Literacy skills, language use, and online health information seeking among Hispanic adults in the United States

Millar, Roberto J.; Sahoo, Shalini; Yamashita, Takashi; Cummins, Phyllis

doi:10.1016/j.pec.2020.02.030

Cited by 29 publications

(18 citation statements)

References 30 publications

(36 reference statements)

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“…In this paper, our focus was less on the "digital divide," which conveys disparities in access to computers and the internet based on the race/ethnicity, education, and income of at-risk populations [16][17][18]. We considered the following question: "Once Spanish-speaking consumers have physical access to technology, to what extent is the content of institutions' websites useful and culturally appropriate in meeting their needs?"…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Communication From Seven Health Care Institutions in North Texas for English- and Spanish-Speaking Cancer Patients: Mixed Method Website Study

Higashi¹,

Sweetenham²,

Israel³

et al. 2021

JMIR Cancer

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Background The COVID-19 pandemic has created an urgent need to rapidly disseminate health information, especially to those with cancer, because they face higher morbidity and mortality rates. At the same time, the pandemic’s disproportionate impact on Latinx populations underscores the need for information to reach Spanish speakers. However, the equity of COVID-19 information communicated through institutions’ online media to Spanish-speaking cancer patients is unknown. Objective We conducted a multimodal, mixed method document review study to evaluate the equity of online information about COVID-19 and cancer available to English- and Spanish-speaking populations from seven health care institutions in North Texas, where one in five adults is Spanish-speaking. Our focus was less on the “digital divide,” which conveys disparities in access to computers and the internet based on the race/ethnicity, education, and income of at-risk populations; rather, our study asks the following question: to what extent is online content useful and culturally appropriate in meeting Spanish speakers’ information needs? Methods We reviewed 50 websites (33 English and 17 Spanish) over a period of 1 week in the middle of May 2020. We sampled seven institutions’ main oncology and COVID web pages, and both internal (institutional) and external (noninstitutional) linked content. We conducted several analyses for each sampled page, including (1) thematic content analysis, (2) literacy level analysis using Readability Studio software, (3) coding using the Patient Education and Materials Assessment Tool (PEMAT), and (4) descriptive analysis of video and diversity content. Results The themes most frequently addressed on English and Spanish websites differed. While “resources/FAQs” were frequently cited themes on both websites, English websites more frequently addressed “news/updates” and “cancer+COVID,” and Spanish websites addressed “protection” and “COVID data.” Spanish websites had on average a lower literacy level (11th grade) than English websites (13th grade), although still far above the recommended guideline of 6th to 8th grade. The PEMAT’s overall average accessibility score was the same for English (n=33 pages) and Spanish pages (n=17 pages) at 82%. Among the Dallas-Fort Worth organizations, the average accessibility of Spanish pages (n=7) was slightly lower than that of English pages (n=19) (77% vs 81%), due mostly to the discrepancy in English-only videos and visual aids. Of the 50 websites, 12 (24%) had embedded videos; however, 100% of videos were in English, including one on a Spanish website. Conclusions We identified an uneven response among the seven health care institutions for providing equitable information to Spanish-speaking Dallas-Fort Worth residents concerned about COVID and cancer. Spanish speakers lack equal access in both diversity of content about COVID-19 and access to other websites, leaving an already vulnerable cancer patient population at greater risk. We recommend several specific actions to enhance content and navigability for Spanish speakers.

