Smoła Paulina, Zwierczyk Urszula, Duplaga Mariusz
Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
Front Digit Health. 2024 Nov 22;6:1458650. doi: 10.3389/fdgth.2024.1458650. eCollection 2024.
The transactional model of e-health literacy addresses not only the skills needed for handling online health-related information but also the capacity to communicate regarding health issues on the Internet. It also emphasizes a critical component of e-health literacy: enabling appraisal and selection of information adequate to individual needs. Our study aimed to culturally adapt the instrument assessingTransactional e-Health Literacy (TeHL) and examine the association between TeHL and the use of e-health services by Polish adult Internet users.
The analysis was conducted on data from an online survey among 1,661 respondents. After cultural adaptation and piloting of the Polish version of the instrument measuring TeHL, exploratory and confirmatory factor analyses were performed on two samples obtained by random splitting of the original data set. The roles of TeHL categories in the use of several types of e-health services were assessed with multivariable logistic regression models.
We have found that the four-factor model of the Polish version of the TeHL instrument, consisting of 17 items, obtained after excluding item 13, shows the best fit to the measurement data (NFI = 0.950, RFI 0.938, TLI = 0.951, CFI = 0.960, GFI = 0.932, RMSEA = 0.066). Regression modeling revealed that Functional e-health literacy is a significant positive predictor of the use of remote physician advice, the Internet Patient Account Portal, portals providing general health-related information, and websites allowing for checking laboratory test results. Communicative eHL was significantly negatively related to the use of general health-related information portals and positively related to the use of portals offering paid medical advice. Critical e-health literacy was a significant negative predictor of the use of remote physician advice and the laboratory test results websites but a positive predictor of using portals offering paid medical advice and websites offering easy access to e-prescriptions. Finally, Translational e-health literacy was significantly positively associated with the use of the Internet Patient Account Portal, general health-related information portals, and laboratory test results websites.
Polish version of the instrument assessing TeHL is a tool of confirmed validity that can be used for e-health research in Poland. The relationships between four types of TeHL and the use of concrete e-health solutions show a complex pattern requiring further evaluation.
电子健康素养的交互模型不仅涉及处理在线健康相关信息所需的技能，还包括在互联网上就健康问题进行沟通的能力。它还强调了电子健康素养的一个关键组成部分：能够评估和选择符合个人需求的信息。我们的研究旨在对评估交易型电子健康素养（TeHL）的工具进行文化适应性调整，并研究波兰成年互联网用户的TeHL与电子健康服务使用之间的关联。
对1661名受访者的在线调查数据进行分析。在对测量TeHL的工具的波兰语版本进行文化适应性调整和预试验后，对通过随机分割原始数据集获得的两个样本进行探索性和验证性因素分析。使用多变量逻辑回归模型评估TeHL类别在几种类型的电子健康服务使用中的作用。
我们发现，波兰语版TeHL工具的四因素模型（由17个项目组成，排除项目13后）与测量数据拟合最佳（NFI = 0.950，RFI = 0.938，TLI = 0.951，CFI = 0.960，GFI = 0.932，RMSEA = 0.066）。回归建模显示，功能性电子健康素养是使用远程医生建议、互联网患者账户门户、提供一般健康相关信息的门户以及允许查看实验室检查结果的网站的显著正向预测因素。沟通性电子健康素养与使用一般健康相关信息门户显著负相关，与使用提供付费医疗建议的门户显著正相关。批判性电子健康素养是使用远程医生建议和实验室检查结果网站的显著负向预测因素，但却是使用提供付费医疗建议的门户和提供便捷电子处方访问的网站的正向预测因素。最后，转化性电子健康素养与使用互联网患者账户门户、一般健康相关信息门户和实验室检查结果网站显著正相关。
评估TeHL的波兰语版工具是一种经过验证有效的工具，可用于波兰的电子健康研究。四种类型的TeHL与具体电子健康解决方案的使用之间的关系呈现出复杂的模式，需要进一步评估。
