New technologies, new disparities: The intersection of electronic health and digital health literacy

Smith, Benjamin R.; Magnani, Jared W.

doi:10.1016/j.ijcard.2019.05.066

Cited by 326 publications

(233 citation statements)

References 15 publications

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“…This highlights the need to integrate eHealth literacy, with its multidimensional characteristics, in HIT conceptual frameworks. This is especially relevant as the evidence is mounting on eHealth literacy’s role in extending the digital divide to health care [ 51 , 52 ] and, just as importantly, in facilitating the adoption of various eHealth apps. For example, our finding of the significance of eHealth literacy to telehealth use intention mirrors other findings where eHealth literacy has been found to have a significant association with the use of or the intention to use other consumer eHealth platforms such as patient portals [ 13 , 14 ] and mHealth [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Understanding the Intention to Use Telehealth Services in Underserved Hispanic Border Communities: Cross-Sectional Study

Ghaddar¹,

Vatcheva²,

Alvarado³

et al. 2020

J Med Internet Res

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Background Despite the United States having one of the leading health care systems in the world, underserved minority communities face significant access challenges. These communities can benefit from telehealth innovations that promise to improve health care access and, consequently, health outcomes. However, little is known about the attitudes toward telehealth in these communities, an essential first step toward effective adoption and use. Objective The purpose of this study is to assess the factors that shape behavioral intention to use telehealth services in underserved Hispanic communities along the Texas-Mexico border and examine the role of electronic health (eHealth) literacy in telehealth use intention. Methods We used cross-sectional design to collect data at a community health event along the Texas-Mexico border. The area is characterized by high poverty rates, low educational attainment, and health care access challenges. Trained bilingual students conducted 322 in-person interviews over a 1-week period. The survey instrument assessed sociodemographic information and telehealth-related variables. Attitudes toward telehealth were measured by asking participants to indicate their level of agreement with 9 statements reflecting different aspects of telehealth use. For eHealth literacy, we used the eHealth Literacy Scale (eHEALS), an 8-item scale designed to measure consumer confidence in finding, evaluating, and acting upon eHealth information. To assess the intention to use telehealth, we asked participants about the likelihood that they would use telehealth services if offered by a health care provider. We analyzed data using univariate, multivariate, and mediation statistical models. Results Participants were primarily Hispanic (310/319, 97.2%) and female (261/322, 81.1%), with an average age of 43 years. Almost three-quarters (219/298) reported annual household incomes below $20,000. Health-wise, 42.2% (136/322) self-rated their health as fair or poor, and 79.7% (255/320) were uninsured. The overwhelming majority (289/319, 90.6%) had never heard of telehealth. Once we defined the term, participants exhibited positive attitudes toward telehealth, and 78.9% (254/322) reported being somewhat likely or very likely to use telehealth services if offered by a health care provider. Based on multivariate proportional odds regression analysis, a 1-point increase in telehealth attitudes reduced the odds of lower versus higher response in the intention to use telehealth services by 23% (OR 0.77, 95% CI 0.73-0.81). Mediation analysis revealed that telehealth attitudes fully mediated the association between eHealth literacy and intention to use telehealth services. For a 1-point increase in eHEALS, the odds of lower telehealth use decreased by a factor of 0.95 (5%; OR 0.95, 95% CI 0.93-0.98; P<.001) via the increase in the score of telehealth attitudes. Conclusions Telehealth promises to address many of the access challenges facing ethnic and racial minorities, rural communities, and low-income populations. Findings underscore the importance of raising awareness of telehealth and promoting eHealth literacy as a key step in fostering positive attitudes toward telehealth and furthering interest in its use.

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Section: Discussionmentioning

confidence: 99%

Understanding the Intention to Use Telehealth Services in Underserved Hispanic Border Communities: Cross-Sectional Study

Ghaddar¹,

Vatcheva²,

Alvarado³

et al. 2020

J Med Internet Res

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“…As has been shown in previous research, poor eHealth literacy and acceptance could lead to disparities [ 53 ]. In particular, factors such as age and disabilities have been negatively associated with the digital divide [ 54 ].…”

Section: Discussionmentioning

confidence: 86%

How People with Parkinson's Disease and Health Care Professionals Wish to Partner in Care Using eHealth: Co-Design Study

