The Associations Among Health-Promoting Lifestyle, eHealth Literacy, and Cognitive Health in Older Chinese Adults: A Cross-Sectional Study.
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ABSTRACT:
SUBMITTER: Li SJ
PROVIDER: S-EPMC7178131 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
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The Associations Among Health-Promoting Lifestyle, eHealth Literacy, and Cognitive Health in Older Chinese Adults: A Cross-Sectional Study.
Li Shao-Jie SJ Yin Yong-Tian YT Cui Guang-Hui GH Xu Hui-Lan HL
International journal of environmental research and public health 20200327 7
<i>Background:</i> Healthy lifestyles and health literacy are strongly associated with cognitive health in older adults, however, it is unclear whether this relationship can be generalized to health-promoting lifestyles and eHealth literacy. To date, no research has examined the interactive effect of health-promoting lifestyles and eHealth literacy on cognitive health. <i>Objective:</i> To examine the associations among health-promoting lifestyles, eHealth literacy, and cognitive health in older ...[more]
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Project description:ObjectiveDigital divide in health-related technology use is a prominent issue for older adults. Improving eHealth literacy may be an important solution to this problem. This study aimed to explore the associations between health literacy, digital skills, and eHealth literacy among older Chinese adults.MethodsA total of 2,144 older adults (mean age, 72.01 ± 6.96 years) from Jinan City, China participated in this study. The eHealth Literacy Scale was used to measure eHealth literacy in older adults. A linear regression model was used to analyze the associations among health literacy, digital skills, and eHealth literacy in older Chinese adults.ResultsThe mean eHealth literacy score of the older adults was 17.56 ± 9.61. After adjusting for sociodemographic characteristics and experience of Internet usage, the results of the linear regression showed that health literacy (B = 0.258, 95% confidence interval (CI) = 0.215-0.302, P< 0.001) and digital skills (B = 0.654, 95% CI = 0.587-0.720, P < 0.001) were positively associated with eHealth literacy. Sensitivity analyses revealed that this association remained robust.ConclusionsThe level of eHealth literacy in older Chinese adults is low. Health literacy and digital skills are associated with eHealth literacy in older adults. In the future, eHealth literacy intervention research should be considered from the perspective of health literacy and digital skills.
| S-EPMC10225956 | biostudies-literature
Project description:BackgroundDuring the COVID-19 pandemic, the internet has significantly spread information, providing people with knowledge and advice about health protection regarding COVID-19. While a previous study demonstrated that health and eHealth literacy are related to COVID-19 prevention behaviors, few studies have focused on the relationship between health literacy, eHealth literacy, and COVID-19-related health behaviors. The latter includes not only preventative behaviors but also conventional health behaviors.ObjectiveThe objective of this study was to develop and verify a COVID-19-related health behavior questionnaire, explore its status and structure, and examine the associations between these behaviors and participants' health literacy and eHealth literacy.MethodsA snowball sampling method was adopted to recruit participants to complete anonymous cross-sectional questionnaire surveys online that assessed sociodemographic information, self-reported coronavirus knowledge, health literacy, eHealth literacy, and COVID-19-related health behaviors.ResultsOf 1873 college students who were recruited, 781 (41.7%) had adequate health literacy; the mean eHealth literacy score was 30.16 (SD 6.31). The COVID-19-related health behavior questionnaire presented a two-factor structure-COVID-19-specific precautionary behaviors and conventional health behaviors-with satisfactory fit indices and internal consistency (Cronbach α=.79). The mean score of COVID-19-related health behaviors was 53.77 (SD 8.03), and scores differed significantly (P<.05) with respect to residence, college year, academic major, family economic level, self-reported health status, having a family member or friend infected with coronavirus, and health literacy level. Linear regression analysis showed that health literacy and eHealth literacy were positively associated with COVID-19-specific precautionary behaviors (βhealth literacy=.149, βeHealth literacy=.368; P<.001) and conventional health behaviors (βhealth literacy=.219, βeHealth literacy=.277; P<.001).ConclusionsThe COVID-19-related health behavior questionnaire was a valid and reliable measure for assessing health behaviors during the pandemic. College students with higher health literacy and eHealth literacy can more actively adopt COVID-19-related health behaviors. Additionally, compared to health literacy, eHealth literacy is more closely related to COVID-19-related health behaviors. Public intervention measures based on health and eHealth literacy are required to promote COVID-19-related health behaviors during the pandemic, which may be helpful to reduce the risk of COVID-19 infection among college students.
