Electronic health (eHealth) literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information. Now, advances in eHealth technology ...have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth. This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts.
The objective of our study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC.
Walker and Avant's concept analysis method was used to guide the systematic review of eHealth literacy definitions (n=10), rating scales (n=6), models (n=4), and peer-reviewed model applications (n=16). Subsequent cluster analyses showed salient themes across definitions. Dimensions, antecedents, and consequences reflected in models and measures were extracted and deductively analyzed based on codes consistent with the TMC.
Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal. Despite the transactional capabilities of eHealth, the role of "communication" in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions.
The Transactional Model of eHealth Literacy and a corresponding definition are proposed. In this novel model, eHealth literacy comprises a hierarchical intrapersonal skillset that mediates the reciprocal effect of contextual factors (ie, user oriented and task oriented) on patient engagement in health care. More specifically, the intrapersonal skillset counteracts the negative effect of "noise" (or impediments) produced by social and relational contexts. Cutting across health and technology literacies, the intrapersonal skillset of eHealth literacy is operationalized through four literacies that correspond with discrete operative skills: (1) functional (ie, locate and understand); (2) communicative (ie, exchange); (3) critical (ie, evaluate); and (4) translational (ie, apply).
The new high-choice media environment has allowed entertainment-oriented people to avoid political news, resulting in a wider gap in political knowledge between entertainment- and news-oriented ...citizens. On the Internet, however, users tend to be concentrated into a handful of portal sites that offer a mixed information environment in which both news and entertainment are readily available. The simultaneous presentation of news and entertainment headlines on portal sites exposes entertainment-oriented people to the news, which may in turn narrow the knowledge gap between them and news-oriented people. To test this hypothesis, we examined the effects of exposure to major portal sites in Japan, where Yahoo! JAPAN attracts a large majority of Internet users. Two studies using self-reported exposure to portal sites (n = 838) and web browsing histories (n = 1,000) demonstrated that even entertainment-oriented people can acquire political knowledge, and thus portal sites can serve as knowledge levelers.
Background
As care shifts from institutional to community settings, family caregivers are providing increasing support to older adults, including complex medical/nursing care. In the mid‐late ...pandemic, technology advancements such as use of online patient portals present opportunities for communication and care delivery. This study aims to assess the association between caregiver medical/nursing tasks or patient portal use with contact, communication, and training of caregivers by healthcare providers.
Methods
We conducted a cross‐sectional analysis of caregiver data from the 2021 National Study of Caregiving (NSOC), linked to the National Health and Aging Trends Study (NHATS). NHATS is nationally‐representative, annual survey of Medicare enrollees; NSOC surveys family/unpaid caregivers of NHATS participants. Logistic regression tested association between whether the caregiver does medical/nursing tasks or uses an online patient portal to contact the medical team (independent variables), and communication with or training by the medical team (dependent variables).
Results
Participants were 1590 caregivers of living, community‐dwelling older adults. More than half (54%) reported no contact with the care recipient's medical team in the past year. Caregivers who did medical/nursing tasks (OR = 3.10; 95% CI: 2.16, 4.46) or who used patient portals (OR = 3.28; 95% CI: 1.96, 5.51) had higher odds of contacting the older adult's medical team. Thirty percent of caregivers stated communication was either not at all or just a little helpful. Sixty‐seven percent reported that providers rarely asked if they needed help managing the older adult's treatments. Just 6% of caregivers reported receiving any caregiver training in the last year.
Conclusions
Both medical/nursing tasks and online patient portal use were independently associated with contact with health providers. Overall contact, communication, and training were limited or of variable value. Despite recent policy changes and technology advancement, there is still a need for improved integration of caregivers into health teams with ongoing assessment of their needs.
