Why we should talk about ehealth Literacy and how BaltCityPrevention helps fostering the discussion

Transcription

1 Webinar Baltic Region Healthy Cities Association Why we should talk about ehealth Literacy and how BaltCityPrevention helps fostering the discussion 4th April 2018, Anna-Lena Pohl Flensburg University of Applied Sciences

2 Questions What is ehealth Literacy and why does it matter? How to improve the ehealth Literacy of citizens? BaltCityPrevention & ehealth Literacy

3 What is ehealth Literacy and why does it matter?

4 Health Literacy Health Literacy has been defined as the cognitive and social skills which determine the motivation and ability of individuals to gain access, to understand and use information in ways which promote and maintain good health. Health Literacy means more than being able to read pamphlets and successfully make appointments. By improving people's access to health information and their capacity to use it effectively, health literacy is critical to empowerment

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6 EHEALTH LITERACY Definition from Norman/Skinner The ability to seek, find, understand, and appraise health information from electronic sources and to apply the gained knowledge to addressing or solving a health problem. Norman CD, Skinner HA. ehealth Literacy: Essential Skills for Consumer Health in a Networked World. Journal of medical Internet research. 2006;8(2):e9.

7 Lily Model Analytical competences Context-sensitive competences E-Health competence + = Norman CD, Skinner HA. ehealth Literacy: Essential Skills for Consumer Health in a Networked World. Journal of medical Internet research. 2006;8(2):e9.

8 The original Lily Model What about contexts of use? What about further user characteristics? What about personality of users?

9 Type of health question Cultural context Social context Institutional context Type of ehealth technology Propositional literacy Communicative expertise Procedural literacy Gilstad, H. Towards a comprehensive model of ehealth Literacy. 2 nd European workshop Practical Aspects of Health Informatics, Trondheim 2014.

10 Definition from Griebel et al 2017 ehealth literacy includes a dynamic and context-specific set of individual and social factors, as well as consideration of technological constraints in the use of digital technologies to search, acquire, comprehend, appraise, communicate, apply and create health information in all contexts of healthcare with the goal of maintaining or improving the quality of life throughout the lifespan. Griebel, L., Enwald, H., Gilstad, H., Pohl, A.-L., Moreland, J., Sedlmayr, M. (forthcoming): ehealth Literacy Research Quo vadis? ( accepted for publication in Informatics for Health and Social Care )

11 Influences on ehealth literacy Structural Influence Model of Health Communication Tennant B, Stellefson M, Dodd V, Chaney B, Chaney D, Paige S, et al. ehealth Literacy and Web 2.0 Health Information Seeking Behaviors Among Baby Boomers and Older Adults. Journal of medical Internet research. 2015;17(3):e70

12 Conceptualization of ehealth Literacy Patient Empowerment Shared Decision Making enables is a prerequiesite for using ehealth for SDM ehealth Literacy is a basis for Health Literacy

13 Leili Lind, Linköping University, Sweden. Presentation at MIE Workshop 2015, available:

14 Trust n= EU citizen European Commission: Factsheet Data Protection Eurobarometer:

15 Some facts about the use of ehealth services...ehealth services often are not accepted by the potential users (e.g. failure of Google Health). 1 the interest in using the services runs out over time. 2 poor usability causes inacceptance. ehealth services are not tailored to individual needs of the users. users competences are insufficient to use the service effectively. 1 Marks R. Lessons from Google Health. [ ]; Available from: 2 Kelders S, Van Gemert-Pijnen J, Werkman A, Nijland N, Seydel E. Effectiveness of a Web-based intervention aimed at healthy dietary and physical activity behavior: a randomized controlled trial about users and usage. J Med Internet Res. 2011;13(2):e32.

16 The digital divide grows Between people with and without internet access. Problem: often it is not only a question of physical access but competences to use technology effectively.

17 How to improve the ehealth Literacy of citizens?

18 How to measure ehealth Literacy? E-Health Literacy Scale (eheals) 1 I know what health resources are available on the Internet. I know where to find useful health resources on the Internet. I know how to find useful health resources on the Internet. I know how to use the Internet to answer my questions about health. I know how to use the information I find on the Internet to help me. I have the skills I need to evaluate the health resources I find on the Internet. I can tell high-quality health resources from low-quality health resources on the Internet. I feel confident in using information from the Internet to make health decisions. 1 Norman CD, Skinner HA. eheals: The ehealth Literacy Scale. Journal of medical Internet research. 2006;8(4):e27.

19 Does the eheals really measures what it intends? Self-Assessment-Tool, user sometimes do not assess their own abilities correctly eheals-items sometimes difficult to distinguish Social media? Mobile Internet use? Based on a single-factor-model, although the ehealth Literacyconcept integrates different meta-literacies, e.g. information seeking and information assessment Soellner R, Huber S, Reder M. The concept of ehealth literacy and its measurement: German translation of the eheals. Journal of Media Psychology. 2014;26(1):29-38.

