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      Diversitäts- und kultursensible Gesundheitsinformationen für mehr digitale Gesundheitskompetenz: Eine kollaborative Community-Forschung zu Barrieren und Bedarfen Translated title: Diversity and culture-sensitive health information for better digital health literacy: A collaborative community research project on barriers and needs

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          Abstract

          Hintergrund

          Bei Gesundheitsfragen spielt das Internet eine zentrale Rolle, wobei Verbraucher:innen vor der Herausforderung stehen, geeignete Such- und Bewertungsstrategien zu entwickeln. Damit Informationen zur Gesundheit im Internet gefunden, verstanden, beurteilt und angewendet werden können, bedarf es digitaler Gesundheitskompetenz auf individueller und auf organisationaler Ebene. Vor dem Hintergrund gesellschaftlicher Pluralität und Diversität wurden Fähigkeiten und Zugänge marginalisierter Communities in diesem Zusammenhang bisher wenig beforscht.

          Ziel

          Diese Studie untersuchte die Nutzung von Online-Gesundheitsinformationen im Alltag aus einer postmigrantischen Perspektive, welche nicht Migrationshintergründe, sondern lokale Kontexte von Migrant:innen in Deutschland als Vulnerabilitätsvariable versteht. Ziel dieser Studie war es, sowohl das digitale Gesundheitsinformationsverhalten marginalisierter Communities ethnografisch und kollaborativ zu erforschen als auch praxisnahe und kultursensible Ansätze für Akteur:innen der Gesundheitskommunikation zu entwickeln ohne migrantisierende Zuschreibungen zu reproduzieren.

          Methoden

          Im Rahmen einer kollaborativen ethnografischen Feldforschung im Stadtteillabor der Bochumer Hustadt von 10/2020–01/2021 führten Community-Forscher:innen online leitfadengestützte Interviews in ihrem Umfeld durch. Die Interviews wurden mittels einer qualitativen Inhaltsanalyse ausgewertet.

          Ergebnisse und Diskussion

          Die Ergebnisse machen deutlich, dass sprachliche, inhaltliche und mediale Aspekte von Online-Gesundheitsinformationen den Zugang zu und Umgang mit diesen für marginalisierte Communities bedingen. Die postmigrantische Perspektive stellt einerseits Migration als hinreichende Analyse- und Erklärungskategorie in Frage und begründet zugleich Diversitäts- und Kultursensibilität als zentrale Komponenten des Zugangs zu Gesundheitsinformationen und der Entwicklung von Maßnahmen zur Stärkung der digitalen Gesundheitskompetenz in pluralen Gesellschaften. Es bedarf sowohl vielsprachiger, transkulturell resonierender und technisch barrierearmer Online-Gesundheitsinformationen als auch gestärkter Interaktion zwischen Individuen einer pluralen postmigrantischen Gesellschaft und der Online-Gesundheitskommunikation.

          Translated abstract

          Background

          When answering health-related questions, consumers turn to the internet to find answers. However, finding health information online can be challenging. Therefore, consumers need to develop suitable search and evaluation strategies. Finding, understanding, assessing, and applying health information requires digital health literacy. Hence, digital health literacy concerns individual and organizational levels. Against the background of social plurality and diversity, the skills and conditions of accessibility of marginalized communities have so far received little attention in this context.

          Objectives

          This study examines the use of online health information in daily life from a post-migrant perspective which considers the local contexts of migrants in Germany as a vulnerability variable rather than the migration histories. The aim of this study was to take a post-migrant perspective and to ethnographically and collaboratively study the digital health information behavior of marginalized communities as well as to develop practical and culturally sensitive approaches for actors in health communication.

          Methods

          Collaborative ethnographic field research on information behavior regarding health-related questions was carried out online from 10/2020–01/2021 in the marginalized urban district of Bochum Hustadt, Germany. Researchers from the urban neighborhood conducted guided interviews in their communities. The interviews were analyzed using qualitative content analysis.

          Results and conclusion

          The results indicate that language, content, and media aspects of online health information shape access to and handling of health information for individuals from marginalized communities. The post-migrant perspective challenges migration as a relevant category of analysis and explanation, while substantiating diversity and cultural sensitivity as central components of access to health information and the development of measures to strengthen digital health literacy in plural societies. There is a need for multilingual, transcultural, and technically barrier-free online health information as well as stronger interaction between individuals in a plural post-migrant society and online health communication.

