Future Implications of eHealth Interventions for Chronic Pain Management in Underserved Populations

DeMonte, C.; Demonte, William; Thorn, Beverly E.

doi:10.2217/pmt.15.9

Cited by 24 publications

(16 citation statements)

References 67 publications

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“…The generally higher-than-average reading level of web-based health information [ 56 , 57 ] may also disadvantage people with limited literacy. In addition, access to digital services to connect with health professionals generally requires some ability to read and write [ 58 ]. Besides, studies continue to find that searching for web-based health information, interpreting such information, and making decisions based on it is challenging for people with low literacy [ 36 , 59 - 61 ].…”

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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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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“…A survey conducted by the Pew Research Center also found that 83% of Latinos surveyed reported obtaining information about health or health care from media sources (including the Internet; Livingston et al, 2008). However, for intervention development, attention needs to be paid to the health literacy and Internet literacy of participants, as well as the ease of use of the technology (Demonte, Demonte, & Thorn, 2015). Efforts should be made to include participant input in the development of interventions, including provider feedback.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of an online health intervention for Latinas with chronic pain.

Pagán-Ortiz

Cortés

2021

Rehabilitation Psychology

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Objective: Chronic pain is a common health problem in the United States, and it is associated with numerous physical and mental health issues. Disparities in pain treatment are high for particular populations, including Latinos, who comprise a significant percent of the U.S. population. The purpose of this study was to develop and evaluate an online health education intervention for Spanish-speaking Latinas with chronic pain. The intervention was developed based on a biopsychosocial approach to treatment and targeted multiple domains including exercise, psychological wellbeing, regaining function, emotional wellbeing, sleep hygiene, and stress management. Method: Through a mixed-method, single-arm design, this pilot study examined patients’ and providers’ acceptability of and satisfaction with the intervention, as well as the impact of the intervention on patients’ knowledge, chronic pain self-efficacy, pain severity, and pain interference (measured pre and post intervention). Results: Both chronic pain patients (n = 40) and provider participants (n = 10) reported high rates of participation, and high ratings for website features and website content. Patient participants also experienced a significant increase in knowledge regarding pain management and treatment options, and in chronic pain self-efficacy, as well as a significant decrease in pain interference. Although means for pain severity were lower at the posttest session, this change was not significant. Conclusions: Overall, results indicate that an online educational intervention that targets Spanish-speaking Latinas with chronic pain is feasible, potentially impactful, and that there is a need for such interventions. Recommendations include additional content and interactive features that could improve satisfaction, engagement, and impact.

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“…The individuals in this study were potentially engaging from a sense of duty and felt compelled to offer mitigation when compliance wavered. There is suggestion that compelling pain management programs may only arise with a population that perceives the need for individualized care, particularly if that population feels disenfranchised [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

Patients Using an Online Forum for Reporting Progress When Engaging With a Six-Week Exercise Program for Knee Conditioning: Feasibility Study

Bright

Hambly

2018

JMIR Rehabil Assist Technol

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BackgroundThe use of electronic health (eHealth) and Web-based resources for patients with knee pain is expanding. Padlet is an online noticeboard that can facilitate patient interaction by posting virtual “sticky notes.”ObjectiveThe primary aim of this study was to determine feasibility of patients in a 6-week knee exercise program using Padlet as an online forum for self-reporting on outcome progression.MethodsUndergraduate manual therapy students were recruited as part of a 6-week study into knee conditioning. Participants were encouraged to post maximum effort readings from quadriceps and gluteal home exercises captured from standard bathroom scales on a bespoke Padlet. Experience and progression reporting were encouraged. Posted data were analyzed for association between engagement, entry frequency, and participant characteristics. Individual data facilitated single-subject, multiple-baseline analysis using statistical process control. Experiential narrative was analyzed thematically.ResultsNineteen participants were recruited (47%, 9/19 female); ages ranged from 19 to 53 years. Twelve individuals (63%) opted to engage with the forum (range 4-40 entries), with five (42%) reporting across all 6 weeks. Gender did not influence reporting (odds ratio [OR] 0.76, 95% CI 0.06-6.93). No significant difference manifested between body mass index and engagement P=.46); age and entry frequency did not correlate (R2=.054, 95% CI –0.42 to 0.51, P=.83). Statistically significant conditioning profiles arose in single participants. Themes of pain, mitigation, and response were inducted from the experiences posted.ConclusionsPatients will engage with an online forum for reporting progress when undertaking exercise programs. In contrast to related literature, no significant association was found with reporting and gender, age, or body mass index. Individual posted data allowed multiple-baseline analysis and experiential induction from participants. Conditioning responses were evident on visual inspection. The importance of individualized visual data to patients and the role of forums in monitoring patients’ progress in symptomatic knee pain populations need further consideration.

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Future Implications of eHealth Interventions for Chronic Pain Management in Underserved Populations

Cited by 24 publications

References 67 publications

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

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

Feasibility of an online health intervention for Latinas with chronic pain.

Patients Using an Online Forum for Reporting Progress When Engaging With a Six-Week Exercise Program for Knee Conditioning: Feasibility Study

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