eHealth literacy and web‐based patient portal usage among kidney and liver transplant recipients

Maroney, Kieran; Curtis, Laura M.; Opsasnick, Lauren; Smith, Kayla; Eifler, Morgan; Moore, Amy; Wedd, Joel; Wolf, Michael S.; Patzer, Rachel E.

doi:10.1111/ctr.14184

Cited by 19 publications

(9 citation statements)

References 33 publications

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“…More than 90% (n =260) of patients in our sample had access to at least 1 technological device, but only two-thirds (n=195) had adequate eHL. Furthermore, this study extends the findings of correlation between eHL and patient portal use previously reported among outpatients and organ transplant recipients to a hospitalized, urban, predominantly Black general medicine population [ 23 ]. Studying eHL and portal attitudes among inpatients captures individuals during the unique stressor of hospitalization and patients who may not engage with outpatient medicine and may otherwise be missed.…”

Section: Discussionsupporting

confidence: 85%

eHealth Literacy and Patient Portal Use and Attitudes: Cross-sectional Observational Study

Deshpande¹,

Arora²,

Vollbrecht³

et al. 2023

JMIR Hum Factors

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Background Throughout the COVID-19 pandemic, patient portals have become more widely used tools of patient care delivery. However, not all individuals have equivalent access or ability to use patient portals. Objective The aim of this study is to evaluate the relationships between eHealth literacy (eHL) and patient portal awareness, use, and attitudes among hospitalized patients. Methods Inpatients completed patient portal surveys; eHL was assessed (eHealth Literacy Scale). Multivariable logistic regression analyses adjusted for age, self-reported race, gender, and educational attainment were completed with significance at P<.006 (Bonferroni correction). Results Among 274 participants, most identified as Black (n=166, 61%) and female (n=140, 51%), mean age was 56.5 (SD 16.7) years, and 178 (65%) reported some college or higher educational attainment. One-quarter (n=79, 28%) had low eHL (mean 27, SD 9.5), which was associated with lower odds of portal access awareness (odds ratio 0.11, 95% CI 0.05-0.23; P<.001), having ever used portals (odds ratio 0.19, 95% CI 0.10-0.36; P<.001), less perceived usefulness of portals (odds ratio 0.20, 95% CI 0.10-0.38; P=.001), and lower likelihood of planning to use portals in the coming years (odds ratio 0.12, 95% CI 0.06-0.25; P<.001). As time through the COVID-19 pandemic passed, there was a trend toward increased perceived usefulness of patient portals (53% vs 62%, P=.08), but average eHL did not increase through time (P=.81). Conclusions Low eHL was associated with less awareness, use, and perceived usefulness of portals. Perceived usefulness of portals likely increased through the COVID-19 pandemic, but patients’ eHL did not. Interventions tailored for patients with low eHL could ensure greater equity in health care delivery through the COVID-19 pandemic.

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Section: Discussionsupporting

confidence: 85%

eHealth Literacy and Patient Portal Use and Attitudes: Cross-sectional Observational Study

Deshpande¹,

Arora²,

Vollbrecht³

et al. 2023

JMIR Hum Factors

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“…Having the composite skills of eHealth literacy allows health consumers not only to increase the availability of health information (Knapp, Madden, Wang, Sloyer, & Shenkman, 2011 ; Mackert et al, 2014 ; Maroney et al, 2020 ), translated into knowledge (Stellefson et al, 2019 ), but also to achieve positive health processes and outcomes, such as quality of life and self-care behaviors (Guo, Hsing, Lin, & Lee, 2021 ; Kim, Kim, & Choi, 2018 ; Neter & Brainin, 2012 ; Stellefson et al, 2019 ). eHealth literacy has the potential to both protect consumers from harm and empower them to fully participate in knowledge-based decision-making (Norman & Skinner, 2006 ), but it may also re-enacts the divisions reported on health literacy in the digital domain.…”

Section: Health Literacy Ehealth Literacy and Their Association With Health Outcomesmentioning

confidence: 99%

“…Tangible outcomes could be adoption of health behaviors (Guo et al, 2021 ; Kim et al, 2018 ; e.g. Mitsutake, Shibata, Ishii, & Oka, 2016 ), healthcare utilization (Maroney et al, 2020 ) and ultimately health (or perceived health, see Shiferaw et al, 2020 ) though a recent review concluded that there are currently too few studies attesting on these associations (Neter & Brainin, 2019 ). eHealth literacy has been measured thus far mostly with eHEALS (Griebel et al, 2017 ; Karnoe & Kayser, 2015 ; Neter & Brainin, 2019 ), though its shortfalls chiefly in assessing ‘participative Internet’ (i.e.…”

