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      eHealth Literacy als Grundlage zur Entwicklung digitaler Technologien in der Gesundheitsförderung und Prävention? Eine systematische Übersicht der Literatur

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          Zusammenfassung

          Hintergrund

          Digitale Technologien stellen ein großes Potenzial für Prävention und Gesundheitsförderung im Hinblick auf die Reichweite und individualisierte sowie bedürfnisorientierte Gestaltung von Informationen dar. Diese müssen von Nutzer*innen verstanden, aber auch innerhalb der Settingprävention vor allem von Organisationen adäquat eingesetzt und in Prozesse der Sturkturentwicklung überführt werden. Das Konzept der eHealth Literacy setzt verschiedenen Determinanten dafür in Zusammenhang.

          Ziel und Methodik

          Um einen Einblick über die Verwendung des Konzepts eHealth Literacy in der Forschung zu digitalen Technologien der Gesundheitsförderung und Prävention zu erhalten, wurde eine systematisierte Literaturrecherche durchgeführt. Dabei wurden die Datenbanken MEDLINE, CINAHL, SocINDEX, PsycINFO, Psyndex, IEEE Xplore, BASE und Web of Science durchsucht.

          Ergebnisse

          Es wurden 35 Artikel identifiziert, die Health Literacy in Bezug zu digitalen Technologien fokussieren. Die Ergebnisse zeigen eine marginale wissenschaftliche Auseinandersetzung mit dem Konzept. Bisher findet keine Anpassung digitaler Technologien an die Health Literacy der Nutzer*innen statt. Das führt zu einer verkürzten Perspektive und zu ungenutztem Potenzial, welches das Konzept bietet.

          Schlussfolgerung

          Es besteht ein dringender Bedarf, ein evidenzbasiertes eHealth-Literacy-Konzept zu entwickeln und anzuwenden, um digitale Technologien und Gesundheitsinformationen zielgruppenspezifisch und ressourcenorientiert modifizieren und in Settings einsetzen zu können.

          Abstract

          Background

          Digital technologies offer great potential for prevention and health promotion in terms of the availability of information and the individualized and needs-oriented design of content. However, it must be possible for the users to understand and apply them within setting-based prevention and organisational change. The concept of eHealth literacy brings together various determinants of this.

          Objective and methodology

          In order to gain insight into the use of the eHealth literacy concept in research on digital technologies for health promotion and prevention, a systematized literature search was conducted. The databases Medline, CINAHL, SocINDEX, PsycINFO, Psyndex, IEEE Xplore, BASE and Web of Science were searched.

          Results

          A total of 35 articles that focus on the concept of health literacy in relation to digital technologies were identified. The results show a marginal scientific discussion of the concept. So far, there is no adaptation of digital technology to the health literacy of users. This leads to a shortened perspective and to unused potential.

          Conclusion

          There is an urgent need to develop and apply an evidence-based eHealth literacy concept in order to modify digital technologies and health information target group-specific and resource-oriented and to use them in settings.

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          Most cited references44

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          Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century

          D Nutbeam (2000)
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            eHealth Literacy: Essential Skills for Consumer Health in a Networked World

            Electronic health tools provide little value if the intended users lack the skills to effectively engage them. With nearly half the adult population in the United States and Canada having literacy levels below what is needed to fully engage in an information-rich society, the implications for using information technology to promote health and aid in health care, or for eHealth, are considerable. Engaging with eHealth requires a skill set, or literacy, of its own. The concept of eHealth literacy is introduced and defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. In this paper, a model of eHealth literacy is introduced, comprised of multiple literacy types, including an outline of a set of fundamental skills consumers require to derive direct benefits from eHealth. A profile of each literacy type with examples of the problems patient-clients might present is provided along with a resource list to aid health practitioners in supporting literacy improvement with their patient-clients across each domain. Facets of the model are illustrated through a set of clinical cases to demonstrate how health practitioners can address eHealth literacy issues in clinical or public health practice. Potential future applications of the model are discussed.
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              Engagement in a Diabetes Self-management Website: Usage Patterns and Generalizability of Program Use

              Background Increased access to the Internet and the availability of efficacious eHealth interventions offer great promise for assisting adults with diabetes to change and maintain health behaviors. A key concern is whether levels of engagement in Internet programs are sufficient to promote and sustain behavior change. Objective This paper used automated data from an ongoing Internet-based diabetes self-management intervention study to calculate various indices of website engagement. The multimedia website involved goal setting, action planning, and self-monitoring as well as offering features such as “Ask an Expert” to enhance healthy eating, physical activity, and medication adherence. We also investigated participant characteristics associated with website engagement and the relationship between website use and 4-month behavioral and health outcomes. Methods We report on participants in a randomized controlled trial (RCT) who were randomized to receive (1) the website alone (n = 137) or (2) the website plus human support (n = 133) that included additional phone calls and group meetings. The website was available in English and Spanish and included features to enhance engagement and user experience. A number of engagement variables were calculated for each participant including number of log-ins, number of website components visited at least twice, number of days entering self-monitoring data, number of visits to the “Action Plan” section, and time on the website. Key outcomes included exercise, healthy eating, and medication adherence as well as body mass index (BMI) and biological variables related to cardiovascular disease risk. Results Of the 270 intervention participants, the average age was 60, the average BMI was 34.9 kg/m2, 130 (48%) were female, and 62 (23%) self-reported Latino ethnicity. The number of participant visits to the website over 4 months ranged from 1 to 119 (mean 28 visits, median 18). Usage decreased from 70% of participants visiting at least weekly during the first 6 weeks to 47% during weeks 7 to 16. There were no significant differences between website only and website plus support conditions on most of the engagement variables. In total, 75% of participants entered self-monitoring data at least once per week. Exercise action plan pages were visited more often than medication taking and healthy eating pages (mean of 4.3 visits vs 2.8 and 2.0 respectively, P < .001). Spearman nonparametric correlations indicated few significant associations between patient characteristics and summary website engagement variables, and key factors such as ethnicity, baseline computer use, age, health literacy, and education were not related to use. Partial correlations indicated that engagement, especially in self-monitoring, was most consistently related to improvement in healthy eating (r = .20, P = .04) and reduction of dietary fat (r = -.31, P = .001). There was also a significant correlation between self-monitoring and improvement in exercise (r = .20, P = .033) but not with medication taking. Conclusions Participants visited the website fairly often and used all of the theoretically important sections, but engagement decreased over 4 months. Usage rates and patterns were similar for a wide range of participants, which has encouraging implications for the potential reach of online interventions. Trial Registration NCT00987285; http://clinicaltrials.gov/show/NCT00987285 (Archived by WebCite at http://www.webcitation.org/5vpe4RHTV)
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Prävention und Gesundheitsförderung
                Präv Gesundheitsf
                Springer Science and Business Media LLC
                1861-6755
                1861-6763
                May 2022
                June 08 2021
                May 2022
                : 17
                : 2
                : 163-169
                Article
                10.1007/s11553-021-00858-5
                5d892850-fbff-45cf-ab92-ebbd08f9c516
                © 2022

                https://creativecommons.org/licenses/by/4.0

                https://creativecommons.org/licenses/by/4.0

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