van Deursen Alexander J A M, van Dijk Jan A G M
University of Twente, Department of Media, Communication and Organization, Enschede, Netherlands.
J Med Internet Res. 2011 Apr 29;13(2):e35. doi: 10.2196/jmir.1581.
Despite the amount of online health information, there are several barriers that limit the Internet's adoption as a source of health information. One of these barriers is highlighted in conceptualizations of the digital divide which include the differential possession of Internet skills, or "eHealth literacy". Most measures of Internet skills among populations at large use self-assessments. The research discussed here applies a multifaceted definition of Internet skills and uses actual performance tests.
The purpose of this study was to assess how ready a sample of the general population is for eHealth. More specifically, four types of Internet skills were measured in a performance test in which subjects had to complete health-related assignments on the Internet.
From November 1, 2009, through February 28, 2010, 88 subjects participated in the study. Subjects were randomly selected from a telephone directory. A selective quota sample was used divided over equal subsamples of gender, age, and education. Each subject had to accomplish assignments on the Internet. The Internet skills accounted for were categorized as operational (basic skills to use the Internet), formal (navigation and orientation), information (finding information), and strategic (using the information for personal benefits). The tests took approximately 1.5 hours and were conducted in a University office, making the setting equally new for all. Successful completion and time spent on the assignments-the two main outcomes-were directly measured by the test leader.
The subjects successfully completed an average of 73% (5.8/8) of the operational Internet skill tasks and an average of 73% (2.9/4) of the formal Internet skill tasks. Of the information Internet skills tasks, an average of 50% (1.5/3) was completed successfully and, of the strategic Internet skills tasks, 35% (0.7/2). Only 28% (25/88) of the subjects were able to successfully complete all operational skills tasks, 39% (34/88), all formal skills tasks, 13% (11/88), all information skills tasks, and 20% (18/88), both the strategic skill tasks. The time spent on the assignments varied substantially. Age and education were the most important contributors to the operational and formal Internet skills. Regarding the formal Internet skills, years of Internet experience also had some influence. Educational level of attainment was the most important contributor to the information and strategic Internet skills.
Although the amount of online health-related information and services is consistently growing, it appears that the general population lacks the skills to keep up. Most problematic appear to be the lack of information and strategic Internet skills, which, in the context of health, are very important. The lack of these skills is also problematic for members of younger generations, who are often considered skilled Internet users. This primarily seems to account for the operational and formal Internet skills. The results of the study strongly call for policies to increase the level of Internet skills.
尽管在线健康信息数量众多，但仍存在若干障碍限制了互联网作为健康信息来源的应用。数字鸿沟的概念突出了其中一个障碍，即互联网技能（或“电子健康素养”）的差异拥有情况。大多数针对普通人群互联网技能的衡量采用自我评估。此处讨论的研究采用了多方面的互联网技能定义，并使用实际操作测试。
本研究的目的是评估普通人群样本对电子健康的准备程度。更具体地说，在一项操作测试中测量了四种类型的互联网技能，受试者必须在互联网上完成与健康相关的任务。
从2009年11月1日至2010年2月28日，88名受试者参与了该研究。受试者从电话簿中随机选取。采用选择性配额样本，按性别、年龄和教育程度分为相等的子样本。每个受试者都必须在互联网上完成任务。所涉及的互联网技能分为操作技能（使用互联网的基本技能）、形式技能（导航和定位）、信息技能（查找信息）和策略技能（将信息用于个人利益）。测试大约需要1.5小时，在大学办公室进行，对所有人来说环境都是同样陌生的。测试负责人直接测量了任务的成功完成情况和完成任务所花费的时间这两个主要结果。
受试者平均成功完成了73%（5.8/8）的操作互联网技能任务和73%（2.9/4）的形式互联网技能任务。在信息互联网技能任务中，平均50%（1.5/3）成功完成，在策略互联网技能任务中，35%（0.7/2）成功完成。只有28%（25/88）的受试者能够成功完成所有操作技能任务，39%（34/88）能完成所有形式技能任务，13%（11/88）能完成所有信息技能任务，20%（18/88）能完成策略技能任务。完成任务所花费的时间差异很大。年龄和教育程度是操作和形式互联网技能的最重要影响因素。关于形式互联网技能，互联网使用年限也有一定影响。受教育程度是信息和策略互联网技能的最重要影响因素。
尽管与健康相关的在线信息和服务数量一直在增长，但普通人群似乎缺乏跟上的技能。最成问题的似乎是缺乏信息和策略互联网技能，而在健康背景下，这些技能非常重要。这些技能的缺乏对年轻一代成员来说也存在问题，他们通常被认为是熟练的互联网用户。这主要似乎体现在操作和形式互联网技能方面。研究结果强烈呼吁制定政策提高互联网技能水平。