20 Digital Health Literacy Instrument by van der Vaart and Drossaert Does not only measure health information seeking online (Health 1.0) but also includes interactivity on the web (Health 2.0) Operational skills Navigation skills Information skills Evaluating reliability (Bewertung der Verlässlichkeit) Determining relevance (Ermittlung der Relevanz) Adding self-generated content Protecting privacy Van der Vaart, R., Drossaert, C. (2017): Development of the Digital Health Literacy Instrument: measuring a broad spectrum of health 1.0 and health 2.0 skills. Journal of Medical Internet 19 (1), e27.

21 Other approaches to measure (e)health Literacy Observational studies Participants are given tasks such as Search for information on management of medication intake. Search for information on chronic disease management. Chan, C.V., Kaufman, D.R.: A framework for characterizing ehealth literacy demands and barriers. Journal of medical Internet research 13, e94 (2011)

22 Measurement tool by Chan et al. Definition how to solve these tasks Classification of learning behaviour: Remembering I Understanding II Applying III Analyzing IV Evaluating V Increase of complexity I - V very complex and time consuming: direct observation of individual persons during their usage of an ehealth system in case of spatially separated user sites with a large number of users it is not practicable to perform such an observational study

23 Patient ehealth Readiness Scale (PERQ) includes items from the eheals + contextual factors like Internet use, support from other persons and demographics such as age and gender (Jones, R.: Development of a Questionnaire and Cross-Sectional Survey of Patient ehealth Readiness and ehealth Inequalities. Medicine 2.0 2, e9 (2013)) See also article from Lary Kayser et al The ehealth Literacy concept does not include all relevant factors explaining the use of interactive ehealth solutions: barriers such as trust, acceptance, motivation A broader range of factors should be included in a measurement tool to adequately assess ehealth Literacy.

24 The competences are not static. Put them in a learning context. Learning contexts are highly influenced by social determinants. Engage local actors.

25 Interventions must be tailored to the specific needs and daily life routines of users. Online learning tools might be suitable for young people or for those already familiar with learning by electronic means. Person to person interventions (interview, presence learning courses) might be suitable for those who have the time to attend and have the access to such courses.

26 Health insurances Which actors are needed? Schools, sport clubs Public libraries Patient organisations Social services IT Companies Interdisciplinary research Health professional Adult education centres Church missions Public Health Authorities, local / national Youth centres

27 BaltCityPrevention Contact: Levke Johannsen, Flensburg University of Applied Sciences

28 BaltCityPrevention - partners Baltic Region Healthy Cities Association South Ostrobothnia Health Technology Development Centre Seinäjoki University of Applied Sciences Seinäjoki Social and Primary Health Care Center Center for Health Education and Diseases Prevention Lithuanian University of Health Sciences The Society of the Family Doctors of Estonia

29 BaltCityPrevention - partners Tallinn University of Technology Liepaja City Council Rīga Stradiņš University SIA TELEMEDICA City of Poznan ScanBalt Flensburg University of Applied Sciences City of Flensburg

30 BaltCityPrevention aims 1) Develop and test a new approach that helps public health authorities in prevention intervention planning It will enable PHA to better tailor the interventions. What the new approach will look like... The PHA will develop together with the user group the tools that will be used in the intervention Participatory and user-driven approach, which leads to Higher acceptance and usability

31 BaltCityPrevention - aims 2) Involve ehealth technologies in the planning and implementation of the intervention Innovate the planning procedures of prevention interventions by involving the user and foster a joint development of tools Implement technology driven tools in interventions such as health games, apps or interactive forums

32 BaltCityPrevention - aims 3) Foster cooperation between PHA and SMEs Innovative input about how to establish and maintain cooperation with SMEs from the health IT sector. Matchmaking events with PHAs and the private sector

33 BaltCityPrevention work plan Extensive preparations Collecting data on needs and requirements of users and target groups. Additionally review of evidence based literature and practice reviews. Transnational exchange and best-practice examples. Cross-sectional cooperation of different departments and involvement of SMEs. Choosing the right tools and methods for implementing the new approach.

34 BaltCityPrevention - work plan The practical testing Testing the whole intervention planning cycle at different pilot sites. Evaluation of the planning procedure and the single methods. Documentation in evaluation reports. All results will be captured in a manual. The intervention model will be applicable in various settings and with different user groups

35 BaltCityPrevention - work plan Matchmaking between public and private sector A matrix will compile all competences, products and services from ehealth SMEs. Matchmaking events will foster the mutual understanding of different working cultures and the cooperation between PHAs and companies / between PHAs / between companies. Project partners will maintain the networking between the actors after the project duration.

36 BaltCityPrevention & ehealth Literacy Contribution to ehealthliteracy User group (adolescents) & target group (PHAs) improve technological skills, media / information / computer literacy The project fosters the understanding of the importantance of involving ICT in prevention and health promotion and thus supports the discussion about the skills of the users