Advertisement

eHealth Literacy as a Mediator of Health Behaviors

  • David R. KaufmanEmail author
  • Jelena Mirkovic
  • Connie Chan
Chapter
Part of the Health Informatics book series (HI)

Abstract

eHealth literacy names a set of core literacies involved in the meaningful and productive use of health technologies. In this chapter, we present an integrative theoretical and methodological cognitive framework for elucidating the nature of these barriers and for fashioning design solutions. The Chan–Kaufman analytic framework differs from other frameworks in that the goals are to develop a diagnostic approach rather than a screening tool. The framework can be used to classify task demands and characterize the barriers encountered in users’ task performance. The methods are illustrated in the context of a health information seeking problem. We then review the research pertaining to the challenges in each of the consumer health domains including information seeking, patient portals, mHealth, social media, and telemedicine. The chapter discusses implications that need to be addressed when developing new health related programs and tools. eHealth tools afford an almost infinite number of new means to achieve health behavior change in the promotion of wellness and in the monitoring and management of chronic illness. The essential question is how do we tune these technologies such that they better address the needs of patients and health consumers at varying levels of eHealth literacy.

Keywords

eHealth literacy Health behavior change Digital divide Task-analytic framework Cognitive complexity Health information seeking Patient portals Social media mHealth Telemedicine 

Notes

Acknowledgements

This work was supported by (1) a grant from the National Institute for Nursing Research (1R21NR010710) awarded to David Kaufman and (2) the Department of Biomedical Informatics at Columbia University. Connie Chan was supported by NLM pre-doctoral fellowship T 15-LM007079.

References

  1. Adams SA. Revisiting the online health information reliability debate in the wake of “web 2.0”: an inter-disciplinary literature and website review. Int J Med Inform. 2010a;79(6):391–400.PubMedCrossRefGoogle Scholar
  2. Adams SA. Blog-based applications and health information: two case studies that illustrate important questions for Consumer Health Informatics [CHI] research. Int J Med Inform. 2010b;79(6):e89–96.PubMedCrossRefGoogle Scholar
  3. Alley S, Jennings C, Plotnikoff RC, Vandelanotte C. Web-based video-coaching to assist an automated computer-tailored physical activity intervention for inactive adults: a randomized controlled trial. J Med Internet Res. 2016;18(8):e223.PubMedPubMedCentralCrossRefGoogle Scholar
  4. Alper J. Health literacy and consumer-facing technology: workshop summary. Washington, DC: National Academies Press; 2015.Google Scholar
  5. Amer A. Reflections on Bloom’s revised taxonomy. Electron J Res Educ Psychol. [Internet]2006;4(1):213–30.Google Scholar
  6. Ancker JS, Kaufman D. Rethinking health numeracy: a multidisciplinary literature review. J Am Med Inform Assoc. 2007;14(6):713–21.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Ancker JS, Barrón Y, Rockoff ML, Hauser D, Pichardo M, Szerencsy A, et al. Use of an electronic patient portal among disadvantaged populations. J Gen Intern Med. 2011;26(10):1117–23.PubMedPubMedCentralCrossRefGoogle Scholar
  8. Archer N, Fevrier-Thomas U, Lokker C, McKibbon KA, Straus S. Personal health records: a scoping review. J Am Med Inform Assoc. 2011;18(4):515–22.PubMedPubMedCentralCrossRefGoogle Scholar
  9. Arocha JF, Hoffman-Goetz L. Understanding health and disease and the nature of internet-based health information. In: Patel VL, Arocha JF, Ancker JS, editors. Cognitive informatics in health and biomedicine: understanding and modeling health behaviors. London: Springer; 2017.Google Scholar
  10. Atkinson NL, Gold RS. The promise and challenge of eHealth interventions. Am J Health Behav. 2002;26(6):494–503.PubMedCrossRefGoogle Scholar
  11. Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38(1):33–42.PubMedCrossRefGoogle Scholar
  12. Baudendistel I, Winkler E, Kamradt M, Längst G, Eckrich F, Heinze O, et al. Personal electronic health records: understanding user requirements and needs in chronic cancer care. J Med Internet Res. 2015;17(5):e121.PubMedPubMedCentralCrossRefGoogle Scholar
  13. Bickmore TW, Pfeifer LM, Jack BW, editors. Taking the time to care: empowering low health literacy hospital patients with virtual nurse agents. ACM; 2009.Google Scholar
  14. Bickmore TW, Pfeifer LM, Byron D, Forsythe S, Henault LE, Jack BW, et al. Usability of conversational agents by patients with inadequate health literacy: evidence from two clinical trials. J Health Commun. 2010;15(S2):197–210.PubMedCrossRefGoogle Scholar
  15. Boulos MNK. Social media and Web 2.0: effect on governance for health. In:Smart governance for health and well-being: the evidence. Copenhagen, Denmark: World Health Organization Regional Office for Europe; 2015. p. 106.Google Scholar
  16. Boulos MNK, Tsouros AD, Holopainen A. ‘Social, innovative and smart cities are happy and resilient’: insights from the WHO EURO 2014 International Healthy Cities Conference. Int J Health Geogr. 2015;14(1):1.CrossRefGoogle Scholar
  17. Catts R, Lau J. Towards information literacy indicators. 2008. http://www.uis.unesco.org/template/pdf/cscl/InfoLit.pdf. http://www.webcitation.org/5w6Keaj6o.