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          Most cited references45

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          Health literacy and public health: A systematic review and integration of definitions and models

          Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.
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            eHEALS: The eHealth Literacy Scale

            Background Electronic health resources are helpful only when people are able to use them, yet there remain few tools available to assess consumers’ capacity for engaging in eHealth. Over 40% of US and Canadian adults have low basic literacy levels, suggesting that eHealth resources are likely to be inaccessible to large segments of the population. Using information technology for health requires eHealth literacy—the ability to read, use computers, search for information, understand health information, and put it into context. The eHealth Literacy Scale (eHEALS) was designed (1) to assess consumers’ perceived skills at using information technology for health and (2) to aid in determining the fit between eHealth programs and consumers. Objectives The eHEALS is an 8-item measure of eHealth literacy developed to measure consumers’ combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. The objective of the study was to psychometrically evaluate the properties of the eHEALS within a population context. A youth population was chosen as the focus for the initial development primarily because they have high levels of eHealth use and familiarity with information technology tools. Methods Data were collected at baseline, post-intervention, and 3- and 6-month follow-up using control group data as part of a single session, randomized intervention trial evaluating Web-based eHealth programs. Scale reliability was tested using item analysis for internal consistency (coefficient alpha) and test-retest reliability estimates. Principal components factor analysis was used to determine the theoretical fit of the measures with the data. Results A total of 664 participants (370 boys; 294 girls) aged 13 to 21 (mean = 14.95; SD = 1.24) completed the eHEALS at four time points over 6 months. Item analysis was performed on the 8-item scale at baseline, producing a tight fitting scale with α = .88. Item-scale correlations ranged from r = .51 to .76. Test-retest reliability showed modest stability over time from baseline to 6-month follow-up (r = .68 to .40). Principal components analysis produced a single factor solution (56% of variance). Factor loadings ranged from .60 to .84 among the 8 items. Conclusions The eHEALS reliably and consistently captures the eHealth literacy concept in repeated administrations, showing promise as tool for assessing consumer comfort and skill in using information technology for health. Within a clinical environment, the eHEALS has the potential to serve as a means of identifying those who may or may not benefit from referrals to an eHealth intervention or resource. Further research needs to examine the applicability of the eHEALS to other populations and settings while exploring the relationship between eHealth literacy and health care outcomes.
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              The Integrative Self: How Self-Reference Integrates Perception and Memory.

              We propose a new account of how self-reference affects information processing. We report evidence that self-reference affects the binding of memory to source, the integration of parts into perceptual wholes, and the ability to switch from a prior association to new associations. Self-reference also influences the integration of different stages of processing, linking attention to decision making, and affects the coupling between brain regions mediating self-representation and attention to the environment. Taken together, the data suggest that self-reference acts as a form of 'integrative glue' which can either enhance or disrupt performance, depending on the task context. We discuss the implications for understanding the self, and future directions for research.
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                Author and article information

                Contributors
                anna.geldermann@uni-bonn.de
                Journal
                Präv Gesundheitsf
                Pra¨vention Und Gesundheitsfo¨rderung
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1861-6755
                1861-6763
                13 February 2023
                13 February 2023
                : 1-20
                Affiliations
                [1 ]GRID grid.6190.e, ISNI 0000 0000 8580 3777, Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, , Universität zu Köln, ; Köln, Nordrhein-Westfalen Deutschland
                [2 ]GRID grid.466372.2, ISNI 0000 0004 0499 6327, Department of Community Health, , Hochschule Gesundheit Bochum, ; Bochum, Nordrhein-Westfalen Deutschland
                [3 ]GRID grid.11500.35, ISNI 0000 0000 8919 8412, Department Social Work, , Hochschule Angewandte Wissenschaften Hamburg, ; Hamburg, Hamburg Deutschland
                [4 ]GRID grid.10388.32, ISNI 0000 0001 2240 3300, Center for Life Ethics, , Universität Bonn, ; Bonn, Nordrhein-Westfalen Deutschland
                Author information
                http://orcid.org/0000-0003-1084-6360
                http://orcid.org/0000-0002-9545-8297
                http://orcid.org/0000-0002-7148-6808
                Article
                1012
                10.1007/s11553-023-01012-z
                9924178
                5a380f5d-536d-4503-b2b4-62b7296924a5
                © The Author(s) 2023

                Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

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                History
                : 6 October 2022
                : 5 January 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100013549, Bundesministerium für Umwelt, Naturschutz, nukleare Sicherheit und Verbraucherschutz;
                Award ID: 28-V-9102X20
                Award Recipient :
                Funded by: Universität zu Köln (1017)
                Categories
                Originalarbeit

                postmigration,diversität,online-gesundheitsinformationen,gesundheitskompetenz,kollaboratives forschen,teilhabe,diversity,online health information,health literacy,collaborative research methods,participation

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