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eHealth Literacy as a Mediator of Health Behaviors

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Cognitive Informatics in Health and Biomedicine

Part of the book series: Health Informatics ((HI))

Abstract

eHealth literacy names a set of core literacies involved in the meaningful and productive use of health technologies. In this chapter, we present an integrative theoretical and methodological cognitive framework for elucidating the nature of these barriers and for fashioning design solutions. The Chan–Kaufman analytic framework differs from other frameworks in that the goals are to develop a diagnostic approach rather than a screening tool. The framework can be used to classify task demands and characterize the barriers encountered in users’ task performance. The methods are illustrated in the context of a health information seeking problem. We then review the research pertaining to the challenges in each of the consumer health domains including information seeking, patient portals, mHealth, social media, and telemedicine. The chapter discusses implications that need to be addressed when developing new health related programs and tools. eHealth tools afford an almost infinite number of new means to achieve health behavior change in the promotion of wellness and in the monitoring and management of chronic illness. The essential question is how do we tune these technologies such that they better address the needs of patients and health consumers at varying levels of eHealth literacy.

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References

  • Adams SA. Revisiting the online health information reliability debate in the wake of “web 2.0”: an inter-disciplinary literature and website review. Int J Med Inform. 2010a;79(6):391–400.

    Article  PubMed  Google Scholar 

  • Adams SA. Blog-based applications and health information: two case studies that illustrate important questions for Consumer Health Informatics [CHI] research. Int J Med Inform. 2010b;79(6):e89–96.

    Article  PubMed  Google Scholar 

  • Alley S, Jennings C, Plotnikoff RC, Vandelanotte C. Web-based video-coaching to assist an automated computer-tailored physical activity intervention for inactive adults: a randomized controlled trial. J Med Internet Res. 2016;18(8):e223.

    Article  PubMed  PubMed Central  Google Scholar 

  • Alper J. Health literacy and consumer-facing technology: workshop summary. Washington, DC: National Academies Press; 2015.

    Google Scholar 

  • Amer A. Reflections on Bloom’s revised taxonomy. Electron J Res Educ Psychol. [Internet]2006;4(1):213–30.

    Google Scholar 

  • Ancker JS, Kaufman D. Rethinking health numeracy: a multidisciplinary literature review. J Am Med Inform Assoc. 2007;14(6):713–21.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ancker JS, Barrón Y, Rockoff ML, Hauser D, Pichardo M, Szerencsy A, et al. Use of an electronic patient portal among disadvantaged populations. J Gen Intern Med. 2011;26(10):1117–23.

    Article  PubMed  PubMed Central  Google Scholar 

  • Archer N, Fevrier-Thomas U, Lokker C, McKibbon KA, Straus S. Personal health records: a scoping review. J Am Med Inform Assoc. 2011;18(4):515–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Arocha JF, Hoffman-Goetz L. Understanding health and disease and the nature of internet-based health information. In: Patel VL, Arocha JF, Ancker JS, editors. Cognitive informatics in health and biomedicine: understanding and modeling health behaviors. London: Springer; 2017.

    Google Scholar 

  • Atkinson NL, Gold RS. The promise and challenge of eHealth interventions. Am J Health Behav. 2002;26(6):494–503.

    Article  PubMed  Google Scholar 

  • Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38(1):33–42.

    Article  CAS  PubMed  Google Scholar 

  • Baudendistel I, Winkler E, Kamradt M, Längst G, Eckrich F, Heinze O, et al. Personal electronic health records: understanding user requirements and needs in chronic cancer care. J Med Internet Res. 2015;17(5):e121.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bickmore TW, Pfeifer LM, Jack BW, editors. Taking the time to care: empowering low health literacy hospital patients with virtual nurse agents. ACM; 2009.

    Google Scholar 

  • Bickmore TW, Pfeifer LM, Byron D, Forsythe S, Henault LE, Jack BW, et al. Usability of conversational agents by patients with inadequate health literacy: evidence from two clinical trials. J Health Commun. 2010;15(S2):197–210.