  18. Catts R, Lau J. Towards information literacy indicators. UNESCO (United Nations Educational, Scientific and Cultural Organization). Information Society Division Communication and Information Sector UNESCO (ed.). IFAP: Information for All Programme, 2008; Document code: CI.2008/WS/1, Paris. UNESCO.Google Scholar
  19. Chan CV, Kaufman DR. A framework for characterizing eHealth literacy demands and barriers. J Med Internet Res. 2011;13(4):e94.PubMedPubMedCentralCrossRefGoogle Scholar
  20. Chan CV, Matthews LA, Kaufman DR. A taxonomy characterizing complexity of consumer eHealth literacy. AMIA Annual Symposium Proceedings. San Francisco, CA: AMIA; 2009a. p. 86–90.Google Scholar
  21. Chan C, Matthews L, Kaufman D. A taxonomy characterizing complexity of consumer eHealth literacy. American Medical Informatics Association Annual Symposium. San Francisco, CA: AMIA Annu Symp Proc; 2009b. p. 86–90.Google Scholar
  22. Chan CV, Mirkovic J, Furniss S, Kaufman DR. eHealth literacy demands and cognitive processes underlying barriers in consumer health information seeking. Knowledge Management E-Learning. 2015;7(4):550–75.Google Scholar
  23. Choi J, Bakken S. Web-based education for low-literate parents in Neonatal Intensive Care Unit: development of a website and heuristic evaluation and usability testing. Int J Med Inform. 2010;79(8):565–75.PubMedPubMedCentralCrossRefGoogle Scholar
  24. Choi J, Jacelon CS, Kalmakis KA. Web-based, pictograph-formatted discharge instructions for low-literacy older adult after hip-replacement surgery: findings of end-user evaluation of the website. Rehabil Nurs. 2016. doi:10.1002/rnj.274 Google Scholar
  25. Cimino JJ, Patel VL, Kushniruk AW. The patient clinical information system [PatCIS]: technical solutions for and experience with giving patients access to their electronic medical records. Int J Med Inform. 2002;68(1):113–27.PubMedCrossRefGoogle Scholar
  26. Cline RJ, Haynes KM. Consumer health information seeking on the Internet: the state of the art. Health Educ Res. 2001;16(6):671–92.PubMedCrossRefGoogle Scholar
  27. Cole-Lewis H, Kershaw T. Text messaging as a tool for behavior change in disease prevention and management. Epidemiol Rev. 2010;32:56–69.PubMedPubMedCentralCrossRefGoogle Scholar
  28. Connolly KK, Crosby ME. Examining e-Health literacy and the digital divide in an underserved population in Hawai’i. Hawai’i J Med Public Health. 2014;73(2):44–8.Google Scholar
  29. Coughlin S, Thind H, Liu B, Jacobs M, Champagne N, Massey RI. Mobile phone apps for preventing cancer through educational and behavioral interventions: state of the art and remaining challenges. JMIR Mhealth Uhealth. 2016;4(2):e69.PubMedPubMedCentralCrossRefGoogle Scholar
  30. Cugelman B, Thelwall M, Dawes P. Online interventions for social marketing health behavior change campaigns: a meta-analysis of psychological architectures and adherence factors. J Med Internet Res. 2011;13(1):e17.PubMedPubMedCentralCrossRefGoogle Scholar
  31. Czaja S, Charness N, Fisk A, Hertzog C, Nair S, Rogers W, et al. Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement [CREATE]. Psychol Aging. 2006;21(2):333.PubMedPubMedCentralCrossRefGoogle Scholar
