Villadsen Sarah Fredsted, Hadi Hajer, Ismail Israa, Osborne Richard H, Ekstrøm Claus Thorn, Kayser Lars
Section of Social Medicine, Department of Public Health, Kobenhavns Universitet, Copenhagen K, Denmark
Section of Social Medicine, Department of Public Health, Kobenhavns Universitet, Copenhagen K, Denmark.
BMJ Open. 2020 May 7;10(5):e037076. doi: 10.1136/bmjopen-2020-037076.
To explore ehealth literacy, ability to actively engage with healthcare providers and health system navigation among pregnant immigrant women and their descendants compared with women of Danish origin.
A cross-sectional survey at antenatal clinics in 2016, Denmark.
Pregnant women attending antenatal care (n=405).
The eHealth Literacy Questionnaire (eHLQ) and two domains from the Health Literacy Questionnaire (HLQ): ability to actively engage with healthcare providers and health system navigation. Range of response options for eHLQ (1-4) and HLQ (1-5). With mixed-effect linear regressions, eHLQ and HLQ among immigrants and their descendants compared with women of Danish origin were assessed.
The response rate was 75%. The overall trend was lower ehealth literacy and HLQ domains among immigrants and their descendants compared with women of Danish origin. For ehealth literacy, the results suggest that challenges related more to digital abilities than motivation, trust and access to technology. The mean ability to engage with digital services was 3.20 (SD 0.44) for women of Danish origin. Non-Western descendants (-0.14, 95% CI -0.31 to 0.02), non-Western (-0.20, 95% CI -0.34 to -0.06) and Western (-0.22, 95% CI -0.39 to -0.06) immigrants had lower adjusted means of this outcome. No differences in motivation to engage with digital services were found for descendants (-0.00, 95% CI -0.17 to 0.17), non-Western (0.03, 95% CI -0.11 to 0.18) or Western (-0.06, 95% CI -0.23 to 0.10) immigrants compared with the mean of the reference (2.85, SD 0.45). Lower ability to engage with healthcare providers was found for non-Western born immigrants (-0.15, CI 95% -0.30 to -0.01) compared with the mean of women with Danish origin (4.15, SD 0.47).
Generally, descendant and immigrant women had lower levels of ehealth literacy and health literacy than women of Danish origin. These differences are potentially antecedents of adverse birth outcomes and could inform structural efforts to mitigate health inequalities.
探讨与丹麦裔女性相比，怀孕的移民妇女及其后代的电子健康素养、与医疗服务提供者积极互动的能力以及健康系统导航能力。
2016年在丹麦产前诊所进行的一项横断面调查。
参加产前护理的孕妇（n = 405）。
电子健康素养问卷（eHLQ）以及健康素养问卷（HLQ）的两个领域：与医疗服务提供者积极互动的能力和健康系统导航能力。eHLQ（1 - 4）和HLQ（1 - 5）的回答选项范围。通过混合效应线性回归，评估移民及其后代与丹麦裔女性相比的eHLQ和HLQ。
回复率为75%。总体趋势是，与丹麦裔女性相比，移民及其后代的电子健康素养和HLQ领域得分较低。对于电子健康素养，结果表明挑战更多地与数字能力相关，而非动机、信任和技术获取。丹麦裔女性使用数字服务的平均能力为3.20（标准差0.44）。非西方后裔（-0.14，95%置信区间-0.31至0.02）、非西方（-0.20，95%置信区间-0.34至-0.06）和西方（-0.22，95%置信区间-0.39至-0.06）移民在这一结果上的调整后均值较低。与对照组均值（2.85，标准差0.45）相比，后裔（-0.00，95%置信区间-0.17至0.17）、非西方（0.03，95%置信区间-0.11至0.18）或西方（-0.06，95%置信区间-0.23至0.10）移民在使用数字服务的动机方面未发现差异。与丹麦裔女性均值（4.15，标准差0.47）相比，非西方出生的移民与医疗服务提供者互动的能力较低（-0.15，95%置信区间-0.30至-0.01）。
总体而言，后裔和移民妇女的电子健康素养和健康素养水平低于丹麦裔女性。这些差异可能是不良出生结局的先兆，并可为减轻健康不平等的结构性努力提供参考。