    Article  PubMed  Google Scholar 

  • Boulos MNK. Social media and Web 2.0: effect on governance for health. In:Smart governance for health and well-being: the evidence. Copenhagen, Denmark: World Health Organization Regional Office for Europe; 2015. p. 106.

    Google Scholar 

  • Boulos MNK, Tsouros AD, Holopainen A. ‘Social, innovative and smart cities are happy and resilient’: insights from the WHO EURO 2014 International Healthy Cities Conference. Int J Health Geogr. 2015;14(1):1.

    Article  Google Scholar 

  • Catts R, Lau J. Towards information literacy indicators. 2008. http://www.uis.unesco.org/template/pdf/cscl/InfoLit.pdf. http://www.webcitation.org/5w6Keaj6o.

  • Catts R, Lau J. Towards information literacy indicators. UNESCO (United Nations Educational, Scientific and Cultural Organization). Information Society Division Communication and Information Sector UNESCO (ed.). IFAP: Information for All Programme, 2008; Document code: CI.2008/WS/1, Paris. UNESCO.

    Google Scholar 

  • Chan CV, Kaufman DR. A framework for characterizing eHealth literacy demands and barriers. J Med Internet Res. 2011;13(4):e94.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chan CV, Matthews LA, Kaufman DR. A taxonomy characterizing complexity of consumer eHealth literacy. AMIA Annual Symposium Proceedings. San Francisco, CA: AMIA; 2009a. p. 86–90.

    Google Scholar 

  • Chan C, Matthews L, Kaufman D. A taxonomy characterizing complexity of consumer eHealth literacy. American Medical Informatics Association Annual Symposium. San Francisco, CA: AMIA Annu Symp Proc; 2009b. p. 86–90.

    Google Scholar 

  • Chan CV, Mirkovic J, Furniss S, Kaufman DR. eHealth literacy demands and cognitive processes underlying barriers in consumer health information seeking. Knowledge Management E-Learning. 2015;7(4):550–75.

    Google Scholar 

  • Choi J, Bakken S. Web-based education for low-literate parents in Neonatal Intensive Care Unit: development of a website and heuristic evaluation and usability testing. Int J Med Inform. 2010;79(8):565–75.

    Article  PubMed  PubMed Central  Google Scholar 

  • Choi J, Jacelon CS, Kalmakis KA. Web-based, pictograph-formatted discharge instructions for low-literacy older adult after hip-replacement surgery: findings of end-user evaluation of the website. Rehabil Nurs. 2016. doi:10.1002/rnj.274

    Google Scholar 

  • Cimino JJ, Patel VL, Kushniruk AW. The patient clinical information system [PatCIS]: technical solutions for and experience with giving patients access to their electronic medical records. Int J Med Inform. 2002;68(1):113–27.

    Article  PubMed  Google Scholar 

  • Cline RJ, Haynes KM. Consumer health information seeking on the Internet: the state of the art. Health Educ Res. 2001;16(6):671–92.

    Article  CAS  PubMed  Google Scholar 

  • Cole-Lewis H, Kershaw T. Text messaging as a tool for behavior change in disease prevention and management. Epidemiol Rev. 2010;32:56–69.

    Article  PubMed  PubMed Central  Google Scholar 

  • Connolly KK, Crosby ME. Examining e-Health literacy and the digital divide in an underserved population in Hawai’i. Hawai’i J Med Public Health. 2014;73(2):44–8.

    Google Scholar 

  • Coughlin S, Thind H, Liu B, Jacobs M, Champagne N, Massey RI. Mobile phone apps for preventing cancer through educational and behavioral interventions: state of the art and remaining challenges. JMIR Mhealth Uhealth. 2016;4(2):e69.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cugelman B, Thelwall M, Dawes P. Online interventions for social marketing health behavior change campaigns: a meta-analysis of psychological architectures and adherence factors. J Med Internet Res. 2011;13(1):e17.