| S-EPMC8104003 | biostudies-literature
Project description:BACKGROUND:Electronic health (eHealth) literacy has become an important topic in health fields. Studies have found that individuals with higher eHealth literacy are more likely to use preventive care services and to have effective interactions with their physicians. In addition, previous studies have revealed a gender difference in the utilization of physician access and outpatient services. Nevertheless, few studies have explored the effect of the three levels of eHealth literacy (functional, interactive, and critical levels) on the four aspects of health services utilization (type, site, purpose, and time interval). It is unclear whether the associations between these three levels of eHealth literacy and the four aspects of health services utilization among college students are positive or negative. OBJECTIVE:The objective of this study was to investigate the associations among gender, eHealth literacy, and health services utilization. METHODS:We used the eHealth Literacy Scale, a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy, and the Health Services Utilization Scale, which is a 10-item instrument developed to measure the four aspects of health services utilization by college students. A nationally representative sample of 489 college students in Taiwan was surveyed. We conducted multiple regression analysis to examine the associations among gender, eHealth literacy, and health services utilization. RESULTS:The study found that being female was negatively related to the purpose aspect of health services utilization (t487=-2.85, P<.01). However, the R2 value of gender on the purpose aspect was low enough to be ignored. Critical (t484=2.98-4.23, P<.01) and interactive eHealth literacy (t484=2.43-2.89, P<.05) were related to three aspects of the health services utilization, and functional eHealth literacy was related to the purpose aspect (t484=-4.99, P<.001). CONCLUSIONS:This study showed that Taiwanese college students with interactive eHealth literacy were more likely to have a higher rate of outpatient care use. Moreover, Taiwanese college students with critical eHealth literacy were more likely to make full use of health services than those with functional eHealth literacy. Finally, the educated and age-restricted sample may attenuate gender disparities in health services utilization among Taiwanese college students.
| S-EPMC6231732 | biostudies-other
Project description:BackgroundeHealth literacy is gaining importance for maintaining and promoting health. Studies have found that individuals with high eHealth literacy are more likely to adopt healthy eating, exercise, and sleep behaviors. In addition, previous studies have shown that various individual factors (eg, frequency of seeking information on health issues, degree of health concern, frequency of eating organic food, and students' college major) are associated with eHealth literacy and health-promoting lifestyles. Nevertheless, few studies have explored the associations among individual factors, eHealth literacy, and health-promoting lifestyles among college students. Moreover, there is a lack of studies that focus on eHealth literacy as a predictor of psychological health behaviors.ObjectiveTo examine the associations among various individual factors, eHealth literacy, and health-promoting lifestyles.MethodsThe eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. The Health-promoting Lifestyle Scale is a 23-item instrument developed to measure college students' self-actualization, health responsibility, interpersonal support, exercise, nutrition, and stress management. A nationally representative sample of 556 valid college students in Taiwan was surveyed. A questionnaire was administered to gather the respondents' background information, including the frequency of seeking information on health issues, the frequency of eating organic food, the degree of health concern, and the students' major. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health-promoting lifestyles.ResultsThe study found that factors such as medical majors (t550=2.47-7.55, P<.05) and greater concern with health (t550=2.15-9.01, P<.05) predicted college students' 4-6 health-promoting lifestyle dimensions and the 3 dimensions of eHealth literacy. Moreover, critical eHealth literacy positively predicted all 6 health-promoting lifestyle dimensions (t547=2.66-7.28, P<.01), functional literacy positively predicted 2 dimensions (t547=2.32-2.98, P<.05), and interactive literacy predicted only the self-actualization dimension (t547=2.81, P<.01).ConclusionsThis study found that participants who majored in medical fields had greater concern with their health and frequently sought health information, exhibited better eHealth literacy, and had a positive health-promoting lifestyle. Moreover, this study showed that college students with a higher critical eHealth literacy engaged better in health-promoting activities than those with functional and interactive literacy.
