Digital health literacy in cardiovascular research

Validation of the digital health literacy assessment among the university students in China

Purpose

With the development of the internet, digital health literacy (DHL) has become increasingly important for managing health. Consequently, various digital health literacy scales have been created for different groups. The purpose of this study was to verify the reliability and validity of the simplified Chinese version of the Digital Health Literacy Assessment (DHLA) scale among university students in China.

Method

Snowball sampling was used to recruit the participants via an online platform (Wenjuan.com), and finally 304 university students were included in the survey. Demographic information and the status of DHL were collected through the online questionnaire. Cronbach's alpha and split-half reliability were used to test the internal consistency of the scale, while the structural validity was verified by exploratory factor analysis and confirmatory factor analysis. Additionally, the convergence of the scale was tested by composite reliability (CR) and average variance extracted (AVE).

Result

Two dimensions were generated from 10 entries in the scale, named Self-rated Digital Health Literacy and Trust Degree of Online Health Information, respectively. The Cronbach's alpha and split-half reliability of the total scale were 0.912 and 0.828, while the Cronbach's alpha of the two dimensions were 0.913 and 0.830, respectively. The structural validity-related indexes of the scale met the standards (RMSEA = 0.079, GFI = 0.943, AGFI = 0.902, CFI = 0.971). In each dimension, the CR and AVE also reached critical values (CR > 0.7 and AVE > 0.5).

Conclusion

The scale had high reliability and validity, indicating the simplified Chinese DHLA scale could be used to evaluate the DHL of university students in China.

Digital Health Literacy in Patients With Heart Failure in Times of Pandemic

This study sought to determine the effect of a digital health literacy program regarding knowledge and skills in the use of digital resources related to self-care and health empowerment for patients with heart failure. A cross-sectional pilot study was conducted before and after the program in patients (n = 28) with heart failure at a tertiary care center. Both a knowledge test and the Health Empowerment Scale were used with a Cronbach's α of 0.89. The information was processed using the statistical software Restudio, which allowed us to make a descriptive and inferential analysis. Seventy-five percent of the participants were men with an average age of 68 years, 60.7% had elementary schooling, 71.4% had preserved ejection fraction, and 57.6% had a family member as a caregiver. A statistically significant change ( P < .005) was found in the level of empowerment and the knowledge and skills in the use of digital resources applied in health. The results showed that the digital health literacy program is a cost-effective intervention that nursing professionals must integrate into continuity of care, not only in pandemic times but also in a permanent and standardized manner. An empowered patient with knowledge and skills in the use of digital resources is a patient with the ability to decide, satisfy needs, and solve problems, with critical thinking and control over their health.

Research progress on digital health literacy of older adults: A scoping review

With the rapid development of digital health today, the lack of digital health literacy in older adults is an urgent problem. It is crucial that older adults adapt to the digital reform in medical treatment, pension, health management, and other fields. Therefore, we reviewed the current development status of digital health literacy among older adults. A total of 47 articles were included in this scoping review. Our findings revealed that research on digital health literacy in older adults is still in its infancy. Further development is warranted especially in terms of assessment tools and intervention methods.

Development and Validation of Digital Health Technology Literacy Assessment Questionnaire

In clinical practice, assessing digital health literacy is important to identify patients who may encounter difficulties adapting to digital health using digital technology and service. We developed the Digital Health Technology Literacy Assessment Questionnaire (DHTL-AQ) to assess the ability to use digital health technology, services, and data. The DHTL-AQ was developed in three phases. In the first phase, the conceptual framework and domains and items were generated from a systematic literature review using relevant theory and surveys. In the second phase, a cross-sectional survey with 590 adults age ≥ 18 years was conducted at an academic hospital in Seoul, Korea in January and February 2020 to test face validity of the items. Then, psychometric validation was conducted to determine the final items and cut-off scores of the DHTL-AQ. The eHealth literacy scale, the Newest Vital Sign, and 10 mobile app task ability assessments were examined to test validity. The final DHTL-AQ includes 34 items in two domains (digital functional and digital critical literacy) and 4 categories (Information and Communications Technology terms, Information and Communications Technology icons, use of an app, evaluating reliability and relevance of health information). The DHTL-AQ had excellent internal consistency (overall Cronbach’s α = 0.95; 0.87–0.94 for subtotals) and acceptable model fit (CFI = 0.821, TLI = 0.807, SRMR = 0.065, RMSEA = 0.090). The DHTL-AQ was highly correlated with task ability assessment (r = 0.7591), and moderately correlated with the eHealth literacy scale (r = 0.5265) and the Newest Vital Sign (r = 0.5929). The DHTL-AQ is a reliable and valid instrument to measure digital health technology literacy.