Improving older adults' e-health literacy through computer training using NIH online resources

Xie, Bo

doi:10.1016/j.lisr.2011.07.006

Cited by 92 publications

(137 citation statements)

References 42 publications

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“…These key elements were proved effective in prior e HiLL studies [4-6,24]. A unique aspect of this study was to compare the effectiveness of the collaborative and individualistic learning methods built into the intervention.…”

Section: Discussionmentioning

confidence: 99%

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Effects of an eHealth Literacy Intervention for Older Adults

Xie¹

2011

J Med Internet Res

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190

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BackgroundOlder adults generally have low health and computer literacies, making it challenging for them to function well in the eHealth era where technology is increasingly being used in health care. Little is known about effective interventions and strategies for improving the eHealth literacy of the older population.ObjectiveThe objective of this study was to examine the effects of a theory-driven eHealth literacy intervention for older adults.MethodsThe experimental design was a 2 × 2 mixed factorial design with learning method (collaborative; individualistic) as the between-participants variable and time of measurement (pre; post) as the within-participants variable. A total of 146 older adults aged 56–91 (mean 69.99, SD 8.12) participated in this study during February to May 2011. The intervention involved 2 weeks of learning about using the National Institutes of Health’s SeniorHealth.gov website to access reliable health information. The intervention took place at public libraries. Participants were randomly assigned to either experimental condition (collaborative: n = 72; individualistic: n = 74).ResultsOverall, participants’ knowledge, skills, and eHealth literacy efficacy all improved significantly from pre to post intervention (P < .001 in all cases; effect sizes were >0.8 with statistical power of 1.00 even at the .01 level in all cases). When controlling for baseline differences, no significant main effect of the learning method was found on computer/Web knowledge, skills, or eHealth literacy efficacy. Thus, collaborative learning did not differ from individualistic learning in affecting the learning outcomes. No significant interaction effect of learning method and time of measurement was found. Group composition based on gender, familiarity with peers, or prior computer experience had no significant main or interaction effect on the learning outcomes. Regardless of the specific learning method used, participants had overwhelmingly positive attitudes toward the intervention and reported positive changes in participation in their own health care as a result of the intervention.ConclusionsThe findings provide strong evidence that the eHealth literacy intervention tested in this study, regardless of the specific learning method used, significantly improved knowledge, skills, and eHealth literacy efficacy from pre to post intervention, was positively perceived by participants, and led to positive changes in their own health care. Collaborative learning did not differ from individualistic learning in affecting the learning outcomes, suggesting the previously widely reported advantages of collaborative over individualistic learning may not be easily applied to the older population in informal settings, though several confounding factors might have contributed to this finding (ie, the largely inexperienced computer user composition of the study sample, potential instructor effect, and ceiling effect). Further research is necessary before a more firm conclusion can be drawn. These findings contribute to th...

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Section: Discussionmentioning

confidence: 99%

“…The general procedures of the present study are similar to those of prior e HiLL studies [4-6,24]. In the first session, participants first signed the consent form (approved by the Institutional Review Board of the University of Maryland).…”

Section: Methodsmentioning

confidence: 99%

Effects of an eHealth Literacy Intervention for Older Adults

Xie¹

2011

J Med Internet Res

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190

202

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“…The present study is part of a larger research project, Electronic Health Information for Lifelong Learners (eHiLL), which aims to improve older adults' e-health literacy through designing and testing design and educational interventions [34][35][36][37]. One key component of the eHiLL project is the cultivation of a core group of older adults interested in helping develop learning materials and strategies to help their age peers learn to use computers to access reliable health information.…”

Section: Participatory Designmentioning

confidence: 99%

“…This group of older adults is called the Older Adult Team (OAT). OAT members formerly participated in an eHiLL intervention [34][35][36][37]. These older adults were selected to participate in the OAT because their computer experience exceeded their peers, and because they were willing to commit to the 3-year duration of the eHiLL-OAT component of the project.…”