    Article  PubMed  PubMed Central  Google Scholar 

  • Czaja S, Charness N, Fisk A, Hertzog C, Nair S, Rogers W, et al. Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement [CREATE]. Psychol Aging. 2006;21(2):333.

    Article  PubMed  PubMed Central  Google Scholar 

  • Darkins A, Ryan P, Kobb R, Foster L, Edmonson E, Wakefield B, et al. Care coordination/home telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. Telemed J E Health. 2008;14(10):1118–26.

    Article  PubMed  Google Scholar 

  • Diviani N, van den Putte B, Meppelink CS, van Weert JCM. Exploring the role of health literacy in the evaluation of online health information: insights from a mixed-methods study. Patient Educ Couns. 2016;99:1017–25.

    Article  PubMed  Google Scholar 

  • Eysenbach G. Consumer health informatics. Br Med J. 2000;320(7251):1713–6.

    Article  CAS  Google Scholar 

  • Eysenbach G. What is eHealth. J Med Internet Res. [Internet]2001;3(2):e20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Eysenbach G. Poverty, human development, and the role of eHealth. J Med Internet Res. 2007;9(4):e34.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ferguson MO, Long JA, Zhu J, Small DS, Lawson B, Glick HA, et al. Low health literacy predicts misperceptions of diabetes control in patients with persistently elevated A1C. Diabetes Educ. 2015;41(3):309–19.

    Article  PubMed  Google Scholar 

  • Ford EW, Hesse BW, Huerta TR. Personal health record use in the united states: forecasting future adoption levels. J Med Internet Res. 2016;18(3):e73.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fox S, Duggan M. Health online. Washington, DC: Pew Internet & American Life Project; 2013.

    Google Scholar 

  • Frost J, Massagli M. Social uses of personal health information within PatientsLikeMe, an online patient community: what can happen when patients have access to one another’s data. J Med Internet Res. 2008;10(3):e15.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gee PM, Greenwood DA, Paterniti DA, Ward D, Miller LMS. The eHealth enhanced chronic care model: a theory derivation approach. J Med Internet Res. 2015;17(4):e86.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gibbons MC, Fleisher L, Slamon RE, Bass S, Kandadai V, Beck JR. Exploring the potential of Web 2.0 to address health disparities. J Health Commun. 2011;16(Suppl 1):77–89.

    Article  PubMed  Google Scholar 

  • Gilstad H. Toward a comprehensive model of eHealth literacy. In Proceedings of the 2nd European Workshop on Practical Aspects of Health Informatics. 2014;63–72. Retrieved from. http://ceur-ws.org/Vol-1251/paper7.pdf.

    Google Scholar 

  • Haggstrom DA, Saleem JJ, Russ AL, Jones J, Russell SA, Chumbler NR. Lessons learned from usability testing of the VA’s personal health record. J Am Med Inform Assoc. 2011;18(Supplement 1):i13–i7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hahn EA, Choi SW, Griffith JW, Yost KJ, Baker DW. Health literacy assessment using talking touchscreen technology [Health LiTT]: a new item response theory-based measure of health literacy. J Health Commun. 2011;16(Suppl 3):150–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff. 2013;32(2):207–14.

    Article  Google Scholar 

  • Hilliman CA, Cimino JJ, Lai AM, Kaufman DR, Starren JB, Shea S. The effects of redesigning the IDEATel architecture on glucose uploads. Telemed E Health. 2009;15(3):248–54.

    Article  Google Scholar 

  • Internet World Stats. World Internet users and population stats. 2016. http://www.internetworldstats.com/stats.htm.

  • Janiak E, Rhodes E, Foster AM. Translating access into utilization: lessons from the design and evaluation of a health insurance Web site to promote reproductive health care for young women in Massachusetts. Contraception. 2013;88(6):684–90.

    Article  PubMed  Google Scholar 

  • Jensen JD, King AJ, Davis LA, Guntzviller LM. Utilization of Internet technology by low-income adults the role of health literacy, health numeracy, and computer assistance. J Aging Health. 2010;22(6):804–26.

