ehealth literacy and health literacy among immigrants and their descendants compared with women of Danish origin: a cross-sectional study using a multidimensional approach among pregnant women

Villadsen, Sarah Fredsted; Hadi, Hajer; Ismail, Israa; Osborne, Richard H.; Ekstrøm, Claus Thorn; Kayser, Lars

doi:10.1136/bmjopen-2020-037076

Cited by 33 publications

(18 citation statements)

References 28 publications

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“…In addition, socioeconomic status and educational attainment also influenced the access to, and uptake of e-health services (Hardiker and Grant 2011). The results were consistent with those of previous studies worldwide (Hoogland et al 2020;Shiferaw et al 2020;Villadsen et al 2020). These identified non-modifiable factors can be used to determine which individuals are at risk of poor e-health literacy, and to indentify the vulnerable population that medical staff need to target (Cheng et al 2020).…”

Section: Discussionsupporting

confidence: 89%

“…At the social/community level, language barriers and cultural barriers influenced the e-health literacy of Chinese immigrants. Our findings were consistent with the lower e-health literacy levels found among adult immigrants in Denmark (Villadsen et al 2020) and America (Chesser et al 2014). Language barriers and cultural barriers aggravate the difficulty of the immigrants in accessing and using e-health resources, especially the older adults, because they have to face multiple challenges of language, culture, and technology.…”

Section: Discussionsupporting

confidence: 88%

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In the digital age: a systematic literature review of the e-health literacy and influencing factors among Chinese older adults

Shi

Zhang

et al. 2021

J Public Health (Berl.)

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Aim This study aimed to explore the current status of e-health literacy among Chinese older adults, and to summarize and analyze the related influencing factors. Subject and methods Following the PRISMA Checklist, we searched MEDLINE, CINAHL Complete (EBSCO), PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, and China Science and Technology Journal Database to identify the relevant literature published between January 2000 and December 2020. The Mixed Methods Assessment Tool (MMAT) was used to appraise the quality of the studies. Results Five articles were included for the systematic review. The results showed that the e-health literacy of Chinese older adults was low. Based on the social-ecological model, the influencing factors at the individual level included age, gender, educational attainment, socioeconomic status, physical and psychological conditions, frequency of internet use, and credibility perception of online health resources; at the interpersonal level, the influencing factors included marital status, being the family carer and being taught how to use internet to find health resources; at the social/community level, influencing factors included language barriers and cultural barriers.Conclusion Current e-health literacy among Chinese older adults is low, which is affected by a number of factors. Medical staff should provide detailed health information with guaranteed accuracy and reliability for elderly people. It is necessary to develop intervention programs tailored to varied educational needs of the elderly with different backgrounds (i.e., age, gender, educational attainment, and socioeconomic status) need to be developed in the near future. Family members are encouraged to teach older adults how to use e-health resource in appropriate ways.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 88%

In the digital age: a systematic literature review of the e-health literacy and influencing factors among Chinese older adults

Shi

Zhang

et al. 2021

J Public Health (Berl.)

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“…Item response theory analysis confirmed that there were no disordered thresholds, and differential item functioning (DIF) testing established evidence of measurement invariance for age and sex [ 21 ]. The eHLQ has since been used to investigate the eHealth literacy of nursing students and pregnant migrant women in Denmark [ 22 , 23 ], as well as to examine the association of eHealth literacy and digital health service use in both Denmark and Australia [ 24 , 25 ]. The tool has also been used in Australia to understand the eHealth literacy needs of community members, leading to the generation of numerous concrete solutions to address the identified needs [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Validity Evidence Based on Relations to Other Variables of the eHealth Literacy Questionnaire (eHLQ): Bayesian Approach to Test for Known-Groups Validity