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Section: Introductionmentioning

confidence: 99%

COVID-19 Communication From Seven Health Care Institutions in North Texas for English- and Spanish-Speaking Cancer Patients: Mixed Method Website Study

Higashi¹,

Sweetenham²,

Israel³

et al. 2021

JMIR Cancer

View full text Add to dashboard Cite

show abstract

“…Access issues, including a lack of broadband internet, and limited English proficiency are linked to lower engagement and satisfaction with telehealth. 44-48 Telemedicine has increased during the COVID-19 pandemic. 49-51 Telemedicine has been shown to improve diabetes outcomes and reduce health disparities among minority populations.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Self-Care Behaviors and Barriers to Clinical Care During COVID-19 Pandemic for Marshallese Adults

Purvis

Moore

Ayers

et al. 2022

The Science of Diabetes Self-Management and Care

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Purpose: The purpose of the study was to explore experiences of Marshallese adults related to diabetes self-care behaviors during the COVID-19 pandemic. Methods: A qualitative descriptive design was utilized to understand participants’ diabetes self-care behaviors during the pandemic. Nine focus groups with 53 participants were held via videoconference and conducted in English, Marshallese, or a mixture of both languages. A priori codes based on diabetes self-care behaviors provided a framework for analyzing and summarizing participant experiences. Results: Both increases and decreases in healthy eating and exercise were described, with improvements in health behaviors attributed to health education messaging via social media. Participants reported increased stress and difficulty monitoring and managing glucose. Difficulty obtaining medication and difficulty seeing their health care provider regularly was reported and attributed to health care provider availability and lack of insurance due to job loss. Conclusions: The study provides significant insight into the reach of health education campaigns via social media and provides important information about the reasons for delays in care, which extend beyond fear of contracting COVID-19 to structural issues.

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“…We limited our sample to English-speaking patients and were not able to capture eHealth and digital literacy disparities that are known to exist in the Hispanic and Latino population. 27 These data are self-reported and do not explore why some participants are not using certain technologies. The survey that participants completed was created by the research team to provide data on questions and concerns that were most pressing to the cancer center and deviated from using known scales of eHealth literacy that, although validated, [22][23][24][25] were not as relevant to our needs.…”

Section: Discussionmentioning

confidence: 99%

Digital Literacy at an Urban Cancer Center: Implications for Technology Use and Vulnerable Patients

Leader

Capparella

Waldman

et al. 2021

JCO Clinical Cancer Informatics

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PURPOSE eHealth literacy, or the ability to seek, find, understand, and appraise health information from electronic sources, has become increasingly relevant in the era of COVID-19, when so many aspects of patient care became dependent on technology. We aimed to understand eHealth literacy among a diverse sample of patients with cancer and discuss ways for health systems and cancer centers to ensure that all patients have access to high-quality care. METHODS A cross-sectional survey of patients with cancer and caregivers was conducted at an NCI-designated cancer center to assess access to the Internet, smartphone ownership, use of mobile apps, willingness to engage remotely with the health care team, and use of the patient portal. Descriptive statistics and bivariate analyses were used to assess frequencies and significant differences between variables. RESULTS Of 363 participants, 55% (n = 201) were female, 71% (n = 241) identified as non-Hispanic White, and 29% (n = 85) reported that their highest level of education was a high school diploma. Most (90%, n = 323) reported having access to the Internet and most (82%, n = 283) reported owning a smartphone. Younger patients or those with a college degree were significantly more likely to own a smartphone, access health information online, know how to download an app on their own, have an interest in communicating with their health care team remotely, or have an account on the electronic patient portal. CONCLUSION As cancer centers increasingly engage patients through electronic and mobile applications, patients with low or limited digital literacy may be excluded, exacerbating current cancer health disparities. Patient-, provider- and system-level technology barriers must be understood and mitigated.

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Literacy skills, language use, and online health information seeking among Hispanic adults in the United States

Cited by 29 publications

References 30 publications

COVID-19 Communication From Seven Health Care Institutions in North Texas for English- and Spanish-Speaking Cancer Patients: Mixed Method Website Study

COVID-19 Communication From Seven Health Care Institutions in North Texas for English- and Spanish-Speaking Cancer Patients: Mixed Method Website Study

Diabetes Self-Care Behaviors and Barriers to Clinical Care During COVID-19 Pandemic for Marshallese Adults

Digital Literacy at an Urban Cancer Center: Implications for Technology Use and Vulnerable Patients

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