| S-EPMC5263862 | biostudies-literature
Project description:BackgroundIn the context of aging and digitalization, the development and application of digital health can help meet the growing health needs of older adults. Improving digital health literacy of older adults may be an effective way to alleviate the shortage of public health resources and improve their health-related quality of life (HRQoL). However, the impact of digital health literacy on HRQoL in older adults and the underlying mechanism remain unclear. This study intends to explore whether digital health literacy has an effect on HRQoL in community-dwelling older adults, and whether health-promoting lifestyle plays a mediating role between digital health literacy and HRQoL, while providing a theoretical basis for the scientific construction of HRQoL intervention programs for older adults.MethodsThe cross-sectional study was conducted in Chongqing, China from September 2020 to April 2021. 572 community-dwelling older adults were surveyed by stratified sampling. Data on sociodemographic characteristics, digital health literacy, health-promoting lifestyle and HRQoL were collected. Univariate analysis was used to compare the differences in HRQoL among community-dwelling older adults with different sociodemographic characteristics. Pearson correlation analysis was used to explore the correlation between digital health literacy, health-promoting lifestyle and HRQoL. SPSS PROCESS macro was used to examine the mediating effect of health-promoting lifestyle between digital health literacy and HRQoL.ResultsThe mean score of HRQoL was 97.97 (SD 11.45). Univariate analysis showed that there were statistically significant differences in HRQoL among community-dwelling older adults with different gender, age, educational level, marital status, and monthly household income per capita (p < 0.05). There were positive correlations between digital health literacy, health-promoting lifestyle and HRQoL, with correlation coefficients ranging from 0.416 to 0.706 (p < 0.001). Digital health literacy was positively associated with HRQoL (β = 0.210, p < 0.001), and health-promoting lifestyle mediated the relationship between digital health literacy and HRQoL, with an indirect effect of 0.175 (95% Bootstrap CI 0.135-0.214).ConclusionDigital health literacy can affect HRQoL through the mediating effect of health-promoting lifestyle. It is suggested that relevant management institutions, communities and families should strengthen the cultivation of the digital health literacy of older adults, promote their development of health-promoting lifestyle, and ultimately improve HRQoL.
| S-EPMC10321557 | biostudies-literature
Project description:BackgroundIn the rapidly developing use of the Internet in society, eHealth literacy-having the skills to utilize health information on the Internet-has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users.ObjectiveThe aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan.MethodsThe participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses.ResultsWe analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth literacy were significantly more likely to exhibit the good health behaviors of physical exercise (adjusted odds ratio [AOR] 1.377, 95% CI 1.131-1.678) and eating a balanced diet (AOR 1.572, 95% CI 1.274-1.940) than individuals with low eHealth literacy.ConclusionsWe found that some health behaviors, including exercise and balanced nutrition, were independently associated with eHealth literacy among Japanese adult Internet users.
