Abstract: eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.
Abstract: Background, measuring an individual-s Health
Literacy is gaining attention, yet no appropriate instrument is available
in Taiwan. Measurement tools that were developed and used in
western countries may not be appropriate for use in Taiwan due to a
different language system. Purpose of this research was to develop a
Health Literacy measurement instrument specific for Taiwan adults.
Methods, several experts of clinic physicians; healthcare
administrators and scholars identified 125 common used health related
Chinese phrases from major medical knowledge sources that easy
accessible to the public. A five-point Likert scale is used to measure
the understanding level of the target population. Such measurement is
then used to compare with the correctness of their answers to a health
knowledge test for validation. Samples, samples under study were
purposefully taken from four groups of people in the northern
Pingtung, OPD patients, university students, community residents,
and casual visitors to the central park. A set of health knowledge index
with 10 questions is used to screen those false responses. A sample
size of 686 valid cases out of 776 was then included to construct this
scale. An independent t-test was used to examine each individual
phrase. The phrases with the highest significance are then identified
and retained to compose this scale. Result, a Taiwan Health Literacy
Scale (THLS) was finalized with 66 health-related phrases under nine
divisions. Cronbach-s alpha of each division is at a satisfactory level
of 89% and above. Conclusions, factors significantly differentiate the
levels of health literacy are education, female gender, age, family
members of stroke victims, experience with patient care, and
healthcare professionals in the initial application in this study..
Abstract: The Taiwan Health Literacy Scale (THLS) was developed to cope with the need of measuring heath literacy of Chinese-speaking adults in Taiwan. Although the scale was proven having good reliability and validity, it was not popularly adopted by the practitioners due to the length, and the time required completing. Based on the THLS, this research further invited healthcare professionals to review the original scale for a possible shorten work. Under the logic of THLS, the research adopted an analytic hierarchy process technique to consolidate the healthcare experts- assessments to shorten the original scale. There are fifteen items out of the original 66 items were identified having higher loadings. Confirmed by the experts and passed a pilot test with 40 undergraduate students, a short form of THLS is then introduced. This research then used 839 samples from the major cities of the Hua-lien county in the eastern part of Taiwan to test the reliability and validity of this new scale. The reliability of the scale is high and acceptable. The current scale is also highly correlated with the original, of which provide evidence for the validity of the scale.