Wannheden¹,

Revenäs²

2020

J Med Internet Res

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Background Worldwide, the number of people with Parkinson’s disease (PD) is predicted to double between the years 2005 and 2030. Chronic care management requires active collaboration and knowledge exchange between patients and health care professionals (HCPs) for best possible health outcomes, which we describe as co-care. eHealth services have the potential to support the realization of co-care between people with PD (PwP) and HCPs. Objective This study aimed to explore how co-care could be operationalized in PD care, supported by eHealth. More specifically, this study explores PwP's and HCPs' expectations and desired eHealth functionalities to achieve co-care. Methods Principles of participatory design were used to enable the identification of co-care needs and design ideas, in a series of 4 half-day co-design workshops. The sample included 7 (4 women) PwP and 9 (4 women) HCPs, including 4 neurologists, 3 nurses, and 2 physiotherapists. The co-design process resulted in a functional prototype that was evaluated by the co-design participants in the last workshop. Data were collected through note cards produced by the participants during the first 3 workshops and focus group discussions during the 3rd and 4th workshops. The data were analyzed using qualitative thematic analysis. After the workshop series, the prototype was demonstrated at a Mini Fair for ongoing PD research and evaluated using a self-developed questionnaire with 37 respondents: 31 PwP (14 women) and 6 informal caregivers (3 women). Descriptive statistics are reported. Results The qualitative analysis of data resulted in 2 main themes. The first theme, core eHealth functionalities and their expected values, describes 6 desired eHealth functionalities for supporting PD co-care between PwP and HCPs: (1) self-tracking, (2) previsit forms, (3) graphical visualization, (4) clinical decision support, (5) self-care recommendations, and (6) asynchronous communication. The second theme, individual and organizational constraints, describes constraints that need to be addressed to succeed with an eHealth service for co-care. Individual constraints include eHealth literacy and acceptance; organizational constraints include teamwork and administrative workload. The majority of the questionnaire respondents (31/37, 84%) perceived that they would benefit from an eHealth service similar to the demonstrated prototype. All prototype functionalities were rated as very important or important by the majority of respondents (ranging from 86% to 97% per functionality). Conclusions This study adds to our knowledge on how PD co-care could be operationalized. Co-care implies a shift from episodic routine-driven care to more flexible care management that is driven by the mutual needs of patients and HCPs and supported by active information exchange between them, as well as automated information processing to generate patient-specific advice. More research is needed to further explore the concept of co-care in chronic care management and what it means for self-care and health care. International Registered Report Identifier (IRRID) RR2-10.2196/11278

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“…In other words, though technology-based solutions exist, due to lack of tailored design and consideration of older users [74][75][76], these solutions may have limited utility and functionality for older females. All of these barriers, in turn, can contribute to the most vulnerable of the population left with little to no access to services [2,46,50,62], especially factoring in the digital divide experienced by people who face both health disparities and economic hardships which may further exacerbates these individuals' unmet healthcare needs [77][78][79]. These combined insights indicate that, while women face substantial health issues amid COVID-19, most of these issues may remain unsolved for a prolonged period of time due to lack of available health solutions [46,50,62].…”

Section: Study Protocol Registration: Prospero Crd42020194003mentioning

confidence: 99%

Evidence-based health solutions for challenges women face during pandemics like COVID-19: A systematic review protocol

Wagers

Lopez

et al. 2020

Preprint

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Background One of the most vulnerable populations to COVID-19 is women. Multiple factors associated with violence against women (i.e. sexual assault, domestic violence, homelessness) create an increased vulnerability for women during the COVID pandemic. Women also constitute the majority of older nursing home residents and healthcare workers (e.g., nurses), who have the most pronounced exposure to COVID-19. These factors combined with resource restraints like rationing and lack of access to healthcare can further exacerbate women’s physical and psychological health issues. While literature has well-documented challenges that women face during COVID-19, there is a lack of evidence-based solutions that have the potential to mitigate these difficulties. Therefore, to address this issue, we aim to conduct a systematic review of the literature to: (1) identify interventions designed for women in the context of pandemics, (2) describe the characteristics and effects of these interventions concerning the distinctive traits of women and pandemics, and (3) present evidence-based health solutions for women to mitigate challenges they face amid and beyond COVID-19. Methods A systematic review of literature will be conducted on databases including PubMed, PsycINFO on the EBSCO platform, CINAHL on the EBSCO platform, and Scopus, based on a search strategy developed in consultation with an experienced medical librarian. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be adopted as the reporting framework, and data extracted (e.g., intervention details) will be evaluated by a multidisciplinary research team. Results NA for now—This is a protocol study. Conclusions Findings of this study will fill an important void in the literature. Considering that, in times of pandemic, women are especially subject to grim health disparities, like pronounced exposure to COVID-19, reproductive health issues, elevated domestic violence, increased mental health challenges, and lack of access to healthcare services, the need for evidence-based health solutions that could address these unique challenges is of paramount importance. A comprehensive understanding of the characteristics and effects of health solutions available to women in the context of pandemics can also help researchers identify areas of improvement regarding intervention design and development. This may further safeguard women’s health and wellbeing amid pandemics like COVID-19 and beyond. Study Protocol Registration: PROSPERO CRD42020194003

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New technologies, new disparities: The intersection of electronic health and digital health literacy

Cited by 326 publications

References 15 publications

Understanding the Intention to Use Telehealth Services in Underserved Hispanic Border Communities: Cross-Sectional Study

Understanding the Intention to Use Telehealth Services in Underserved Hispanic Border Communities: Cross-Sectional Study

How People with Parkinson's Disease and Health Care Professionals Wish to Partner in Care Using eHealth: Co-Design Study

Evidence-based health solutions for challenges women face during pandemics like COVID-19: A systematic review protocol

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