| S-EPMC4969548 | biostudies-literature
Project description:BACKGROUND:Parents often use digital media to search for information related to their children's health. As the quantity and quality of digital sources meant specifically for parents expand, parents' digital health literacy is increasingly important to process the information they retrieve. One of the earliest developed and widely used instruments to assess digital health literacy is the self-reported eHealth Literacy Scale (eHEALS). However, the eHEALS has not been psychometrically validated in a sample of parents. Given the inconsistency of the eHEALS underlying factor structure across previous reports, it is particularly important for validation to occur. OBJECTIVE:This study aimed to determine the factor structure of the German eHEALS measure in a sample of parents by adopting classic and modern psychometric approaches. In particular, this study sought to identify the eHEALS validity as a unidimensional index as well as the viability for potential subscales. METHODS:A cross-sectional design was used across two purposive sampling frames: online and paper administrations. Responses were collected between January 2018 and May 2018 from 703 Swiss-German parents. In addition to determining the sampling characteristics, we conducted exploratory factor analysis of the eHEALS by considering its ordinal structure using polychoric correlations. This analysis was performed separately for online-based and paper-based responses to examine the general factor strength of the eHEALS as a unidimensional index. Furthermore, item response theory (IRT) analyses were conducted by fitting eHEALS to a bifactor model to further inspect its unidimensionality and subscale viability. RESULTS:Parents in both samples were predominantly mothers (622/703, 88.5%), highly educated (538/703, 76.9%), of Swiss nationality (489/703, 71.8%), and living with a partner (692/703, 98.4%). Factor analyses of the eHEALS indicated the presence of a strong general factor across both paper and online samples, and the Wilcoxon rank-sum test indicated that the eHEALS total sum score was not significantly different between the paper and online samples (P=.12). Finally, the IRT analyses indicated negligible multidimensionality, insufficient subscale reliability after accounting for the eHEALS general factor, and a reduced subset of items that could serve as a unidimensional index of the eHEALS across the paper and online samples. CONCLUSIONS:The German eHEALS evidenced good psychometric properties in a parent-specific study sample. Factor analyses indicated a strong general factor across purposively distinct sample frames (online and paper). IRT analyses validated the eHEALS as a unidimensional index while failing to find support for subscale usage.
| S-EPMC7101498 | biostudies-literature
Project description:BackgroundThe eHealth Literacy Scale (eHEALS) is a tool for the self-assessment of perceived comfort and skills in using the internet as a source for health-related information. Although evidence exists of the reliability and construct and structural validity of the scale, there is a lack of evidence in relation to what is proposed by Norman and Skinner in their theoretical lily model of eHealth literacy; in particular it is not clear whether having a higher level of health literacy can positively influence electronic health (eHealth) literacy as measured by the eHEALS.ObjectiveOur study aim was to assess whether real-life experiences from studying or working in the health field, as a proxy of higher functional health literacy, correlate with self-referred eHealth literacy as measured by the eHEALS.MethodsA Web-based survey was conducted among adults living in Northeast Italy using an Italian version of the eHEALS (IT-eHEALS). In order to be able to measure the effect of higher functional health literacy on eHealth literacy, we divided our sample into two groups, respectively characterized by studying or working experience in the health sector and by lack thereof. Mean differences between eHEALS were calculated using t test and effect size evaluated using Cohen d. To ensure the validity of the IT-eHEALS, we evaluated its psychometric properties (internal consistency and dimensionality) and construct validity (by evaluating its correlation with respondents age, gender, educational attainment, self-rated health, use of internet for health-related purposes, and working status).ResultsA total of 868 respondents that completed the IT-eHEALS were included for analysis, of which 259 had working or studying experience in the health field. Mean (SD) eHEALS total score was 28.2 (6.2) for the whole sample, with statistically significant differences (P<.001) between the two groups, with the higher health literate group scoring significantly better (31.9 (5.9) vs 26.7 (5.6), respectively), with a standardized mean difference (Cohen d) of 0.9. Interestingly, we found a weak, yet significant, correlation between eHealth literacy and respondent characteristics for the higher health literate group only, as measured by positive Spearman correlation coefficients for age (0.11, P=.001), educational attainment (0.19, P=.002) and self-rated health (0.14, P=.024). Also, in line with current literature, correlation of eHEALS score with frequency of internet use for health-related purposes was significant for both groups (0.32, P<.001 and 0.15, P<.001 for higher and lower health literacy group, respectively). In our study we could not find any difference related to gender, while a significant difference for working status was only present when considering the sample as a whole (P=.03).ConclusionsOur study demonstrates a sizeable effect of higher levels of functional health literacy on the eHEALS score, corroborating what was initially proposed by Norman and Skinner in the lily model of eHealth literacy.
