Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 30, 2020
Date Accepted: Oct 26, 2020
Date Submitted to PubMed: Oct 27, 2020
Relationship between levels of digital health literacy based on the Taiwan Digital Health Literacy Assessment and accurate assessment of online health information: : Cross-Sectional Questionnaire Study
ABSTRACT
Background:
Literatures have distinguished that although the public search for health information on the Internet without verifying, the messages spread. Whether the public has the ability to determine the credibility of Internet health information is a perplexing question.
Objective:
This study used the eHealth Literacy Scale (eHEALS) that evaluates digital health literacy to understand its ability to identify correct Internet health information.
Methods:
eHEALS was translated and localized into a Taiwanese cultural traditional Chinese version—Taiwan-eHEALS (Tw-eHEALS). Simultaneously, a health knowledge question bank was constructed to determine the accuracy of the health information. The study subjects were adult Taiwanese residents aged ≥20 years. Snowball sampling was employed, and Internet questionnaires were anonymously completed by the subjects. Based on the accuracy of results from the health knowledge question bank, receiver operating characteristic curve analysis was used to classify the Tw-eHEALS score results into low, medium, and high risk of misjudging health information to understand the relationship between digital health literacy and the ability to determine the credibility of Internet health information. Logistic regression was used to analyze factors associated with risk levels of digital health literacy, and linear regression was used to analyze factors associated with health literacy.
Results:
There were 1,588 valid questionnaires in this study. Logistic regression analysis showed that regardless of the comparison between high-risk subjects and medium- or low-risk subjects, subjects with a high risk of misjudging health information had a lower education level, lower income, and poor self-perceived health and that these subjects did not or rarely browsed the Internet; these differences were statistically significant. Subjects with low digital health literacy were men, older, had a lower education level, worked as laborers, had low income, worked in non-medical fields, did not or rarely browse the Internet, and had poor self-perceived health; these differences were statistically significant.
Conclusions:
This study showed Tw-eHEALS can be used to test the ability to determine the credibility of Internet health information. Study results recommended that the ability to correctly determine health information be improved and the careful use of health information should be promoted in older people, people with low education levels, low income, those who do not or rarely browse the Internet, and those who have poor self-perceived health to increase their digital health literacy. Tw-eHEALS can be used in the future in medical decision or health knowledge platforms to screen for the user’s ability to discriminate Internet health information.
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