Current status and influencing factors of digital health literacy among community-dwelling older adults in Southwest China: a cross-sectional study

In the paper

“This study showed that most older adults had a low sense of media participation, and they were accustomed to acting as receivers rather than communicators, which was consistent with previous research results [19, 51].”

What the sources say

• Not checked yetcites [19] Choi NG, DiNitto DM. The digital divide among low-income homebound older adults: internet use patterns, eHealth literacy, and attitudes toward computer/internet use. J Med Internet Res. 2013;15(5):e93. https://doi.org/10.2196/jmir.2645. source
• Not checked yetcites [51] Wang W, Zhuang X, Shao P. Exploring health information sharing behavior of Chinese elderly adults on WeChat. Healthcare. 2020;8(3):207. https://doi.org/10.3390/healthcare8030207. source

In the paper

“Among them, education level, marital status, self-rated health status, degree of health concerns, duration of Internet usage, time spent using the Internet per day, frequency of Internet usage, frequency of receiving guidance passively from family members, perceived usefulness, perceived ease of use and perceived reliability were positively correlated with digital health literacy”

In the paper

“In this study, the digital health application ability of the older adults was weak, most of whom lacked the ability to turn the Internet health knowledge into action and apply it to health self-management.”

In the paper

“The younger, better educated and married older adults had higher digital health literacy, which was consistent with previous research results [14, 26].”

What the sources say

• Not checked yetcites [14] Li S, Cui G, Yin Y, Wang S, Liu X, Chen L. Health-promoting behaviors mediate the relationship between eHealth literacy and health-related quality of life among Chinese older adults: a cross-sectional study. Qual Life Res. 2021;30(8):2235–43. https://doi.org/10.1007/s11136-021-02797-2. source
• Not checked yetcites [26] Tennant B, Stellefson M, Dodd V, Chaney B, Chaney D, Paige S, Alber J. EHealth literacy and web 2.0 health information seeking behaviors among baby boomers and older adults. J Med Internet Res. 2015;17(3):e70. https://doi.org/10.2196/jmir.3992. source

In the paper

“while age and perceived risk were negatively correlated with digital health literacy.”

In the paper

“The mean score of digital health literacy of participants was 37.10 (SD 18.65), ranging from 15 to 74.”

• Also stated in: § Results · plain

  “The average score of digital health literacy was 37.10 (SD 18.65).”

In the paper

“The results showed that the regression model was significant (F = 222.510, P < 0.001), and 13 factors entered the regression equation, which could jointly account for 83.5% of the total variation, as shown in Table 3.”

In the paper

“As shown in Table 1 and Table 2, respondents with different age, education level, residential status, marital status, monthly household income per capita, self-rated health status, degree of health concerns, duration of Internet usage, frequency of Internet usage, time spent using the Internet per day, frequency of asking for help actively and receiving guidance passively from family members on”

In the paper

“In terms of Internet usage factors, duration of Internet usage, frequency of Internet usage, time spent using the Internet per day, and the frequency of receiving guidance passively from family members were the influencing factors of the digital health literacy of older adults.”

In the paper

“In this study, 48.42% of older adults lived with their spouses and children/grandchildren or live with children/grandchildren only, having the advantage of family education.”

In the paper

“It was worth noting that frequency of asking for help actively from family members did not enter the regression equation, while the frequency of receiving guidance passively from family members entered the final regression equation.”

In the paper

“the digital health literacy assessment adopted the Digital Health Literacy Assessment Scale for community-dwelling older adults, which was developed by the research group, proven to be with good internal consistency (0.941), split-half reliability (0.889), test–retest reliability (0.941), content validity (0.967), criterion validity (0.938) and construct validity.”

In the paper

“The number of Internet users in China aged 60 and over has tripled in the past five years, making them the fastest growing group [48, 49].”

What the sources say

• Not checked yetcites [48] China Internet Network Information Center (CNNIC). The 47th China statistical report on internet development. 2021. http://www.cnnic.net.cn/hlwfzyj/hlwxzbg/hlwtjbg/202102/P020210203334633480104.pdf. Accessed 27 Jul 2021.
• Not checked yetcites [49] China Internet Network Information Center (CNNIC). The 37th China statistical report on internet development. 2016. http://www.cnnic.net.cn/hlwfzyj/hlwxzbg/hlwtjbg/201601/P020160122444930951954.pdf. Accessed 27 Jul 2021.

In the paper

“The item-level CVIs of all questions were rated 1.000, and the scale-level CVI thus computed was also 1.000.”

In the paper

“In this process, the ability to acquire and evaluate Internet health information has been gradually established [50].”