Cheng¹,

Elsworth²,

Osborne³

2021

J Med Internet Res

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Background As health resources and services are increasingly delivered through digital platforms, eHealth literacy is becoming a set of essential capabilities to improve consumer health in the digital era. To understand eHealth literacy needs, a meaningful measure is required. Strong initial evidence for the reliability and construct validity of inferences drawn from the eHealth Literacy Questionnaire (eHLQ) was obtained during its development in Denmark, but validity testing for varying purposes is an ongoing and cumulative process. Objective This study aims to examine validity evidence based on relations to other variables—using data collected with the known-groups approach—to further explore if the eHLQ is a robust tool to understand eHealth literacy needs in different contexts. A priori hypotheses are set for the expected score differences among age, sex, education, and information and communication technology (ICT) use for each of the 7 eHealth literacy constructs represented by the 7 eHLQ scales. Methods A Bayesian mediated multiple indicators multiple causes model approach was used to simultaneously identify group differences and test measurement invariance through differential item functioning across the groups, with ICT use as a mediator. A sample size of 500 participants was estimated. Data were collected at 3 diverse health sites in Australia. Results Responses from 525 participants were included for analysis. Being older was significantly related to lower scores in 4 eHLQ scales, with 3. Ability to actively engage with digital services having the strongest effect (total effect –0.37; P<.001), followed by 1. Using technology to process health information (total effect –0.32; P<.001), 5. Motivated to engage with digital services (total effect –0.21; P=.01), and 7. Digital services that suit individual needs (total effect –0.21; P=.02). However, the effects were only partially mediated by ICT use. Higher education was associated with higher scores in 1. Using technology to process health information (total effect 0.22; P=.01) and 3. Ability to actively engage with digital services (total effect 0.25; P<.001), with the effects mostly mediated by ICT use. Higher ICT use was related to higher scores in all scales except 2. Understanding health concepts and language and 4. Feel safe and in control. Either no or ignorable cases of differential item functioning were found across the 4 groups. Conclusions By using a Bayesian mediated multiple indicators multiple causes model, this study provides supportive validity evidence for the eHLQ based on relations to other variables as well as established evidence regarding internal structure related to measurement invariance across the groups for the 7 scales in the Australian community health context. This study also demonstrates that the eHLQ can be used to gain valuable insights into people’s eHealth literacy needs to help optimize access and use of digital health and promote health equity.

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“…Adequate understanding of health information provided face-to-face by a health worker depends on several factors, such as health literacy, language proficiency, and the cultural competence and communication skills of both the patient and healthcare worker [ 9 , 10 , 11 , 12 ]. In addition, migrant background, educational level, and occupational and economic status can also influence the understanding of the health information of a patient [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Newly Arrived Migrant Women’s Experience of Maternity Health Information: A Face-to-Face Questionnaire Study in Norway

Bains

Sundby

Lindskog

et al. 2021

IJERPH

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Limited understanding of health information may contribute to an increased risk of adverse maternal outcomes among migrant women. We explored factors associated with migrant women’s understanding of the information provided by maternity staff, and determined which maternal health topics the women had received insufficient coverage of. We included 401 newly migrated women (≤5 years) who gave birth in Oslo, excluding migrants born in high-income countries. Using a modified version of the Migrant Friendly Maternity Care Questionnaire, we face-to-face interviewed the women postnatally. The risk of poor understanding of the information provided by maternity staff was assessed in logistic regression models, presented as adjusted odds ratios (aORs), with 95% confidence intervals (CI). The majority of the 401 women were born in European and Central Asian regions, followed by South Asia and North Africa/the Middle East. One-third (33.4%) reported a poor understanding of the information given to them. Low Norwegian language proficiency, refugee status, no completed education, unemployment, and reported interpreter need were associated with poor understanding. Refugee status (aOR 2.23, 95% CI 1.01–4.91), as well as a reported interpreter need, were independently associated with poor understanding. Women who needed but did not get a professional interpreter were at the highest risk (aOR 2.83, 95% CI 1.59–5.02). Family planning, infant formula feeding, and postpartum mood changes were reported as the most frequent insufficiently covered topics. To achieve optimal understanding, increased awareness of the needs of a growing, linguistically diverse population, and the benefits of interpretation services in health service policies and among healthcare workers, are needed.

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ehealth literacy and health literacy among immigrants and their descendants compared with women of Danish origin: a cross-sectional study using a multidimensional approach among pregnant women

Cited by 33 publications

References 28 publications

In the digital age: a systematic literature review of the e-health literacy and influencing factors among Chinese older adults

In the digital age: a systematic literature review of the e-health literacy and influencing factors among Chinese older adults

Validity Evidence Based on Relations to Other Variables of the eHealth Literacy Questionnaire (eHLQ): Bayesian Approach to Test for Known-Groups Validity

Newly Arrived Migrant Women’s Experience of Maternity Health Information: A Face-to-Face Questionnaire Study in Norway

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