Background: Advances in technology and policy changes, have led to nationwide efforts to increase consumer access and patient and family engagement with their health care system, through the use of ...electronic health information, as a way to advance person-centered health. Providing patients with the ability to participate in their health care electronically can lead to better communication with providers, care, and outcomes as well as lower costs. UF Health utilizes MyUFHealth as a secure web platform through which patients and their caregivers can engage with their care teams and manage their health. Pediatric patients, particularly inpatients, have lower rates of MyUFHealth enrollment, therefore this project aimed to reduce this disparity. Overall Goal: Offer all pediatric patients admitted to the Hospitalist service access codes to MyUFHealth and increase enrollment by 20 percent by December 30, 2017. Methods and Interventions: An enrollment protocol for Inpatient Pediatric units was developed and a discharge nurse and pediatric coordinator were trained to assist with MyUFHealth activation for individual patients on the hospitalist service. The project had two staged interventions: 1) enrollment of patients less than 12 years of age and 2) expansion to enroll teens (12-17 years of age). A multidisciplinary team (physicians, nurses, IT, legal) used Plan-Do-Study-Act cycles to conduct ongoing evaluation of MyUFHealth enrollment among patients on the hospitalist service. Implementation included staff education, creation of Pareto and control charts, key driver and fishbone diagrams, and process maps. Outcome measures included MyUFHealth activation data. Principal Findings: Key findings included identification of 'best times' to conduct enrollment on units, establishing a pathway for parents of incapacitated adolescents to obtain proxy status, addition of children in the family who were not currently admitted, providing information regarding the use of the mobile application and security of MyUFHealth, providing just-in- time explanation regarding appointment reminders and the computer-literacy requirement and recognizing that the small number of enrollment facilitators reduced the project's reach. Patient/caregiver 'Buy-in' as a result of face-to-face interaction between the MyUFHealth enrollment facilitator and patient /caregiver was noted informally. There was an increase of MyUFHealth activation for pediatric patients admitted to the Hospitalist service by almost 300%, (absolute increase from 9% to 26%). Conclusions and Future Directions: MyUFHealth allows for continued opportunity to engage patients and their parents in their electronic medical records. Expansion to other Pediatric units was delayed due to an insufficient number of MyUFHealth enrollment facilitators. Next steps include a grant submission to support increased staffing with plans of expanding to the Newborn Nursery and PICU as well as additional inpatient services, general outpatient services and multispecialty clinics. We will review data on how many times parents/patients accessed their MyUFHealth and what were the most common reasons to engage.
IMPORTANCE: Telehealth services, which allow patients to communicate with a remotely located clinician, are increasingly available; however, prevalence of telehealth use, including videoconferencing ...visits, remains unclear. OBJECTIVE: To measure the use of and willingness to use telehealth modalities across the US population. DESIGN, SETTING, AND PARTICIPANTS: This survey study, conducted between February 2019 and April 2019, asked participants about their use of different telehealth modalities, reasons for not using videoconferencing visits, and willingness to use videoconferencing visits. Questions were continuously posed to panel members and closed after 2555 responses were obtained, at which point 3932 panel members had been invited, for a 65.0% response rate. EXPOSURES: Demographic characteristics (ie, age, sex, race, rural/urban residency, education level, and income). MAIN OUTCOMES AND MEASURES: Self-reported use of specific telehealth modalities, reasons for nonuse, and willingness to use videoconferencing in the future. RESULTS: A total of 2555 individuals completed the survey with a mean (SD) age of 57.2 (14.2) years; 1453 respondents (weighted percentage, 51.9%) were women, and 2043 (weighted percentage, 73.4%) were White individuals. Overall, 1343 respondents (weighted percentage, 50.8%) reported use of a nontelephone telehealth modality, ranging from 873 respondents (weighted percentage, 31.9%) for patient portals and 89 respondents (weighted percentage, 4.2%) for videoconferencing visits. Although 1309 respondents (weighted percentage, 49.2%) overall answered that they were willing or very willing to use videoconferencing visits, respondents who were Black individuals (OR, 0.58; 95% CI, 0.38-0.91), aged older than 65 years (OR, 0.51; 95% CI, 0.40-0.66), or had less education (high school or less vs advanced degrees: OR, 0.37; 95% CI, 0.25-0.56) were less likely to express willingness. CONCLUSIONS AND RELEVANCE: Despite the focused policy attention on videoconferencing visits, the results of this survey study suggest that other forms of telehealth were more dominant prior to 2020. Targeted efforts may be necessary for videoconferencing visits to reach patient groups who are older or have less education, and payer policies supporting other forms of telemedicine may be appropriate to enhance access.
With the advent of the patient-centered care paradigm, it is important to examine what patients' reports of medication experience (PROME) mean to patient care. PROME available through a Web portal ...provide information on medication treatment options and outcomes from the patient's perspective. Patients who find certain PROME compelling are likely to mention them at their physician visit, triggering a discussion between the patient and the physician. However, no studies have examined PROME's potential applicability to patient care.
This study aimed to examine older (≥50 years) adults' perceptions of the health care applicability of a hypothetical PROME Web portal. Specifically, this study investigated whether PROME would facilitate patient-physician communication, and identified the preferred reporting items and the trusted sponsors of such a PROME Web portal.
We used a cross-sectional, self-administered, 5-point Likert scale survey to examine participants' perceptions of a hypothetical PROME Web portal that compared PROME for 5 common antihypertensive medications. Between August and December 2013, we recruited 300 members of 7 seniors' centers in a metropolitan area of a southeastern state of the United States to participate in the survey.