| S-EPMC6246968 | biostudies-literature
Project description:BackgroundModification of health literacy (HL) is an important factor for improving and maintaining oral health. The aim of the study is to examine the association of HL with oral health-promoting behaviour (OHPB) and assess possible mediating effects of HL on the impact of socioeconomic status on OHPB.MethodsA cross-sectional questionnaire survey on the Slovak general adult population (N = 360, mean age 39) was conducted in 2014 and 2015. The association of HL (9 domains of the Health Literacy Questionnaire) and OHPB was analysed using logistic regression models adjusted for gender, age and educational level. Testing the mediating effect of HL domains between education attainment and OHPB was performed using the Sobel test.ResultsWomen and respondents with higher education reported better OHPB. Regular tooth-brushing is associated with better HL in five domains: Feeling understood and supported by healthcare provider, Having sufficient information to manage my health, Activelymanaging my health, Social support for health, Appraisal of health information (Odds ratios (ORs) from 1.64 to 2.33, p < 0.05). Using interdental tools is in association with better HL in two domains: Feeling understood and supported by a healthcare provider and Having sufficient information to manage my health (ORs 1.71 to 1.80, p < 0.05). Respondents who visited a dentist for prevention score higher in Social support for health (OR 1.79, p < 0.05). Using a tongue scraper and single brush and reporting gums bleeding is notstatistically significantly associated with HL. Mediation was confirmed between the effect of respondents' education on using fluoride toothpaste - mediated respondent's ability to find good health information. Frequency of tooth-brushing and using interdental hygiene aids were both mediated by patient's sufficient information to manage health.ConclusionsOur results indicate HL to be an important factor related to good oral health, and HL should be considered when planning oral health interventions.
| S-EPMC5853055 | biostudies-literature
Project description:BackgroundIn spite of strict regulation of coronavirus disease 2019 (COVID-19) preventive measures and containment in China, there are still confirmed cases sporadically occurring in many cities. College students live in groups and have active social activities so that it will trigger a serious public health event once an infection event occurs. Thus, identifying the status and related factors of protective behaviors among them after receiving vaccination will be crucial for epidemic control. This study aimed to gather information on the protective behaviors and to identify the associations of COVID-19 risk perception, eHealth literacy, and protective behaviors for Chinese college students following vaccination.MethodsA cross-sectional survey of college students engaged in protective behaviors post vaccination was conducted using the COVID-19 risk perception scale, eHealth literacy scale, and protective behaviors following vaccination questionnaire in one of the groups. Multiple linear regression analysis was used to confirm the correlation among the COVID-19 risk perception, eHealth literacy, and protective behaviors for Chinese college students.ResultsA total of 5,641 Chinese college students were included. Male students comprised 59.01% with an average age of (21.39 ± 2.75) years and most students rating their health as very good (44.85%) or pretty good (46.98%). A smaller percentage (13.76%) believed that they would likely or most likely be infected with COVID-19 after getting vaccinated. In addition, more than 1 in 10 (10.35%) college students had ever suspected to suffer from post-vaccination reactions following the COVID-19 vaccination. The mean score of protective behaviors was 26.06 ± 3.97. Approximately one-third (30.42%) of the students always or often did not wear a mask when going out. Some college students (29.25%) did not maintain distance of at least 1 m from others in social situations. Older female college students who were in good health and perceived as being at a low risk of getting infected with COVID-19, and those never suspected to suffer from post-vaccination reactions expected to engage in post-vaccination protective measures. Those with a higher level of perceived risk, severe risk perception and eHealth literacy, and a lower level of unknown risk perception were more likely to engage in further protective behaviors after getting vaccinated.ConclusionsOverall, the level of protective behaviors among the Chinese college students following vaccination could be improved, especially for male, younger college students in poor health. This study revealed the predictive effects of risk perception and eHealth literacy on protective behaviors, recommending that the negative and positive effects of risk perception should be balanced in epidemic risk management, and eHealth literacy promotion should also be emphasized for public health and social measures.
| S-EPMC8850378 | biostudies-literature