What the sources say

• Not checked yetcites [50] Yang E, Chang SJ, Ryu H, Kim HJ, Jang SJ. Comparing factors associated with eHealth literacy between young and older adults. J Gerontol Nurs. 2020;46(8):46–56. https://doi.org/10.3928/00989134-20200707-02. source

In the paper

“At the same time, the existing researches on influencing factors of digital health literacy among older adults mainly focus on objective factors such as sociodemographic characteristics and digital factors [13, 33, 34]. Less attention is paid to subjective factors such as attitude towards Internet health information and social environment factors such as family support, which is lack of systematic”

What the sources say

• Not checked yetcites [13] Hoogland AI, Mansfield J, Lafranchise EA, Bulls HW, Johnstone PA, Jim HSL. EHealth literacy in older adults with cancer. J Geriatr Oncol. 2020;11(6):1020–2. https://doi.org/10.1016/j.jgo.2019.12.015. source
• Not checked yetcites [33] Lwin MO, Panchapakesan C, Sheldenkar A, Calvert GA, Lim LKS, Lu J. Determinants of eHealth literacy among adults in China. J Health Commun. 2020;25(5):385–93. https://doi.org/10.1080/10810730.2020.1776422. source
• Not checked yetcites [34] Cherid C, Baghdadli A, Wall M, Mayo NE, Berry G, Harvey EJ, Albers A, Bergeron SG, Morin SN. Current level of technology use, health and eHealth literacy in older Canadians with a recent fracture—a survey in orthopedic clinics. Osteoporosis Int. 2020;31(7):1333–40. https://doi.org/10.1007/s00198-020-05359-3. source

In the paper

“our estimated minimum sample size was 418.”

In the paper

“The higher digital health literacy of the married older adults may be due to the fact that older adults with good family functions are more likely to get family emotional support, thus having more family involvement and guidance when using digital health services [52, 53].”

What the sources say

• Not checked yetcites [52] Terp R, Kayser L, Lindhardt T. Older patients’ competence, preferences, and attitudes toward digital technology use: explorative study. JMIR Hum Factors. 2021;8(2):e27005. https://doi.org/10.2196/27005. source
• Not checked yetcites [53] Portz JD, Fruhauf C, Bull S, Boxer RS, Bekelman DB, Casillas A, Gleason K, Bayliss EA. “Call a teenager… that’s what I do!” - grandchildren help older adults use new technologies: qualitative study. JMIR aging. 2019;2(1):e13713. https://doi.org/10.2196/13713. source

In the paper

“One possible reason is that China gained full access to the Internet in 1994, later than many developed countries.”

In the paper

“Digital Health Literacy 2.0 emphasizes that users should not only be passive receivers, but also have the ability to actively participate in communication by interacting and sharing health-related information [21].”

What the sources say

• Not checked yetcites [21] Paige SR, Stellefson M, Krieger JL, Anderson-Lewis C, Cheong J, Stopka C. Proposing a transactional model of eHealth literacy: concept analysis. J Med Internet Res. 2018;20(10):e10175. https://doi.org/10.2196/10175. source

In the paper

“However, it still has some problems, such as unclear score boundary [28], inability to accurately judge the actual level of users' digital health literacy [29], and lack of evaluation of critical and interactive health literacy [30, 31].”

What the sources say

• Not checked yetcites [28] Quinn S, Bond R, Nugent C. Quantifying health literacy and eHealth literacy using existing instruments and browser-based software for tracking online health information seeking behavior. Comput Hum Behav. 2017;69:256–67. https://doi.org/10.1016/j.chb.2016.12.032. source
• Not checked yetcites [29] van der Vaart R, van Deursen AJ, Drossaert CH, Taal E, van Dijk JA, van de Laar MA. Does the eHealth literacy scale (eHEALS) measure what it intends to measure? Validation of a dutch version of the eHEALS in two adult populations. J Med Internet Res. 2011;13(4):e86. https://doi.org/10.2196/jmir.1840. source
• Not checked yetcites [30] Norman C. EHealth literacy 2.0: problems and opportunities with an evolving concept. J Med Internet Res. 2011;13(4):e125. https://doi.org/10.2196/jmir.2035. source
• Not checked yetcites [31] van der Vaart R, Drossaert C. Development of the digital health literacy instrument: measuring a broad spectrum of health 1.0 and health 2.0 skills. J Med Internet Res. 2017;19(1):e27. https://doi.org/10.2196/jmir.6709. source

In the paper

“Previous research results showed that there was a gap between the digital health literacy level of Chinese older adults and that of developed countries [14, 27].”

