Department of Communication Studies, University of Iowa.
Department of Communication, University of Findlay.
Health Commun. 2020 Nov;35(12):1435-1446. doi: 10.1080/10410236.2019.1641395. Epub 2019 Jul 22.
Advancements in health information technology (HealthIT) and the electronic exchanges of health information have "revolutionized" health systems in the US. However, adopting technological developments into the healthcare system has the potential to benefit populations with more resources, further exacerbating health status disparities. Efficacious utilization of HealthIT requires eHealth literacy. Although eHealth literacy is comprised of six factors, new research indicates that the components related to technology literacy may be more impactful in eHealth literacy among certain populations (e.g., older populations who shoulder a greater illness-management burden). Recognizing the importance of technology literacy in eHealth literacy across the lifespan, we investigate generational differences in New Communication Technology (NCT) use and eHealth literacy, especially considering how NCT adoption theory might systematically inform scholars' understanding of eHealth literacy. Participants included 525 adults primarily in the Midwestern United States. We found significant differences between generational groups across all variables. We found that UTAUT determinants such as performance expectancy and effort expectancy explained 38% of the variance in eHealth literacy, controlling for age, sex, level of education, and prior online health information seeking. Finally, we engaged with early critiques of UTAUT, finding that when applying UTAUT in voluntary (vs. mandatory) contexts, scholars should reconsider variables previously dismissed, such as attitude. In doing this, we extend UTAUT in three ways: new contexts (voluntary NCT adoption), endogenous theoretical mechanisms (eHealth literacy), and exogenous variables (attitude; lifespan). These findings underscore a need for a targeted approach to improve eHealth literacy and health self-management across generations.
健康信息技术（HealthIT）的进步和健康信息的电子交换“彻底改变”了美国的医疗体系。然而，将技术发展纳入医疗保健系统有可能使资源更多的人群受益，进一步加剧健康状况的差异。有效利用 HealthIT 需要电子健康素养。尽管电子健康素养由六个因素组成，但新的研究表明，与技术素养相关的成分在某些人群（例如，承担更大疾病管理负担的老年人群）的电子健康素养中可能更具影响力。认识到整个生命周期中技术素养在电子健康素养中的重要性，我们调查了新通信技术（NCT）使用和电子健康素养方面的代际差异，特别是考虑到 NCT 采用理论如何系统地为学者对电子健康素养的理解提供信息。参与者主要是来自美国中西部的 525 名成年人。我们发现，在所有变量方面，不同代际群体之间存在显著差异。我们发现，UTAUT 决定因素，如绩效预期和努力预期，在控制年龄、性别、教育水平和先前在线健康信息搜索后，解释了电子健康素养 38%的变化。最后，我们参与了对 UTAUT 的早期批评，发现当在自愿（与强制）环境中应用 UTAUT 时，学者们应该重新考虑以前被忽视的变量，例如态度。通过这样做，我们从三个方面扩展了 UTAUT：新的情境（自愿的 NCT 采用）、内源性理论机制（电子健康素养）和外生变量（态度；生命周期）。这些发现强调需要采取有针对性的方法来提高不同代际的电子健康素养和健康自我管理水平。
