Available tools to evaluate digital health literacy and engagement with eHealth resources: A scoping review

Background: As eHealth and use of information and communication technologies (ICT) within healthcare becomes widespread, it is important to ensure that these forms of healthcare are accessible to the users. One factor that is key to accessing eHealth is digital health literacy. Objectives: This scoping review assesses available tools that can be used to evaluate digital health literacy. Methods: A systematic literature search was made in MEDLINE, CINAHL, APA PsychInfo, Ageline, AMED, and APA PsychArticles to present the tools currently in use to assess digital health literacy. A qualitative synthesis of the evidence was carried out using a data charting form created for this review. Extracted data included details of the population of investigation and digital health literacy tool used. A report was produced following PRISMA-ScR guidelines. Results: In total, 53 papers with adult participants and 3 with adolescent participants (aged between 12 and 19 years) were included in the scoping review. 5 questionnaires were identified that measured digital health literacy or attitudes towards the internet, of which the eHealth Literacy Scale (eHEALS) was the most commonly used questionnaire for both adults and children. Two children's questionnaires were often accompanied by a second task to verify the accuracy of the responses to the eHEALS questions. Conclusions: eHEALS is the most commonly used method to assess digital health literacy and assess whether an individual is able to engage actively with eHealthcare or virtual resources. However, care needs to be taken to ensure that its administration does not exclude digitally disadvantaged groups from completing it. Future research would benefit from assessing whether digital health literacy tools are appropriate for use in clinical settings, working to ensure that any scales developed in this area are practical and can be used to support the allocation of resources to ensure that people are able to access healthcare equitably

Available tools to evaluate digital health literacy and engagement with eHealth resources: A scoping review

Background: As eHealth and use of information and communication technologies (ICT) within healthcare becomes widespread, it is important to ensure that these forms of healthcare are accessible to the users. One factor that is key to accessing eHealth is digital health literacy. Objectives: This scoping review assesses available tools that can be used to evaluate digital health literacy. Methods: A systematic literature search was made in MEDLINE, CINAHL, APA PsychInfo, Ageline, AMED, and APA PsychArticles to present the tools currently in use to assess digital health literacy. A qualitative synthesis of the evidence was carried out using a data charting form created for this review. Extracted data included details of the population of investigation and digital health literacy tool used. A report was produced following PRISMA-ScR guidelines. Results: In total, 53 papers with adult participants and 3 with adolescent participants (aged between 12 and 19 years) were included in the scoping review. 5 questionnaires were identified that measured digital health literacy or attitudes towards the internet, of which the eHealth Literacy Scale (eHEALS) was the most commonly used questionnaire for both adults and children. Two children’s questionnaires were often accompanied by a second task to verify the accuracy of the responses to the eHEALS questions. Conclusions: eHEALS is the most commonly used method to assess digital health literacy and assess whether an individual is able to engage actively with eHealthcare or virtual resources. However, care needs to be taken to ensure that its administration does not exclude digitally disadvantaged groups from completing it. Future research would benefit from assessing whether digital health literacy tools are appropriate for use in clinical settings, working to ensure that any scales developed in this area are practical and can be used to support the allocation of resources to ensure that people are able to access healthcare equitably

Implications for the design of a Diagnostic Decision Support System (DDSS) to reduce time and cost to diagnosis in paediatric shoulder instability.

BACKGROUND: Currently the diagnosis of shoulder instability, particularly in children, is difficult and can take time. These diagnostic delays can lead to poorer outcome and long-term complications. A Diagnostic Decision Support System (DDSS) has the potential to reduce time to diagnosis and improve outcomes for patients. The aim of this study was to develop a concept map for a future DDSS in shoulder instability. METHODS: A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists decision-making processes. RESULTS: Twenty-five physiotherapists, (18F:7 M) from four separate clinical sites participated. The themes identified related to 'Variability in diagnostic processes and lack of standardised practice' and 'Knowledge and attitudes towards novel technologies for facilitating assessment and clinical decision making'. CONCLUSION: No common structured approach towards assessment and diagnosis was identified. Lack of knowledge, perceived usefulness, access and cost were identified as barriers to adoption of new technology. Based on the information elicited a conceptual design of a future DDSS has been proposed. Work to develop a systematic approach to assessment, classification and diagnosis is now proposed. Trial Registraty This was not a clinical trial and so no clinical trial registry is needed

Sensemaking in the early stages of the COVID-19 pandemic: A narrative exploration of polarised morality in an NHS Trust.