Section: Health Literacy Ehealth Literacy and Their Association With Health Outcomesmentioning

confidence: 99%

Group differences in health literacy are ameliorated in ehealth literacy

Neter

Brainin

Baron‐Epel

2021

Health Psychology and Behavioral Medicine

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Background: Heath literacy and eHealth literacy are skills that enable individuals to seek, understand and use information in ways which promote and maintain health. The present study examined group differences (ethnicity, immigration) in both literacies and whether there exists an association between the literacies and potential outcomes/gains in health behaviors, health care utilization, perceived health and perceived outcomes of Internet search. Methods: Participants included 819 Israeli men and women who responded to a nationally representative random-digital-dial (RDD) telephone survey. Respondents were veteran Jews, immigrants from the Former Soviet Union, and Palestinian Citizens of Israel. Results: Significant differences between the groups were found in health literacy, especially in higher ordered skills, so that the immigrant group was the lowest, after accounting for demographic variables. No significant group differences were found in eHealth literacy. Health literacy was found to be significantly associated with healthcare utilization, perceived health and perceived outcomes of Internet search while eHealth literacy was associated with perceived health and perceived outcomes of Internet search. No interaction was found between group and literacies in the prediction of the outcomes. Conclusions: Immigration hampers health literacy but differences are ameliorated in eHealth literacy. Finding on association between literacies and outcomes replicated previous ones and the absence of moderation by group attests to the robustness of the models on health literacies.

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“…HL may be essential for this subgroup of patients who must navigate the highly complex process of obtaining and caring for a KT. 9 One study demonstrated that 9% of living donor KT recipients and 14% of deceased donor KT recipients have limited HL. 10 Limited HL has been associated with immunosuppression nonadherence.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Health Literacy and Outcomes Before and After Kidney Transplantation

Lorenz

Petterson

Schinstock

et al. 2022

Transplantation Direct

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Background. Limited health literacy (HL) is associated with decreased kidney function and death in patients with chronic kidney disease. Less is known about the impact of HL on kidney transplant (KT) outcomes. The aim of this study was to examine the relationship between HL and KT outcomes, including rates of waitlisting, healthcare utilization, acute rejection, renal allograft function, renal allograft failure, and death. Methods. We performed a retrospective review of HL data previously collected at our center. HL was assessed in a convenience sample of consecutive, English-speaking patients age ≥18 y who were evaluated for KT at Mayo Clinic in Minnesota between June 2015 and March 2017 as part of a practice improvement feasibility project (n = 690). HL was assessed using the 4-item Brief Health Literacy Screening Tool modified for the outpatient KT evaluation process. The 4 items assess confidence completing forms, reading comprehension, and oral literacy. Results. Overall, 30.4% of patients had limited or marginal HL. Patients with limited or marginal HL were less likely than those with adequate HL to be waitlisted for KT (hazard ratio = 0.62 and 0.69, respectively), even after adjusting for age, marital status, body mass index, Charlson comorbidity index, or dialysis dependency. Patient HL was not associated with post-KT healthcare utilization, acute rejection, or renal allograft function. Patients with limited or marginal HL appeared to experience a higher risk of renal allograft failure and post-KT death, but the number of events was small, and the relationship was statistically significant only for marginal HL. Conclusions. Inadequate HL is common in KT candidates and independently associated with decreased waitlisting for KT. We observed no statistically significant relationship between HL and posttransplant outcomes in our cohort. Further efforts to improve communication in patients with inadequate HL may improve access to KT.

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eHealth literacy and web‐based patient portal usage among kidney and liver transplant recipients

Cited by 19 publications

References 33 publications

eHealth Literacy and Patient Portal Use and Attitudes: Cross-sectional Observational Study

eHealth Literacy and Patient Portal Use and Attitudes: Cross-sectional Observational Study

Group differences in health literacy are ameliorated in ehealth literacy

The Relationship Between Health Literacy and Outcomes Before and After Kidney Transplantation

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