    Article  PubMed  Google Scholar 

  • Jiménez AL, de León EM, Sims G, Hiraldo-Lebrón CM, Small PJ, Boulos MNK. Leveraging technology for health equity. In:Stigma and prejudice. Switzerland: Springer; 2016. p. 277–301.

    Chapter  Google Scholar 

  • Jones DA. Personal health record task force. J Med Libr Assoc. 2010;98:3.

    Article  Google Scholar 

  • Kamel Boulos MN, Kickbusch I, Pelikan J, Apfel F, Tsouros A. Social media and mobile health (Chapter 13, under Part B: Taking action to create and strengthen health literacy-friendly settings). In:Health literacy: the solid facts. Copenhagen, Denmark: World Health Organization Regional Office for Europe; 2013. p. 63–7.

    Google Scholar 

  • Kaufman DR, Patel VL, Hilliman C, Morin PC, Pevzner J, Weinstock RS, et al. Usability in the real world: assessing medical information technologies in patients’ homes. J Biomed Inform. 2003a;36(1–2):45–60.

    Article  PubMed  Google Scholar 

  • Kaufman D, Starren J, Patel V, Morin P, Hilliman C, Pevzner J, et al., editors. A cognitive framework for understanding barriers to the productive use of a diabetes home telemedicine system. American Medical Informatics Association Annual Symposium. American Medical Informatics Association; 2003b.

    Google Scholar 

  • Kaufman DR, Pevzner J, Hilliman C, Weinstock RS, Teresi J, Shea S, et al. Redesigning a telehealth diabetes management program for a digital divide seniors population. Home Health Care Manag Prac. 2006;18(3):223–34.

    Article  Google Scholar 

  • Kayser L, Kushniruk A, Osborne RH, Norgaard O, Turner P. Enhancing the effectiveness of consumer-focused health information technology systems through eHealth literacy: a framework for understanding users’ needs. JMIR Hum Factors. 2015;2(1):e9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Keselman A. Health information literacy as a tool for addressing adolescent behaviors, knowledge, skills, and academic trajectories. In: Patel VL, Arocha JF, Ancker JS, editors. Cognitive informatics in health and biomedicine: understanding and modeling health behaviors. London: Springer; 2017.

    Google Scholar 

  • Kim H, Xie B, editors. Health literacy and internet-and mobile app-based health services: a systematic review of the literature. ASIST. American Society for Information Science; 2015.

    Google Scholar 

  • Kim E, Stolyar A, Lober W, Herbaugh A, Shinstrom S, Zierler B, et al. Challenges to using an electronic personal health record by a low-income elderly population. J Med Internet Res. [Internet]2009;11(4):e44.

    Article  PubMed  PubMed Central  Google Scholar 

  • Knapp C, Madden V, Wang H, Sloyer P, Shenkman E. Internet use and eHealth literacy of low-income parents whose children have special health care needs. J Med Internet Res. 2011;13(3):e75.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kobayashi LC, Wardle J, von Wagner C. Internet use, social engagement and health literacy decline during ageing in a longitudinal cohort of older English adults. J Epidemiol Commun Health. 2015;69(3):278–283; DOI: 10.1136/jech-2014-204733

    Google Scholar 

  • Koopman RJ, Petroski GF, Canfield SM, Stuppy JA, Mehr DR. Development of the PRE-HIT instrument: patient readiness to engage in health information technology. BMC Fam Pract. 2014;15:18.

    Article  PubMed  PubMed Central  Google Scholar 

  • Korda H, Itani Z. Harnessing social media for health promotion and behavior change. Health Promot Pract. 2013;14(1):15–23.

    Article  PubMed  Google Scholar 

  • Krathwohl DR. A revision of bloom’s taxonomy: an overview. Theory Pract. 2002;41(4):212–8.

    Article  Google Scholar 

  • Krebs P, Prochaska JO, Rossi JS. A meta-analysis of computer-tailored interventions for health behavior change. Prev Med. 2010;51(3):214–21.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kreps GL, Neuhauser L. New directions in eHealth communication: opportunities and challenges. Patient Educ Couns. 2010;78(3):329–36.

