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How to Test Digital Health Literacy in Older Adult Patients

Conducting digital health literacy assessments via the telephone yields more stable results for older adult patient populations.

digital health literacy

Source: Thinkstock

By Sara Heath

- Administering digital health literacy assessments via the telephone presents an opportunity to understand older patient internet use and online health information seeking, according to a recent study in the Journal of Medical Internet Research.

More patients, especially those over the age of 50, are using the internet to access information about their own health than ever before. However, the breadth of digital information increases the likelihood that a patient will encounter misinformation. It is thus critical for healthcare professionals to understand the internet use habits and abilities of older patients.

“Greater Internet adoption has increased the availability of health information for consumers, yet disparities in access to relevant online health information persist, especially among users with insufficient skills to discriminate between credible and fraudulent online health information,” the researchers explained.

Administering a patient health literacy assessment is useful for understanding these patient characteristics. eHealth literacy assessments, such as the 8-item eHEALS assessment, look at patient abilities to seek, find, understand, and appraise health information from online sources.

But efforts to obtain answers from older patients often hit roadblocks. Older patients don’t usually like to complete survey items on an electronic form or on a paper questionnaire.

READ MORE: How Digital, Health Literacy Drives mHealth Patient Engagement

Instead, conducting these surveys via the telephone proves effective, the research team has found.

In a test of nearly 300 patients over the age of 50, the research team found that telephone eHEALS assessments are equally effective as the survey administered over other media.

“Assessing consumer comfort and self-efficacy in using technology to access online health resources can help identify skill gaps and gauge the likelihood that users will be successful when using the Internet to access relevant health information,” the researchers observed.

“Results from this study suggest that administering eHEALS to older adults via telephone produces a reliable measure with scores that possess sufficient construct validity evidence.”

The researchers also pointed out a few specific findings about the patient characteristics tested in eHEALS. Notably, the team found that three scales for eHealth literacy are correlated with one another.

READ MORE: The Difference Between Patient Education and Health Literacy

Those three scales relate to utility of health information for patients and confidence in using health information. The correlated survey features include the following:

  • I know how to use the health information I find on the internet to help me
  • I know how to use the internet to answer my questions about health
  • I feel confident in using information from the internet to make health decisions

“These three factors showed moderate to high correlations with one another,” the researchers explained. “The relationship between personal motivations for health information seeking and an individual’s perceived capability to use digital technologies can be affected by online environments with socially persuasive forms of media.”

The eHEALS assessment also tends to capture more information about older patients with high digital health literacy than those with low digital health literacy, the team found. It could be valuable for the assessment to include more survey measures to glean information about patients with limited digital health literacy to better target interventions to improve online information seeking.

“Among older adults, however, there is potential for additional underlying subscales to measure older adults’ confidence to locate, use, and evaluate online health information,” the researchers concluded.

“As older Internet users continue to visit online support groups and discussion forums to find new information about health care perspectives and experiences, it will be important to consider modifying the original eHEALS to adequately measure online health information-seeking behaviors in older populations.”

READ MORE: Patient Pre-Registration Tips for a Quality Consumer Experience

With more health information available via the internet, it will be important for healthcare professionals to understand how patients interact with that information.

A 2013 report from Pew Research Center found that 35 percent of patients have used an online resource to understand their health or obtain a diagnosis. Forty-six percent of those patients said their online self-diagnosis led them to seek medical attention, while 38 percent said they allowed the symptoms to run their course, Pew found.

These well-meaning online searches can have negative consequences. Patients with limited ability to discern quality online health information may develop misdiagnoses. And if those patients are part of the 38 percent of patients who allow online diagnoses to run their course, patients may face serious health side effects.

Healthcare professionals must understand patient online search habits and how patients vet their online sources to counter these online health search risks. Providers can then equip patients with better search habits and resources by establishing a baseline assessment about patient digital health literacy.

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