  32. Darkins A, Ryan P, Kobb R, Foster L, Edmonson E, Wakefield B, et al. Care coordination/home telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. Telemed J E Health. 2008;14(10):1118–26.PubMedCrossRefGoogle Scholar
  33. Diviani N, van den Putte B, Meppelink CS, van Weert JCM. Exploring the role of health literacy in the evaluation of online health information: insights from a mixed-methods study. Patient Educ Couns. 2016;99:1017–25.PubMedCrossRefGoogle Scholar
  34. Eysenbach G. Consumer health informatics. Br Med J. 2000;320(7251):1713–6.CrossRefGoogle Scholar
  35. Eysenbach G. What is eHealth. J Med Internet Res. [Internet]2001;3(2):e20.PubMedPubMedCentralCrossRefGoogle Scholar
  36. Eysenbach G. Poverty, human development, and the role of eHealth. J Med Internet Res. 2007;9(4):e34.PubMedPubMedCentralCrossRefGoogle Scholar
  37. Ferguson MO, Long JA, Zhu J, Small DS, Lawson B, Glick HA, et al. Low health literacy predicts misperceptions of diabetes control in patients with persistently elevated A1C. Diabetes Educ. 2015;41(3):309–19.PubMedCrossRefGoogle Scholar
  38. Ford EW, Hesse BW, Huerta TR. Personal health record use in the united states: forecasting future adoption levels. J Med Internet Res. 2016;18(3):e73.PubMedPubMedCentralCrossRefGoogle Scholar
  39. Fox S, Duggan M. Health online. Washington, DC: Pew Internet & American Life Project; 2013.Google Scholar
  40. Frost J, Massagli M. Social uses of personal health information within PatientsLikeMe, an online patient community: what can happen when patients have access to one another’s data. J Med Internet Res. 2008;10(3):e15.PubMedPubMedCentralCrossRefGoogle Scholar
  41. Gee PM, Greenwood DA, Paterniti DA, Ward D, Miller LMS. The eHealth enhanced chronic care model: a theory derivation approach. J Med Internet Res. 2015;17(4):e86.PubMedPubMedCentralCrossRefGoogle Scholar
  42. Gibbons MC, Fleisher L, Slamon RE, Bass S, Kandadai V, Beck JR. Exploring the potential of Web 2.0 to address health disparities. J Health Commun. 2011;16(Suppl 1):77–89.PubMedCrossRefGoogle Scholar
  43. Gilstad H. Toward a comprehensive model of eHealth literacy. In Proceedings of the 2nd European Workshop on Practical Aspects of Health Informatics. 2014;63–72. Retrieved from. http://ceur-ws.org/Vol-1251/paper7.pdf.Google Scholar
  44. Haggstrom DA, Saleem JJ, Russ AL, Jones J, Russell SA, Chumbler NR. Lessons learned from usability testing of the VA’s personal health record. J Am Med Inform Assoc. 2011;18(Supplement 1):i13–i7.PubMedPubMedCentralCrossRefGoogle Scholar
  45. Hahn EA, Choi SW, Griffith JW, Yost KJ, Baker DW. Health literacy assessment using talking touchscreen technology [Health LiTT]: a new item response theory-based measure of health literacy. J Health Commun. 2011;16(Suppl 3):150–62.PubMedPubMedCentralCrossRefGoogle Scholar
  46. Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff. 2013;32(2):207–14.CrossRefGoogle Scholar
  47. Hilliman CA, Cimino JJ, Lai AM, Kaufman DR, Starren JB, Shea S. The effects of redesigning the IDEATel architecture on glucose uploads. Telemed E Health. 2009;15(3):248–54.CrossRefGoogle Scholar