An overwhelming majority of study participants (243/300, 81.0%) had a favorable perception of PROME's health care applicability. They were mostly positive that PROME would facilitate patient-physician communication, except for the perception that physicians would be upset by the mention of PROME (n=133, 44.3%). Further, 85.7% (n=257) of participants considered the PROME information trustworthy, and 72.0% (n=216) were willing to participate by reporting their own medication experiences. Study participants wanted the PROME Web portal to report the number of reviews, star ratings, and individual comments concerning different medication attributes such as side effects (224/809, 27.7%), cost (168/809, 20.8%), and effectiveness (153/809, 18.9%). Finally, the PROME Web portal sponsorship was important to participants, with the most trusted sponsor being academic institutions (120/400, 30.0%).
PROME, if well compiled through Web portals, have the potential to facilitate patient-physician communication.
The International Soil Moisture Network (ISMN) was initiated in 2009 to support calibration and validation of remote sensing products and land surface models, and to facilitate studying the behavior ...of our climate over space and time. The ISMN does this by collecting and harmonizing soil moisture data sets from a large variety of individually operating networks and making them available through a centralized data portal. Due to the diversity of climatological conditions covered by the stations and differences in measurement devices and setup, the quality of the measurements is highly variable. Therefore, appropriate quality characterization is desirable for a correct use of the data sets. This study presents a new, automated quality control system for soil moisture measurements contained in the ISMN. Two types of quality control procedures are presented. The first category is based on the geophysical dynamic range and consistency of the measurements. It includes flagging values exceeding a certain threshold and checking the validity of soil moisture variations in relation to changes in soil temperature and precipitation. In particular, the usability of global model- or remote sensing-based temperature and precipitation data sets were tested for this purpose as an alternative to in situ measurements, which are often not recorded at the soil moisture sites themselves. The second category of procedures analyzes the shape of the soil moisture time series to detect outliers (spikes), positive and negative breaks, saturation of the signal, and unresponsive sensors. All methods were first validated and then applied to all the data sets currently contained in the ISMN. A validation example of an AMSR-E satellite and a GLDAS-Noah model product showed a small but positive impact of the flagging. On the basis of the positive results of this study we will add the flags as a standard attribute to all soil moisture measurements contained in the ISMN.
The prevalence of mental health disorders continues to rise, with almost 4% of the world population having an anxiety disorder and almost 3.5% having depression in 2017. Despite the high prevalence, ...only one-third of people with depression or anxiety receive treatment. Over the last decade, the use of digital health interventions (DHIs) has risen rapidly as a means of accessing mental health care and continues to increase. Although there is evidence supporting the effectiveness of DHIs for the treatment of mental health conditions, little is known about what aspects are valued by users and how they might be improved.
This systematic review aimed to identify, appraise, and synthesize the qualitative literature available on service users' views and experiences regarding the acceptability and usability of DHIs for depression, anxiety, and somatoform disorders.
A systematic search strategy was developed, and searches were run in 7 electronic databases. Qualitative and mixed methods studies published in English were included. A meta-synthesis was used to interpret and synthesize the findings from the included studies.
A total of 24 studies were included in the meta-synthesis, and 3 key themes emerged with descriptive subthemes. The 3 key themes were initial motivations and approaches to DHIs, personalization of treatment, and the value of receiving personal support in DHIs. The meta-synthesis suggests that participants' initial beliefs about DHIs can have an important effect on their engagement with these types of interventions. Personal support was valued very highly as a major component of the success of DHIs. The main reason for this was the way it enabled individual personalization of care.
Findings from the systematic review have implications for the design of future DHIs to improve uptake, retention, and outcomes in DHIs for depression, anxiety, and somatoform disorders. DHIs need to be personalized to the specific needs of the individual. Future research should explore whether the findings could be generalized to other health conditions.
Whilst online learning has gained rapid momentum, the development of online technology and practices that support the delivery of online courses with a large research component has been slow. In ...2017, the School of Psychological Sciences at Monash University, Australia, developed a potentially scalable and transferable online research portal. This is an all-in-one platform that is designed to facilitate and support online research and research supervision, for supervisors and students. The research portal has evolved to currently provide research and research supervision support to over 700 online psychology students at the university. This paper describes the development, implementation and impact of the research portal and presents data from a preliminary evaluation of its usability and user satisfaction. Both research students and supervisors from the fully online fourth-year Graduate Diploma of Psychology Advanced program at Monash University participated in a series of focus groups, individual usability testing sessions, and surveys, and reported favourably on the research portal’s research supervisor and supervisee user satisfaction and usability. Qualitative and quantitative feedback provided useful information supporting research portal improvement and expansion possibilities, allowing an increasingly valuable contribution to online research supervision, research and research teaching.
Implications for practice or policy
All research students will be able to complete their research-related professional training online.
Research supervisors and students will be able to access a standardised best practice online research supervision and research tool across courses and topics.
Course leaders will be able to expand online education with an online research supervision and research tool that supports all research programs.
Universities will be able to provide a research learning pathway for all students.
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