Health Literacy and eHealth: Challenges and Strategies

Abstract

Given the impact of health literacy (HL) on patients' outcomes, limited health literacy is a major barrier to improve cancer care globally. HL refers to the degree in which an individual is able to acquire, process, and comprehend information in a way to be actively involved in their health decisions. Previous research found that almost half of the population in developed countries have difficulties in understanding health-related information. With the gradual shift toward the shared decision making process and digital transformation in oncology, the need for addressing low HL issues is crucial. Decision making in oncology is often accompanied by considerable consequences on patients' lives, which requires patients to understand complex information and be able to compare treatment methods by considering their own values. How health information is perceived by patients is influenced by various factors including patients' characteristics and the way information is presented to patients. Currently, identifying patients with low HL and simple data visualizations are the best practice to help patients and clinicians in dealing with limited health literacy. Furthermore, using eHealth, as well as involving HL mediators, supports patients to make sense of complex information.

Digital Trends, Digital Literacy, and E-Health Engagement Predictors of Breast and Colorectal Cancer Survivors: A Population-Based Cross-Sectional Survey

“…In the previous five years, the WHO has produced several important papers, including Digital Technologies: Shaping the Future of Primary Health Care (2018) and the first WHO guideline recommendations on Digital Interventions for Health System Strengthening (2019) [ 45 ]. Digital health will surpass the internet as a means of providing cancer patients with digital informational support in the future [ 46 ].…”

“…Digital health literacy is linked to people’s ability to evaluate online health sources and their trust in the Internet as a health information source, according to a systematic review [ 25 ]. Our results show that low digital health literacy among cancer survivors could represent a major access barrier for the use and adoption of m-health tools that will be developed in the future [ 46 ]. The results of a binary logistic regression analysis showed that higher levels of self-perceived digital literacy were independent predictors of greater interest in obtaining health information during survivorship and more receptiveness of acceptability of using m-health apps to provide cancer supportive care.…”

“…However, the deployment of digital health technologies like m-health and eHealth in oncology should address the heterogeneity of digital health literacy and user characteristics from different age groups to benefit cancer survivors along the care continuum [ 60 ]. Tailoring digital interventions like Patient Decision Aids (PDAs) and risk visualisation tools can help patients with low digital literacy actively participate in decision-making with their doctors [ 46 ]. Furthermore, educational interventions for cancer patients can be delivered through interactive media using digital interventions designed for varying levels of digital literacy and leveraging web-based delivery systems.Additionally, without careful strategic planning that accounts for patients’ engagement barriers, facilitators, requirements, and opportunities, digital health technologies may not only fail to improve health care equity in the context of cancer, but may actually exacerbate existing disparities [ 60 ].…”

“…Digital navigators and telehealth task forces are examples [ 62 , 63 ]. Digitally-skilled family members or informal carers with biomedical backgrounds and a high education can serve as mediators for patients with limited digital health literacy [ 46 ]…”

Patients' Attitudes Towards the Use of AI-Based Decision Aids for Breast Cancer Treatment Decision-Making: A Qualitative Study

“…It is important to consider the speci c needs and capabilities of older individuals when designing and implementing patient decision aids, ensuring they are accessible, user-friendly, and tailored to their unique requirements. A long-term plan such as developing educational materials and making terminology lists for each health area is recommended to overcome this (37).…”