  48. Internet World Stats. World Internet users and population stats. 2016. http://www.internetworldstats.com/stats.htm.
  49. Janiak E, Rhodes E, Foster AM. Translating access into utilization: lessons from the design and evaluation of a health insurance Web site to promote reproductive health care for young women in Massachusetts. Contraception. 2013;88(6):684–90.PubMedCrossRefGoogle Scholar
  50. Jensen JD, King AJ, Davis LA, Guntzviller LM. Utilization of Internet technology by low-income adults the role of health literacy, health numeracy, and computer assistance. J Aging Health. 2010;22(6):804–26.PubMedCrossRefGoogle Scholar
  51. Jiménez AL, de León EM, Sims G, Hiraldo-Lebrón CM, Small PJ, Boulos MNK. Leveraging technology for health equity. In:Stigma and prejudice. Switzerland: Springer; 2016. p. 277–301.CrossRefGoogle Scholar
  52. Jones DA. Personal health record task force. J Med Libr Assoc. 2010;98:3.CrossRefGoogle Scholar
  53. Kamel Boulos MN, Kickbusch I, Pelikan J, Apfel F, Tsouros A. Social media and mobile health (Chapter 13, under Part B: Taking action to create and strengthen health literacy-friendly settings). In:Health literacy: the solid facts. Copenhagen, Denmark: World Health Organization Regional Office for Europe; 2013. p. 63–7.Google Scholar
  54. Kaufman DR, Patel VL, Hilliman C, Morin PC, Pevzner J, Weinstock RS, et al. Usability in the real world: assessing medical information technologies in patients’ homes. J Biomed Inform. 2003a;36(1–2):45–60.PubMedCrossRefGoogle Scholar
  55. Kaufman D, Starren J, Patel V, Morin P, Hilliman C, Pevzner J, et al., editors. A cognitive framework for understanding barriers to the productive use of a diabetes home telemedicine system. American Medical Informatics Association Annual Symposium. American Medical Informatics Association; 2003b.Google Scholar
  56. Kaufman DR, Pevzner J, Hilliman C, Weinstock RS, Teresi J, Shea S, et al. Redesigning a telehealth diabetes management program for a digital divide seniors population. Home Health Care Manag Prac. 2006;18(3):223–34.CrossRefGoogle Scholar
  57. Kayser L, Kushniruk A, Osborne RH, Norgaard O, Turner P. Enhancing the effectiveness of consumer-focused health information technology systems through eHealth literacy: a framework for understanding users’ needs. JMIR Hum Factors. 2015;2(1):e9.PubMedPubMedCentralCrossRefGoogle Scholar
  58. Keselman A. Health information literacy as a tool for addressing adolescent behaviors, knowledge, skills, and academic trajectories. In: Patel VL, Arocha JF, Ancker JS, editors. Cognitive informatics in health and biomedicine: understanding and modeling health behaviors. London: Springer; 2017.Google Scholar
  59. Kim H, Xie B, editors. Health literacy and internet-and mobile app-based health services: a systematic review of the literature. ASIST. American Society for Information Science; 2015.Google Scholar
  60. Kim E, Stolyar A, Lober W, Herbaugh A, Shinstrom S, Zierler B, et al. Challenges to using an electronic personal health record by a low-income elderly population. J Med Internet Res. [Internet]2009;11(4):e44.PubMedPubMedCentralCrossRefGoogle Scholar
  61. Knapp C, Madden V, Wang H, Sloyer P, Shenkman E. Internet use and eHealth literacy of low-income parents whose children have special health care needs. J Med Internet Res. 2011;13(3):e75.PubMedPubMedCentralCrossRefGoogle Scholar
  62. Kobayashi LC, Wardle J, von Wagner C. Internet use, social engagement and health literacy decline during ageing in a longitudinal cohort of older English adults. J Epidemiol Commun Health. 2015;69(3):278–283; DOI: 10.1136/jech-2014-204733 Google Scholar
  63. Koopman RJ, Petroski GF, Canfield SM, Stuppy JA, Mehr DR. Development of the PRE-HIT instrument: patient readiness to engage in health information technology. BMC Fam Pract. 2014;15:18.PubMedPubMedCentralCrossRefGoogle Scholar
  64. Korda H, Itani Z. Harnessing social media for health promotion and behavior change. Health Promot Pract. 2013;14(1):15–23.PubMedCrossRefGoogle Scholar
