Background The internet is now a major source of health information. With the growth of internet users, eHealth literacy has emerged as a new concept for digital health care. Therefore, health professionals need to consider the eHealth literacy of consumers when providing care utilizing digital health technologies. Objective This study aimed to identify currently available eHealth literacy instruments and evaluate their measurement properties to provide robust evidence to researchers and clinicians who are selecting an eHealth literacy instrument. Methods We conducted a systematic review and meta-analysis of self-reported eHealth literacy instruments by applying the updated COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) methodology. Results This study included 7 instruments from 41 articles describing 57 psychometric studies, as identified in 4 databases (PubMed, CINAHL, Embase, and PsycInfo). No eHealth literacy instrument provided evidence for all measurement properties. The eHealth literacy scale (eHEALS) was originally developed with a single-factor structure under the definition of eHealth literacy before the rise of social media and the mobile web. That instrument was evaluated in 18 different languages and 26 countries, involving diverse populations. However, various other factor structures were exhibited: 7 types of two-factor structures, 3 types of three-factor structures, and 1 bifactor structure. The transactional eHealth literacy instrument (TeHLI) was developed to reflect the broader concept of eHealth literacy and was demonstrated to have a sufficient low-quality and very low-quality evidence for content validity (relevance, comprehensiveness, and comprehensibility) and sufficient high-quality evidence for structural validity and internal consistency; however, that instrument has rarely been evaluated. Conclusions The eHealth literacy scale was the most frequently investigated instrument. However, it is strongly recommended that the instrument's content be updated to reflect recent advancements in digital health technologies. In addition, the transactional eHealth literacy instrument needs improvements in content validity and further psychometric studies to increase the credibility of its synthesized evidence.
Purpose: As Korea has been rapidly transformed to be a multicultural society, it becomes essential for nurses to develop cultural competency. The purpose of this descriptive study was to assess the cultural competency level of general hospital nurses and to examine its contributing factors adopting ecological model. Method: A convenience sample of 327 nurses from six general hospitals in Seoul metropolitan area was recruited between November 14 to 28, 2011. Cultural competency was measured using the Korean version of the Caffrey Cultural Competence in Healthcare Scale (CCCHS) and Cultural Competence Assessment(CCA). Hierarchical multiple regression analysis was performed to assess the influence of intrapersonal, cultural-experience, and organizational factors on cultural competency. Results: Mean cultural competency in this study was 2.57(±0.43). Cultural competency was associated with job position (p=.044) at the intrapersonal level. At the cultural experience level, foreign language classes experience (p=.005), fluency in a foreign language (p=.000), experience of working with foreign health care professionals (p=.000) were associated cultural competency. At the organizational level, training program (p=.000), job description (p=.002), health education materials (p=.016), insufficient job control (p=.000), and interpersonal conflicts (p=.011) showed significant difference. Foreign language class experience, foreign language fluency, experience of working with foreign health care professionals, and job control were the most consistent predictors of cultural competence and explained 20.4% of the total variance in the proposed ecological model. Conclusions: The findings suggest that to enhance cultural competency in general hospital nurses, cultural experience and organizational factors need to be more fully considered than intrapersonal factors.
This study was designed to determine the effect of an academic-workplace partnership intervention, "3,000 more steps," on improving physical activity (PA) and body composition of workers, and compare the characteristics of those workers who completed and did not complete the program. Participants were 70 sedentary office workers from an airline company. Pedometers determined their daily steps, and body composition was compared before and after the 8-week intervention; 39 of 70 (55.7%) participants completed the program. Daily steps increased from 5,811 to 9,240, and fat mass, waist-hip ratio, and body mass index (BMI) decreased for the completers. Non-completers had lower average PA and higher average fat mass at baseline than did completers. Overall, a workplace PA program could be successfully undertaken by occupational health nurses and a research team in partnership. However, to implement a cost-effective intervention program for inactive workers, further research is needed to ascertain why some workers do not complete the program.
PurposeThis systematic review aimed to identify, appraise, and synthesize the best available evidence for the effectiveness of cultural competence educational interventions on health professional and patient outcomes.MethodsWe conducted a systematic review of randomized and non‐randomized controlled trials. We searched seven electronic databases including MEDLINE, EMBASE, Cochrane Library, and four Korean databases in June 2018. Studies that provided cultural competence educational interventions for health professionals and measured the impact on health professional outcomes, patient outcomes, or both were included. A narrative synthesis of study findings was performed.ResultsEleven studies met the inclusion criteria. Studies used a randomized (n = 5) and a non‐randomized controlled trial (n = 6) design and were conducted in the USA (n = 7), South Korea (n = 3), and Sweden (n = 1). Cultural competence education was provided mostly to those of single occupations, nurses (n = 5) or physicians (n = 4). The delivery mode was classroom (n = 7), online (n = 3), or blended learning (n = 1), using mainly lectures, discussions, and case studies as teaching and learning methods. Education duration ranged from less than 1 hr to 3 days. Nine studies reported significantly improved health professional outcomes compared to the control group. Patient outcomes were reported in three studies. Only one study reported significant effect on patient satisfaction (d = 0.94) and trust (d = 0.71). There was no significant effect on patient physiological outcomes.ConclusionsCultural competence educational interventions had a positive effect on health professional outcomes. There is a considerable lack of research assessing patient outcomes, and there is limited evidence on whether interventions can change patient outcomes.
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