    Article  PubMed  Google Scholar 

  • Kreps GL, Sparks L. Meeting the health literacy needs of immigrant populations. Patient Educ Couns. 2008;71(3):328–32.

    Article  PubMed  Google Scholar 

  • Kushniruk A, Turner P, editors. A framework for user involvement and context in the design and development of safe e-Health systems. Stud Health Technol Inform. 2012; 180:353–7.

    Google Scholar 

  • Lai AM, Siek KA. Designing and deploying mobile health interventions. In: Patel VL, Kannampallil TG, Kaufman DR, editors. Cognitive informatics for biomedicine. London: Springer; 2015. p. 279–306.

    Chapter  Google Scholar 

  • Laranjo L, Arguel A, Neves AL, Gallagher AM, Kaplan R, Mortimer N, et al. The influence of social networking sites on health behavior change: a systematic review and meta-analysis. J Am Med Inform Assoc. 2014;22:243–56.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lau AYS, Gabarron E, Fernandez-Luque L, Armayones M. Social media in health—what are the safety concerns for health consumers? Health Inform Manag J. 2012;41(2):30–5.

    Article  Google Scholar 

  • Laugksch RC. Scientific literacy: a conceptual overview. Sci Educ. 2000;84(1):71–94.

    Article  Google Scholar 

  • Maher CA, Lewis LK, Ferrar K, Marshall S, De Bourdeaudhuij I, Vandelanotte C. Are health behavior change interventions that use online social networks effective? A systematic review. J Med Internet Res. 2014;16(2):e40.

    Article  PubMed  PubMed Central  Google Scholar 

  • McCray AT. Promoting Health Literacy. J Am Med Inform Assoc. 2005;12(2):152–63.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meppelink CS, van Weert JCM, Haven CJ, Smit EG. The effectiveness of health animations in audiences with different health literacy levels: an experimental study. J Med Internet Res. 2015;17(1):e11.

    Article  PubMed  PubMed Central  Google Scholar 

  • Metzger MJ, Flanagin AJ. Using Web 2.0 technologies to enhance evidence-based medical information. J Health Commun. 2011;16(Suppl 1):45–58.

    Article  PubMed  Google Scholar 

  • Miyamoto SW, Henderson S, Young HM, Pande A, Han JJ. Tracking health data is not enough: a qualitative exploration of the role of healthcare partnerships and mHealth technology to promote physical activity and to sustain behavior change. JMIR Mhealth Uhealth. 2016;4(1):e5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Monkman H, Kushniruk A. A health literacy and usability heuristic evaluation of a mobile consumer health application. Stud Health Technol Inform. 2013;192:724–8.

    PubMed  Google Scholar 

  • Monkman H, Griffith J, Kushniruk AW. Evidence-based heuristics for evaluating demands on eHealth literacy and usability in a mobile consumer health application. Stud Health Technol Inform. 2015;216:358–62.

    PubMed  Google Scholar 

  • Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A, Hoving C. A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication. J Med Internet Res. 2013;15(4):e85.

    Article  PubMed  PubMed Central  Google Scholar 

  • Morahan-Martin JM. How internet users find, evaluate, and use online health information: a cross-cultural review. Cyberpsychol Behav. 2004;7(5):497–510.

    Article  PubMed  Google Scholar 

  • Murphy PW, Davis TC, Long SW, Jackson RH, Decker BC. Rapid estimate of adult literacy in medicine [REALM]: a quick reading test for patients. J Read. 1993;37:124–30.

    Google Scholar 

  • Murray E. Web-based interventions for behavior change and self-management: potential, pitfalls, and progress. Medicine 20. 2012;1(2):e3.

    Google Scholar 

  • Neter E, Brainin E. eHealth literacy: extending the digital divide to the realm of health information. J Med Internet Res. 2012;14(1):e19.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nielsen-Bohlman L, Panzer AM, Kindig DA. Health literacy: a prescription to end confusion. Washington, DC: National Academies Press; 2004.