  65. Krathwohl DR. A revision of bloom’s taxonomy: an overview. Theory Pract. 2002;41(4):212–8.CrossRefGoogle Scholar
  66. Krebs P, Prochaska JO, Rossi JS. A meta-analysis of computer-tailored interventions for health behavior change. Prev Med. 2010;51(3):214–21.PubMedPubMedCentralCrossRefGoogle Scholar
  67. Kreps GL, Neuhauser L. New directions in eHealth communication: opportunities and challenges. Patient Educ Couns. 2010;78(3):329–36.PubMedCrossRefGoogle Scholar
  68. Kreps GL, Sparks L. Meeting the health literacy needs of immigrant populations. Patient Educ Couns. 2008;71(3):328–32.PubMedCrossRefGoogle Scholar
  69. Kushniruk A, Turner P, editors. A framework for user involvement and context in the design and development of safe e-Health systems. Stud Health Technol Inform. 2012; 180:353–7.Google Scholar
  70. Lai AM, Siek KA. Designing and deploying mobile health interventions. In: Patel VL, Kannampallil TG, Kaufman DR, editors. Cognitive informatics for biomedicine. London: Springer; 2015. p. 279–306.CrossRefGoogle Scholar
  71. Laranjo L, Arguel A, Neves AL, Gallagher AM, Kaplan R, Mortimer N, et al. The influence of social networking sites on health behavior change: a systematic review and meta-analysis. J Am Med Inform Assoc. 2014;22:243–56.PubMedPubMedCentralCrossRefGoogle Scholar
  72. Lau AYS, Gabarron E, Fernandez-Luque L, Armayones M. Social media in health—what are the safety concerns for health consumers? Health Inform Manag J. 2012;41(2):30–5.CrossRefGoogle Scholar
  73. Laugksch RC. Scientific literacy: a conceptual overview. Sci Educ. 2000;84(1):71–94.CrossRefGoogle Scholar
  74. Maher CA, Lewis LK, Ferrar K, Marshall S, De Bourdeaudhuij I, Vandelanotte C. Are health behavior change interventions that use online social networks effective? A systematic review. J Med Internet Res. 2014;16(2):e40.PubMedPubMedCentralCrossRefGoogle Scholar
  75. McCray AT. Promoting Health Literacy. J Am Med Inform Assoc. 2005;12(2):152–63.PubMedPubMedCentralCrossRefGoogle Scholar
  76. Meppelink CS, van Weert JCM, Haven CJ, Smit EG. The effectiveness of health animations in audiences with different health literacy levels: an experimental study. J Med Internet Res. 2015;17(1):e11.PubMedPubMedCentralCrossRefGoogle Scholar
  77. Metzger MJ, Flanagin AJ. Using Web 2.0 technologies to enhance evidence-based medical information. J Health Commun. 2011;16(Suppl 1):45–58.PubMedCrossRefGoogle Scholar
  78. Miyamoto SW, Henderson S, Young HM, Pande A, Han JJ. Tracking health data is not enough: a qualitative exploration of the role of healthcare partnerships and mHealth technology to promote physical activity and to sustain behavior change. JMIR Mhealth Uhealth. 2016;4(1):e5.PubMedPubMedCentralCrossRefGoogle Scholar
  79. Monkman H, Kushniruk A. A health literacy and usability heuristic evaluation of a mobile consumer health application. Stud Health Technol Inform. 2013;192:724–8.PubMedGoogle Scholar
  80. Monkman H, Griffith J, Kushniruk AW. Evidence-based heuristics for evaluating demands on eHealth literacy and usability in a mobile consumer health application. Stud Health Technol Inform. 2015;216:358–62.PubMedGoogle Scholar
  81. Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A, Hoving C. A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication. J Med Internet Res. 2013;15(4):e85.PubMedPubMedCentralCrossRefGoogle Scholar
  82. Morahan-Martin JM. How internet users find, evaluate, and use online health information: a cross-cultural review. Cyberpsychol Behav. 2004;7(5):497–510.PubMedCrossRefGoogle Scholar
  83. Murphy PW, Davis TC, Long SW, Jackson RH, Decker BC. Rapid estimate of adult literacy in medicine [REALM]: a quick reading test for patients. J Read. 1993;37:124–30.Google Scholar
  84. Murray E. Web-based interventions for behavior change and self-management: potential, pitfalls, and progress. Medicine 20. 2012;1(2):e3.Google Scholar
