sample (N = 1,070) showed that descriptive norms were positively related to eHealth use. Also, descriptive norms were indirectly associated with eHealth use via injunctive norms, attitudes and self-efficacy. Moderated mediation analysis indicated that these direct and indirect relationships differed across the two countries. This study highlights the important role of descriptive norms in promoting older adults’ eHealth use behavior and addresses potential country differences in how the elderly respond to descriptive norms. Several important theoretical and practical implications are also discussed.

Creation of a telehealth application empowering patients with multiple sclerosis: MyApp4SEP

Introduction: Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system. International recommendations advocate multidisciplinary management in specialized centers, still not widely accessible at present. Moreover, this doesn’t fit to newly diagnosed or pauci-symptomatic patients that are still professionally active. Ultimately, the lack of recognition of invisible disorders still persists.&#x0D; The use of e-health as tool for care has been evaluated for many years and its growth is supported by various evidence of its effectiveness in MS.&#x0D; To our knowledge no comprehensive e-health tool exists in Belgium that aims at empowering MS patients from the prodromal to a more advanced disease stage.&#x0D; Policy Context And Objective: Following our involvement in the national and regional public health plan "Integrated Care for a better health" (www.integreo.be) via the federal project Chronicopôle, we gave up the ""symptom and discipline-centered"" approach to develop a more integrated one : health promotion tied to the daily life of patients.&#x0D; A strong involvement of users in every stages of development of a e-health solution is required to meet their specificities and needs. Placing them at the heart of the thinking process was therefore mandatory.&#x0D; Such a design needs a multi-step approach involving: Analysis of user needs, definition of desired functionality and finally, development and testing of acceptability and user experience.&#x0D; We partnered with the Wallonia e-health Living Lab (WeLL) for methodological guidance to achieve this. Based on their approach, different workshops were proposed, first to a group of MS patients, but also to a group of health professionals, in order to leave a dichotomous thinking framework.&#x0D; Target Population: Any Belgian French speaking person (Dutch translation pending) with MS. Healthcare professionals involved in MS patients care.&#x0D; Highlights: Two workshops (n = 11 patients) were organized in collaboration with the WeLL. They took place at their offices and focused on fundamental needs/issues in care pathways of patients. Furthermore, a specific workshop for health professionals was also organized. From the aggregation of these two expertises emerged the architecture and functionalities of our tool.&#x0D; The application content was determined as follow: patient record, documentation (developing literacy), peer’s good tips, toolbox (exercises, questionnaires), diary and logbook, directory (personal and relevant resources).&#x0D; During the IT development, all the patients/partners were able to give their opinion and validate each step via a functional analysis of each module. Finally, about 20 patients tested the application during a period of 3 months. Final modifications were made before publishing on the main application stores.&#x0D; Conclusion: MyApp4SEP is fully developed and available for free on the Play Store and the App Store starting from november 2022.&#x0D; Co-creation leads our project and aims at maximize health literacy by putting as first objective coping with real world caveats of our patients.&#x0D; The goal for the next few years is evolve the app based on patients/users feedbacks and propositions but also by developing partnership with other teams working in a "patient-centered" approach among other chronic diseases.