    Google Scholar 

  • Noblin AM, Wan TH, Fottler M. The impact of health literacy on a patient’s decision to adopt a personal health record. Perspect Health Inf Manag. 2012;1

    Google Scholar 

  • Norgaard O, Furstrand D, Klokker L, Karnoe A, Batterham R, Kayser L, et al. The e-health literacy framework: a conceptual framework for characterizing e-health users and their interaction with e-health systems. Knowledge Management E-Learning. 2015;7(4):522–40.

    Google Scholar 

  • Norman C. eHealth literacy 2.0: problems and opportunities with an evolving concept. J Med Internet Res. 2011;13(4):e125.

    Article  PubMed  PubMed Central  Google Scholar 

  • Norman CD, Skinner HA. eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res. 2006a;8(2):e9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Norman CD, Skinner HA. eHEALS: the eHealth Literacy Scale. J Med Internet Res. [Internet]. 2006b; 8(4):e27. http://www.jmir.org/2006/4/e27/

    Google Scholar 

  • Oregon Evidence-based Practice Center. Barriers and drivers of health information technology use for the elderly, chronically ill, and underserved. Rockville, MD: Agency for Healthcare Research and Quality; 2008.

    Google Scholar 

  • Pagliari C. Design and evaluation in eHealth: challenges and implications for an interdisciplinary field. J Med Internet Res. 2007;9(2):e15.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pew Research Center. Internet use over time. 2014.

    Google Scholar 

  • Reeder B, David A. Health at hand: a systematic review of smart watch uses for health and wellness. J Biomed Inform. 2016;63:269–76.

    Article  PubMed  Google Scholar 

  • Rudd RE, Moeykens BA, Colton TC. Health and literacy: a review of medical and public health literature. In: Comings J, Garners B, Smith C, editors. Annual review of adult learning and literacy . New York, NY: Jossey-Bass, Inc.; 2000. p. 158–99.1

    Google Scholar 

  • Rudd R, Kirsch I, Yamamoto K. Literacy and health in America. Princeton, NJ: Policy Information Report Educational Testing Service; 2004. p. 52.

    Google Scholar 

  • Sarkar U, Karter AJ, Liu JY, Adler NE, Nguyen R, Lopez A, et al. The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system—results from the Diabetes Study of Northern California [DISTANCE]. J Health Commun. 2010;15(S2):183–96.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al. Association of health literacy with diabetes outcomes. JAMA. 2002;288(4):475–82.

    Article  PubMed  Google Scholar 

  • Sharit J, Hernández M, Czaja S, Pirolli P. Investigating the roles of knowledge and cognitive abilities in older adult information seeking on the Web. ACM Trans Comput Hum Interact. 2008;15(1):3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shea S, Starren J, Weinstock RS, Knudson PE, Teresi J, Holmes D, et al. Columbia University’s Informatics for Diabetes Education and Telemedicine [IDEATel] Project: rationale and design. J Am Med Inform Assoc. 2002;9(1):49–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shea S, Weinstock RS, Teresi JA, Palmas W, Starren J, Cimino JJ, et al. A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus: 5 year results of the IDEATel study. J Am Med Inform Assoc. 2009;16(4):446–56.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12(1):80.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sørensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, et al. Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire [HLS-EU-Q]. BMC Public Health. 2013;13(1):948.

    Article  PubMed  PubMed Central  Google Scholar 

  • Starren J, Hripcsak G, Sengupta S, Abbruscato CR, Knudson PE, Weinstock RS, et al. Columbia University’s Informatics for Diabetes Education and Telemedicine [IDEATel] project: technical implementation. J Am Med Inform Assoc. 2002;9(1):25–36.

    Article  PubMed  PubMed Central  Google Scholar 

  • Starren JB, Nesbitt TS, Chiang MF. Telehealth. In: Shortliffe EH, Cimino JJ, editors. Biomedical informatics. London: Springer; 2014. p. 541–60.