  85. Neter E, Brainin E. eHealth literacy: extending the digital divide to the realm of health information. J Med Internet Res. 2012;14(1):e19.PubMedPubMedCentralCrossRefGoogle Scholar
  86. Nielsen-Bohlman L, Panzer AM, Kindig DA. Health literacy: a prescription to end confusion. Washington, DC: National Academies Press; 2004.Google Scholar
  87. Noblin AM, Wan TH, Fottler M. The impact of health literacy on a patient’s decision to adopt a personal health record. Perspect Health Inf Manag. 2012;1Google Scholar
  88. Norgaard O, Furstrand D, Klokker L, Karnoe A, Batterham R, Kayser L, et al. The e-health literacy framework: a conceptual framework for characterizing e-health users and their interaction with e-health systems. Knowledge Management E-Learning. 2015;7(4):522–40.Google Scholar
  89. Norman C. eHealth literacy 2.0: problems and opportunities with an evolving concept. J Med Internet Res. 2011;13(4):e125.PubMedPubMedCentralCrossRefGoogle Scholar
  90. Norman CD, Skinner HA. eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res. 2006a;8(2):e9.PubMedPubMedCentralCrossRefGoogle Scholar
  91. Norman CD, Skinner HA. eHEALS: the eHealth Literacy Scale. J Med Internet Res. [Internet]. 2006b; 8(4):e27. http://www.jmir.org/2006/4/e27/Google Scholar
  92. Oregon Evidence-based Practice Center. Barriers and drivers of health information technology use for the elderly, chronically ill, and underserved. Rockville, MD: Agency for Healthcare Research and Quality; 2008.Google Scholar
  93. Pagliari C. Design and evaluation in eHealth: challenges and implications for an interdisciplinary field. J Med Internet Res. 2007;9(2):e15.PubMedPubMedCentralCrossRefGoogle Scholar
  94. Pew Research Center. Internet use over time. 2014.Google Scholar
  95. Reeder B, David A. Health at hand: a systematic review of smart watch uses for health and wellness. J Biomed Inform. 2016;63:269–76.PubMedCrossRefGoogle Scholar
  96. Rudd RE, Moeykens BA, Colton TC. Health and literacy: a review of medical and public health literature. In: Comings J, Garners B, Smith C, editors. Annual review of adult learning and literacy . New York, NY: Jossey-Bass, Inc.; 2000. p. 158–99.1Google Scholar
  97. Rudd R, Kirsch I, Yamamoto K. Literacy and health in America. Princeton, NJ: Policy Information Report Educational Testing Service; 2004. p. 52.Google Scholar
  98. Sarkar U, Karter AJ, Liu JY, Adler NE, Nguyen R, Lopez A, et al. The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system—results from the Diabetes Study of Northern California [DISTANCE]. J Health Commun. 2010;15(S2):183–96.PubMedPubMedCentralCrossRefGoogle Scholar
  99. Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al. Association of health literacy with diabetes outcomes. JAMA. 2002;288(4):475–82.PubMedCrossRefGoogle Scholar
  100. Sharit J, Hernández M, Czaja S, Pirolli P. Investigating the roles of knowledge and cognitive abilities in older adult information seeking on the Web. ACM Trans Comput Hum Interact. 2008;15(1):3.PubMedPubMedCentralCrossRefGoogle Scholar
  101. Shea S, Starren J, Weinstock RS, Knudson PE, Teresi J, Holmes D, et al. Columbia University’s Informatics for Diabetes Education and Telemedicine [IDEATel] Project: rationale and design. J Am Med Inform Assoc. 2002;9(1):49–62.PubMedPubMedCentralCrossRefGoogle Scholar
  102. Shea S, Weinstock RS, Teresi JA, Palmas W, Starren J, Cimino JJ, et al. A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus: 5 year results of the IDEATel study. J Am Med Inform Assoc. 2009;16(4):446–56.PubMedPubMedCentralCrossRefGoogle Scholar
  103. Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12(1):80.PubMedPubMedCentralCrossRefGoogle Scholar
  104. Sørensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, et al. Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire [HLS-EU-Q]. BMC Public Health. 2013;13(1):948.PubMedPubMedCentralCrossRefGoogle Scholar
  105. Starren J, Hripcsak G, Sengupta S, Abbruscato CR, Knudson PE, Weinstock RS, et al. Columbia University’s Informatics for Diabetes Education and Telemedicine [IDEATel] project: technical implementation. J Am Med Inform Assoc. 2002;9(1):25–36.PubMedPubMedCentralCrossRefGoogle Scholar
