Working towards a ready to implement digital literacy program

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Abstract

Background

As healthcare continues to expand online and digital care offerings multiply, the importance of digital inclusion and equity is now better recognized. Yet despite impressive regional grassroots efforts, today there remain few readily deployable programs designed to support patient digital literacy.

Methods

Digital Outreach for Obtaining Resources and Skills (DOORs) is one such digital literacy program that has evolved over the last 5 years to meet the rising demand. Through community partnerships, the DOORs curriculum and delivery has been updated to make the program more accessible and applicable as Coronavirus Disease 2019 (COVID-19) changes healthcare. Participants’ experience in the most updated iteration of DOORS was assessed through surveys and semi-structured interviews.

Results

Improvements to DOORs include an updated DOORs curriculum, updated facilitator manual, an online platform with a learning management system, standardized training, patient-facing educational handouts, consolidation of all DOORs materials into a single package that is ready to be shared with other groups, implementation of a single-session intervention model, and Spanish translation. Participants reported improved confidence on 72% of the digital skills assessed. Thematic analysis resulted in three themes: awareness of divide, patient-centered design, and expanded skills and confidence.

Conclusions

Combined, these changes and participant outcomes better position DOORS to meet the rising need for digital literacy and offers a scalable model for teams across the world.

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Most cited references 40

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Using thematic analysis in psychology

Virginia Braun, Victoria Clarke (2014)

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Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)

Anthony Smith, Emma Thomas, Centaine Snoswell … (2020)

The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare.

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eHEALS: The eHealth Literacy Scale

Cameron Norman, Harvey A Skinner (2006)

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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Author and article information

Journal

Journal ID (nlm-ta): Mhealth

Journal ID (iso-abbrev): Mhealth

Journal ID (publisher-id): MH

Title: mHealth

Publisher: AME Publishing Company

ISSN (Electronic): 2306-9740

Publication date (Electronic): 04 September 2023

Publication date Collection: 2023

Volume: 9

Electronic Location Identifier: 32

Affiliations

[1]deptDepartment of Psychiatry, Beth Israel Deaconess Medical Center , Harvard Medical School , Boston, MA, USA

Author notes

Contributions: (I) Conception and design: All authors; (II) Administrative support: J Torous; (III) Provision of study materials or patients: N Alon, S Perret; (IV) Collection and assembly of data: S Perret, N Alon; (V) Data analysis and interpretation: N Alon, S Perret; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

Correspondence to: John Torous, MD, MBI. Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02115, USA. Email: jtorous@ 123456bidmc.harvard.edu .

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ORCID: 0000-0002-9571-991X.

Article

Publisher ID: mh-09-23-13

DOI: 10.21037/mhealth-23-13

PMC ID: 10643183

SO-VID: 18abf3e2-62d9-492e-821c-a13df4ec1bdc

License:

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

Working towards a ready to implement digital literacy program

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Abstract

Background

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Novel Coronavirus Disease COVID-19

Most cited references 40

Using thematic analysis in psychology

Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)

eHEALS: The eHealth Literacy Scale

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