Section: Participatory Designmentioning

confidence: 99%

Co-designing an e-health tutorial for older adults

Xie

Yeh

Walsh

et al. 2012

Proceedings of the 2012 iConference

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Older adults' ability to access and use electronic health information is generally low, requiring innovative approaches for improvement. An integrated e-tutorial overlays instructions onto Websites. The literature suggests integrated e-tutorials are more effective than paper or video-based tutorials for younger people, but little is known about their effectiveness for older adults. This study explores the applicability of an integrated e-health tutorial for older adults. An integrated e-tutorial, the Online Tutorial Overlay Presenter (OnTOP), added an instructional overlay to the NIHSeniorHealth.gov Website. Overlay features were examined in seven participatory design sessions with seven older adults. Participatory design techniques were used to elicit participants' preferences for tutorial features. Three themes emerged: 1) using contextual cues; 2) tailoring to the learner's literacy level; and 3) enhancing interfaces with multimedia cues. These findings improved the design features of OnTOP. They also generated empirical evidence about the effects of multimedia learning among older adults.

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“…Public libraries have been successful in improving decision making in accessing high-quality health information, reducing computer anxiety, and increasing computer interest and self-efficacy among older adults [122,123], and health care providers could leverage or learn from these community institutions. However, other technologies may require substantial modifications to In these cases, alternative communication channels may be necessary to deliver a desired behavioral or clinical intervention; we want to be careful to construct patient-centered technologies versus technology-centered patients.…”

Section: Education and Training To Facilitate The Use Of Patient-centmentioning

confidence: 99%

The Use of Cancer-Specific Patient-Centered Technologies Among Underserved Populations in the United States: Systematic Review (Preprint)

Tarver¹,

Haggstrom²

2018

Preprint

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IntroductionIn the US, more than 1.6 million new cases of cancer are estimated to be diagnosed each year [1], however, the burden of cancer among the US population is not shared equally.Medically underserved populations (i.e. groups with economic barriers, or cultural and/or linguistic barriers to primary medical care services [2]) such as racial and ethnic minorities and individuals of lower socioeconomic status [3], have a higher cancer burden when compared to their counterparts which can be partially attributed to differences in the access to, and quality of, care they receive [4][5][6]. A wide range of technologies are available to patients, including personal health records [PHRs] [7], Internet-based [eHealth] technologies [8, 9], mobile[mHealth] applications [10], and telemedicine [11]. These technologies have the potential to improve access to care by patients and empower individuals to participate more actively in their care [12,13]. For example, there is evidence that patient-centered technologies (also commonly referred to as consumer health information technologies) provide patient-centered care by increasing patients' quality of health care [14], improving communication with providers [11,[15][16][17], providing tailored education and lifestyle messages [18] [14], and promoting selfmanagement of health care [19]. While these health information technologies have also been proposed as a means to reduce health care disparities [13,[20][21][22], little is known about their use among underserved populations.To date, reviews on the use of patient-centered technologies have largely focused upon the general population. For example, a recent review by Kim and Nahm [23] found several benefits to the use of patient-accessible personal health records, including consumer empowerment, improved patient-provider communication, increased access to data during times 2 of emergency, improved chronic disease management, and increased likelihood of behavior change. Several concerns were also raised regarding the broader dissemination of personal health records, including data privacy and security; data accuracy, health literacy, and the digital divide. With regards to mobile technologies, Krishna and colleagues [24] found significant improvements in medication adherence, smoking quit rates, self-efficacy, and other health outcomes (e.g., asthma symptoms, blood sugar control, stress levels). Limited attention has also been given to the potential of patient-accessible personal health records (PHRs) among specific disease classes [25, 26], however, Price and colleagues [27] found PHR interventions targeting asthma, diabetes, fertility, glaucoma, HIV, hyperlipidemia, and hypertension (but not cancer) to have beneficial effects such as better quality of care, improved access to care, and increased productivity. Racial/ethnic minority populations have been targeted to interventions to facilitate weight loss; overall, Internet-based technologies (eHealth) were only able to effect short term weight loss, while mobile technol...

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Improving older adults' e-health literacy through computer training using NIH online resources

Cited by 92 publications

References 42 publications

Effects of an eHealth Literacy Intervention for Older Adults

Effects of an eHealth Literacy Intervention for Older Adults

Co-designing an e-health tutorial for older adults

The Use of Cancer-Specific Patient-Centered Technologies Among Underserved Populations in the United States: Systematic Review (Preprint)

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