  106. Starren JB, Nesbitt TS, Chiang MF. Telehealth. In: Shortliffe EH, Cimino JJ, editors. Biomedical informatics. London: Springer; 2014. p. 541–60.CrossRefGoogle Scholar
  107. Subramaniam M, St. Jean B, Taylor NG, Kodama C, Follman R, Casciotti D. Bit by bit: using design-based research to improve the health literacy of adolescents. JMIR Res Protoc. 2015;4(2):e62.PubMedPubMedCentralGoogle Scholar
  108. Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ. Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. J Am Med Inform Assoc. 2006;13(2):121–6.PubMedPubMedCentralCrossRefGoogle Scholar
  109. Tennant B, Stellefson M, Dodd V, Chaney B, Chaney D, Paige S, et al. eHealth literacy and Web 2.0 health information seeking behaviors among baby boomers and older adults. J Med Internet Res. 2015;17(3):e70.PubMedPubMedCentralCrossRefGoogle Scholar
  110. Teolis MG. A MedlinePlus® kiosk promoting health literacy. J Consum Health Internet. 2010;14(2):126–37.PubMedPubMedCentralCrossRefGoogle Scholar
  111. Thoman E. Skills and strategies for media education. Educ Leadersh. 1999;56:50–4.Google Scholar
  112. Vargas PA, Robles E, Harris J, Radford P. Using information technology to reduce asthma disparities in underserved populations: a pilot study. J Asthma. 2010;47(8):889–94.PubMedPubMedCentralCrossRefGoogle Scholar
  113. van Vugt M, de Wit M, Cleijne WH, Snoek FJ. Use of behavioral change techniques in web-based self-management programs for type 2 diabetes patients: systematic review. J Med Internet Res. 2013;15(12):e279.PubMedPubMedCentralCrossRefGoogle Scholar
  114. Webb T, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010;12(1):e4.PubMedPubMedCentralCrossRefGoogle Scholar
  115. Weitzman ER, Kaci L, Mandl KD. Acceptability of a personally controlled health record in a community-based setting: implications for policy and design. J Med Internet Res. 2009;11(2):e14.PubMedPubMedCentralCrossRefGoogle Scholar
  116. Wicks P, Massagli M, Frost J, Brownstein C, Okun S, Vaughan T, et al. Sharing health data for better outcomes on PatientsLikeMe. J Med Internet Res. 2010;12(2):e19.PubMedPubMedCentralCrossRefGoogle Scholar
  117. Wicks P, Keininger DL, Massagli MP, de la Loge C, Brownstein C, Isojärvi J, et al. Perceived benefits of sharing health data between people with epilepsy on an online platform. Epilepsy Behav. 2012;23(1):16–23.PubMedCrossRefGoogle Scholar
  118. Wildevuur SE, Simonse LW. Information and communication technology-enabled person-centered care for the “big five” chronic conditions: scoping review. J Med Internet Res. 2015;17(3):e77.PubMedPubMedCentralCrossRefGoogle Scholar
  119. Wootton R. Twenty years of telemedicine in chronic disease management–an evidence synthesis. J Telemed Telecare. 2012;18(4):211–20.PubMedPubMedCentralCrossRefGoogle Scholar
  120. World Health Organisation. Health Literacy: the solid facts. Copenhagen: World Health Organisation; 2013.Google Scholar
  121. Yamin CK, Emani S, Williams DH, Lipsitz SR, Karson AS, Wald JS, et al. The digital divide in adoption and use of a personal health record. Arch Intern Med. 2011;171(6):568–74.PubMedCrossRefGoogle Scholar
  122. Yost KJ, Webster K, Baker DW, Jacobs EA, Anderson A, Hahn EA. Acceptability of the talking touchscreen for health literacy assessment. J Health Commun. 2010;15(S2):80–92.PubMedPubMedCentralCrossRefGoogle Scholar
  123. Zeng QT, Tse T. Exploring and developing consumer health vocabularies. J Am Med Inform Assoc. 2006;13(1):24–9.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • David R. Kaufman
    • 1
    Email author
  • Jelena Mirkovic
    • 2
  • Connie Chan
    • 3
  1. 1.Department of Biomedical InformaticsArizona State UniversityScottsdaleUSA
  2. 2.Center for Shared Decision Making and Collaborative Care ResearchOslo University HospitalOsloNorway
  3. 3.Colorado SpringsColoradoUSA

Personalised recommendations