    Chapter  Google Scholar 

  • Subramaniam M, St. Jean B, Taylor NG, Kodama C, Follman R, Casciotti D. Bit by bit: using design-based research to improve the health literacy of adolescents. JMIR Res Protoc. 2015;4(2):e62.

    PubMed  PubMed Central  Google Scholar 

  • Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ. Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. J Am Med Inform Assoc. 2006;13(2):121–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tennant B, Stellefson M, Dodd V, Chaney B, Chaney D, Paige S, et al. eHealth literacy and Web 2.0 health information seeking behaviors among baby boomers and older adults. J Med Internet Res. 2015;17(3):e70.

    Article  PubMed  PubMed Central  Google Scholar 

  • Teolis MG. A MedlinePlus® kiosk promoting health literacy. J Consum Health Internet. 2010;14(2):126–37.

    Article  PubMed  PubMed Central  Google Scholar 

  • Thoman E. Skills and strategies for media education. Educ Leadersh. 1999;56:50–4.

    Google Scholar 

  • Vargas PA, Robles E, Harris J, Radford P. Using information technology to reduce asthma disparities in underserved populations: a pilot study. J Asthma. 2010;47(8):889–94.

    Article  PubMed  PubMed Central  Google Scholar 

  • van Vugt M, de Wit M, Cleijne WH, Snoek FJ. Use of behavioral change techniques in web-based self-management programs for type 2 diabetes patients: systematic review. J Med Internet Res. 2013;15(12):e279.

    Article  PubMed  PubMed Central  Google Scholar 

  • Webb T, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010;12(1):e4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weitzman ER, Kaci L, Mandl KD. Acceptability of a personally controlled health record in a community-based setting: implications for policy and design. J Med Internet Res. 2009;11(2):e14.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wicks P, Massagli M, Frost J, Brownstein C, Okun S, Vaughan T, et al. Sharing health data for better outcomes on PatientsLikeMe. J Med Internet Res. 2010;12(2):e19.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wicks P, Keininger DL, Massagli MP, de la Loge C, Brownstein C, Isojärvi J, et al. Perceived benefits of sharing health data between people with epilepsy on an online platform. Epilepsy Behav. 2012;23(1):16–23.

    Article  PubMed  Google Scholar 

  • Wildevuur SE, Simonse LW. Information and communication technology-enabled person-centered care for the “big five” chronic conditions: scoping review. J Med Internet Res. 2015;17(3):e77.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wootton R. Twenty years of telemedicine in chronic disease management–an evidence synthesis. J Telemed Telecare. 2012;18(4):211–20.

    Article  PubMed  PubMed Central  Google Scholar 

  • World Health Organisation. Health Literacy: the solid facts. Copenhagen: World Health Organisation; 2013.

    Google Scholar 

  • Yamin CK, Emani S, Williams DH, Lipsitz SR, Karson AS, Wald JS, et al. The digital divide in adoption and use of a personal health record. Arch Intern Med. 2011;171(6):568–74.

    Article  PubMed  Google Scholar 

  • Yost KJ, Webster K, Baker DW, Jacobs EA, Anderson A, Hahn EA. Acceptability of the talking touchscreen for health literacy assessment. J Health Commun. 2010;15(S2):80–92.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zeng QT, Tse T. Exploring and developing consumer health vocabularies. J Am Med Inform Assoc. 2006;13(1):24–9.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This work was supported by (1) a grant from the National Institute for Nursing Research (1R21NR010710) awarded to David Kaufman and (2) the Department of Biomedical Informatics at Columbia University. Connie Chan was supported by NLM pre-doctoral fellowship T 15-LM007079.

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Correspondence to David R. Kaufman .

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Kaufman, D.R., Mirkovic, J., Chan, C. (2017). eHealth Literacy as a Mediator of Health Behaviors. In: Patel, V., Arocha, J., Ancker, J. (eds) Cognitive Informatics in Health and Biomedicine. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-319-51732-2_13

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