BackgroundThe eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully.ObjectiveThe objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months.MethodsOnline questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS.ResultsWe collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008).ConclusionsTo our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and random samples drawn from an increasingly important cohort. The results give increased confidence to researchers using the scale in a range of eHealth assessment applications from primary care to health promotions.

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BackgroundMost evidence (not all) points in the direction that individuals with a higher level of health literacy will less frequently utilize the health care system than individuals with lower levels of health literacy. The underlying reasons of this effect are largely unclear, though people’s ability to seek health information independently at the time of wide availability of such information on the Internet has been cited in this context.ObjectiveWe propose and test two potential mediators of the negative effect of eHealth literacy on health care utilization: (1) health information seeking and (2) gain in empowerment by information seeking.MethodsData were collected in New Zealand, the United Kingdom, and the United States using a Web-based survey administered by a company specialized on providing online panels. Combined, the three samples resulted in a total of 996 baby boomers born between 1946 and 1965 who had used the Internet to search for and share health information in the previous 6 months. Measured variables include eHealth literacy, Internet health information seeking, the self-perceived gain in empowerment by that information, and the number of consultations with one’s general practitioner (GP). Path analysis was employed for data analysis.ResultsWe found a bundle of indirect effect paths showing a positive relationship between health literacy and health care utilization: via health information seeking (Path 1), via gain in empowerment (Path 2), and via both (Path 3). In addition to the emergence of these indirect effects, the direct effect of health literacy on health care utilization disappeared.ConclusionsThe indirect paths from health literacy via information seeking and empowerment to GP consultations can be interpreted as a dynamic process and an expression of the ability to find, process, and understand relevant information when that is necessary.

Purpose – The purpose of this paper is to investigate the experiences of older consumers with a range of product packaging. Design/methodology/approach – The study uses qualitative diary research (QDR). Ten seniors recorded all their experiences with packaging over a two-week period. Using a frame narrative that views ageing as multidimensional, diary entries uncover rich data that goes beyond physical age-related issues. Findings – In addition to physical problems with packaging, older adults experience psychological frustration and feelings of alienation. Social implications of dependence on others are also discovered, despite many being purchasers of up-market luxury products. Research limitations/implications – The study is exploratory and due to its qualitative methodology findings cannot be generalised to the wider population. Nevertheless it provides a starting point for future research into packaging and senior consumers. Practical implications – The study has implications for all managers who participate in planning and designing brand packaging and calls for them to work more closely with ergonomics and design professionals in order to better plan for the needs of a large and growing sector of the population. Social implications – Findings suggest that the basic need to feed oneself is hampered by some packaging, which of course is detrimental to the quality of life of older adults. Originality/value – Few studies consider packaging and older consumers and this is particularly true in the marketing literature. This is the first study to use QDR in this context, and as such has several advantages over recall studies. The study also makes a contribution to knowledge pertaining to vulnerable consumers.

Purpose The purpose of this paper is to examine a form of anti-consumption termed moral avoidance. Design/methodology/approach The study builds and tests a model of moral avoidance, using a sample (n=457) of adults aged 50-94 years. Findings Two distinct forms of this type of anti-consumption emerged, one based on exploitation of eco-systems and one on exploitation of humans. Ecology concerns and perceived consumer effectiveness are significant antecedents to both forms, while ethical ideology also impacts anti-consumption for social reasons. Greater numbers practice this form of anti-consumption for social reasons than for ecology reasons. Practical implications The study uncovers new underlying reasons why people practice moral avoidance and in so doing guides managers in their targeting and decision making. Originality/value The study is the first to demonstrate that this form of anti-consumption has two different perspectives: planet and people. Moreover, older adults are important ethical consumers, but no previous study has explored them from an anti-consumption perspective.

This article introduces the trajectory touchpoint technique (TTT), a service design methodology that harnesses customer experiences for enriched understanding of value throughout multilevel service components to ultimately increase innovativeness. We detail the design and development of the TTT using design science research, a goal-oriented methodology that produces robust and practical solutions to organizational problems. We demonstrate the TTT’s practical utility through collaborations with different organizations (n = 9) and diverse service users (n = 240). We show how the TTT is an easy to use methodology that enhances understanding of value creation and illustrate its benefits with concrete examples of innovations to service encounters, the service system, and the value constellation. We reveal how a service design methodology can be the bridge between the theoretical standpoint of S-D logic’s perspective on value cocreation and the practical tools and techniques required to operationalize it.

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This paper presents the results of a cross‐national study into the ecological worldview of senior consumers using the New Ecological Paradigm (NEP) scale. It was designed to examine the extent to which senior respondents in the UK, Germany, Japan and Hungary are endorsing the NEP scale and which factors determine NEP in the four countries under study. Our study is the first of its kind to measure the ecological worldview of older consumers across different nations. Examinations of the overall frequency and mean distributions of the NEP scale showed that the majority of seniors in each country support the NEP statements, but there is no general support for pro‐NEP orientation. The relationship between values [using list of values (LOV) scale] and environmental attitudes was tested through a series of regression analyses calculated separately for each country. According to the results, a very weak relationship between some of the LOV values and the NEP scale was found in all the samples. Our study contributes to both cross‐cultural environmental attitude research and to consumer studies in general.