Mertens Lien, Dewitte Harrie, Seuntjens Lieve, Vanobberghen Rita, Aertgeerts Bert
Department of Family Medicine and Primary Care, University of Leuven (KULeuven), Belgium.
Department of Family Medicine and Primary Care, University of Antwerp (UAntwerpen), Belgium.
PEC Innov. 2022 Jun 12;1:100056. doi: 10.1016/j.pecinn.2022.100056. eCollection 2022 Dec.
We aimed to investigate whether the use of an e-health tool, guided by a healthcare provider, can improve health literacy (HL) in primary care.
We set up a longitudinal prospective cohort study in a primary care clinic in Brussels. Diabetes patients were invited to participate in two study consultations with a trained healthcare provider, in which an e-health tool was introduced. The (HLQ) was used to evaluate HL before (n = 59) and after intervention (n = 41). The data were analysed within SPSS, Version 26. Additionally, impressions and experiences of both patients and healthcare providers were collected throughout the different phases of the study.
Patients feel significantly stronger in finding good health information after intervention (p = 0.041), with relatively stronger progress for the subgroup with weaker digital skills (p = 0.029). Participants also declare understanding health information better after intervention (p = 0.050). Specifically, the lower educated participants feel reinforced to correctly evaluate and assess health information and come closer to the skill level of the higher educated patients after intervention. The relationship with the healthcare provider was also more markedly enhanced within the group of the lower educated (p = 0.008; difference between higher and lower educated), which could strengthen self-management in the long run.
The guided use of an e-health tool in primary care strengthens various patient HL skills. Most particularly the skills "the ability to find good health information" and "understand health information well enough to know what to do" are reinforced. Moreover, patient populations with lower HL, such as the lower educated and lower digitally skilled, show a greater learning potential.
Our results offer further proof for the learnable and flexible nature of HL, and show that even a small e-health intervention, in a very diverse patient population, can produce significant, positive effects on HL. These results need to be considered as promising, and a motivation for further investments in more widely accessible e-health tools to further improve HL at population level and to bridge health differences.
我们旨在调查在医疗保健提供者的指导下使用电子健康工具是否可以提高初级保健中的健康素养（HL）。
我们在布鲁塞尔的一家初级保健诊所开展了一项纵向前瞻性队列研究。邀请糖尿病患者与经过培训的医疗保健提供者进行两次研究咨询，期间引入了一种电子健康工具。使用健康素养问卷（HLQ）在干预前（n = 59）和干预后（n = 41）评估健康素养。数据在SPSS 26版本中进行分析。此外，在研究的不同阶段收集了患者和医疗保健提供者的印象和体验。
干预后患者在寻找优质健康信息方面的信心显著增强（p = 0.041），数字技能较弱的亚组进展相对更大（p = 0.029）。参与者还宣称干预后对健康信息的理解更好（p = 0.050）。具体而言，受教育程度较低的参与者在干预后更有信心正确评估和判断健康信息，并接近受教育程度较高患者的技能水平。在受教育程度较低的人群中，与医疗保健提供者的关系也得到了更显著的改善（p = 0.008；高学历与低学历之间的差异），从长远来看这可能会加强自我管理。
在初级保健中指导使用电子健康工具可增强患者的多种健康素养技能。尤其是“找到优质健康信息的能力”和“充分理解健康信息以知道该怎么做”这两项技能得到了加强。此外，健康素养较低的患者群体，如受教育程度较低和数字技能较差的人群，显示出更大的学习潜力。
我们的结果为健康素养的可学习性和灵活性提供了进一步的证据，并表明即使是在非常多样化的患者群体中进行的小型电子健康干预，也可以对健康素养产生显著的积极影响。这些结果应被视为很有前景，并激励进一步投资于更易于获取的电子健康工具，以在人群层面进一步提高健康素养并缩小健康差距。