What the sources say

• Not checked yetcites [14] Li S, Cui G, Yin Y, Wang S, Liu X, Chen L. Health-promoting behaviors mediate the relationship between eHealth literacy and health-related quality of life among Chinese older adults: a cross-sectional study. Qual Life Res. 2021;30(8):2235–43. https://doi.org/10.1007/s11136-021-02797-2. source
• Not checked yetcites [27] Li S, Yin Y, Cui G, Xu H. The associations among health-promoting lifestyle, eHealth literacy, and cognitive health in older Chinese adults: a cross-sectional study. Int J Env Res Pub He. 2020;17(7):2263. https://doi.org/10.3390/ijerph17072263. source

In the paper

“The scale has been proved to have good discrimination, reliability, validity and practicability”

In the paper

“The application ability of digital health literacy is the highest cognitive level of digital health literacy, which is cultivated by acquiring information from all lower-level digital health literacy dimensions (namely, acquisition and evaluation ability and interaction ability) [21].”

What the sources say

• Not checked yetcites [21] Paige SR, Stellefson M, Krieger JL, Anderson-Lewis C, Cheong J, Stopka C. Proposing a transactional model of eHealth literacy: concept analysis. J Med Internet Res. 2018;20(10):e10175. https://doi.org/10.2196/10175. source

In the paper

“Older adults with high perceived usefulness, ease of use, reliability and low perceived risk of Internet health information may have more active attitude towards digital health services usage, which directly affects their behavior intention and leads to more positive usage behaviors, thus having higher digital health literacy.”

In the paper

“It was suggested that older adults were more inclined to learn passively than to seek guidance actively from their family members for obtaining Internet health information, and family members' teaching of acquiring Internet health information skills can improve the digital health knowledge and skills more effectively.”

In the paper

“the digital health literacy assessment used the self-assessment scale, which inevitably led to self-reported bias and could not fully reflect the actual digital health literacy operation ability of the participants.”

In the paper

“As one of the six core literacy of digital health literacy, computer literacy is the foundation of digital health literacy cultivation [20].”

What the sources say

• Not checked yetcites [20] Norman CD, Skinner HA. EHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res. 2006;8(2):e9. https://doi.org/10.2196/jmir.8.2.e9. source

In the paper

“The study by Yang et al. also showed that the attitude towards Internet health information was the most important predictor of digital health literacy [50].”

What the sources say

• Not checked yetcites [50] Yang E, Chang SJ, Ryu H, Kim HJ, Jang SJ. Comparing factors associated with eHealth literacy between young and older adults. J Gerontol Nurs. 2020;46(8):46–56. https://doi.org/10.3928/00989134-20200707-02. source

In the paper

“Older adults who perceive themselves to be good health and pay more attention to health have stronger self-care awareness and health information needs, and they are more likely to actively seek online health knowledge and skills and practice them in daily life [55].”

What the sources say

• Not checked yetcites [55] Aponte J, Nokes KM. Validating an electronic health literacy scale in an older Hispanic population. J Clin Nurs. 2017;26(17–18):2703–11. https://doi.org/10.1111/jocn.13763. source

In the paper

“Studies have shown that increasing the frequency of subjects using professional health websites is an effective intervention measure to improve digital health literacy [56, 57].”

What the sources say

• Not checked yetcites [56] Melholt C, Joensson K, Spindler H, Hansen J, Andreasen JJ, Nielsen G, Noergaard A, Tracey A, Thorup C, Kringelholt R, Dinesen BI. Cardiac patients’ experiences with a telerehabilitation web portal: implications for eHealth literacy. Patient Educ Couns. 2018;101(5):854–61. https://doi.org/10.1016/j.pec.2017.12.017. source
• Not checked yetcites [57] Mitsuhashi T. Effects of two-week e-learning on eHealth literacy: a randomized controlled trial of Japanese Internet users. PeerJ. 2018;6:e5251. https://doi.org/10.7717/peerj.5251. source

In the paper

“Considering that the level of digital health literacy is closely related to the Internet penetration rate and the level of economic development [19]”

What the sources say

• Not checked yetcites [19] Choi NG, DiNitto DM. The digital divide among low-income homebound older adults: internet use patterns, eHealth literacy, and attitudes toward computer/internet use. J Med Internet Res. 2013;15(5):e93. https://doi.org/10.2196/jmir.2645. source

In the paper

“this study only investigated community-dwelling older adults in the main urban areas of Chongqing, China, as well as other limitations in the selection associated with the sample design already explained in the methodological section.”

In the paper

“The research by Paek et al. proved that communication with peers can enhance digital health literacy [54].”

What the sources say

• Not checked yetcites [54] Paek HJ, Hove T. Social cognitive factors and perceived social influences that improve adolescent eHealth literacy. Health Commun. 2012;27(8):727–37. https://doi.org/10.1080/10410236.2011.616627. source

In the paper

“among which the lack of interactive ability and application ability of digital health literacy deserved more attention from not only health professionals, but also public health policy makers and implementers.”