This article presents an analysis of personal diaries kept by health-care staff within a specialist NHS Trust in England during the initial 3 months of the COVID-19 pandemic. It adopts a moral sensemaking perspective to explore how NHS employees mobilised and reframed ideas of right and wrong in order to make sense of unprecedented uncertainty and displacement. By focussing on how the macro and micro politics of the pandemic were played out in the organisation, the study finds that polarised moral judgements were invoked in order to justify and rationalise a broad array of associated emergent emotions, intuitions, behaviours and practices. This polarisation of moral responses could be seen as a desire to bring order out of chaos and put matters back into place following displacement. This is inevitably an ongoing, complex and variegated enterprise whose results can be as often discomforting as they can be reassuring. Indeed, while moral sensemaking was partly beneficial for staff in that it promoted a greater sense of camaraderie and support for others, it also appeared to have darker consequences in terms of staff wellbeing and the development of more impermeable social boundaries across the organisation through processes of moral 'othering'

Evaluating the clinical decision making of physiotherapists in the assessment and management of paediatric shoulder instability

Objective: To elicit what information and clinical decision-making processes physiotherapists use in the assessment and management of paediatric shoulder instability. Design: Qualitative study. A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists’ decision-making processes. Setting: Physiotherapy departments from across four separate clinical sites. Subjects: Twenty-five physiotherapists, (18F:7M), ranging from two to 29 years post qualification. Outcomes measures: Thematic analysis. The initial round of coding was used to draw up a quantitative assessment of the diagnoses and map information used for clinical decision-making against the International Classification of Functioning (ICF) framework. Results: The themes identified related to ‘Differences in diagnoses, classification and diagnostic processes’, ‘Diagnostic process occurs over a long period of time’, ‘Management and prognosis are influenced by a number of factors’ and ‘Diagnostic test choices and prognosis influenced by factors beyond the patient injury’. Conclusion: Current methods of assessment are prone to bias and error and may lead to inconsistent or delayed provision of essential care. Further work is needed to develop methods of measurement and frameworks which can accurately identify relevant physiological mechanisms and personal factors associated with shoulder instability as a part of the assessment/diagnostic process

Experiences and care needs of children with long Covid: a qualitative study.

Long Covid, the patient-preferred term, describes symptoms persisting after an acute episode of Covid-19 infection. Symptoms in children and young people (CYP) can affect daily routine, with broader impacts on education, health-related quality of life, and social activities, which may have long term effects on health and wellbeing. To explore the lived experiences and care needs of CYP with Long Covid from the perspectives of CYP with Long Covid, their parents, and professionals associated with the care of children and families living with Long Covid. CYP and their parent/carer were invited for interview following participation in a cohort study, which recruited from a primary care setting. Interviews were carried out with four CYP with Long Covid (all female, aged 10-17 years), three interviews included a parent. Two focus groups were conducted, which included seven professionals involved with care of CYP or Long Covid, from a range of disciplines. Interviews and focus groups were transcribed verbatim, and data analysed thematically using constant comparison techniques. The main themes presented are Living with Long Covid; Uncertainty surrounding Long Covid; and Seeking help for symptoms. Long Covid can severely impact the lives of CYP and their families. CYP and their families need to be listened to by professionals and have any uncertainties acknowledged. It is imperative that agencies working with them understand the condition, its impact, and are able to offer support where needed. [Abstract copyright: Copyright © 2023, The Authors.

Co-producing health information materials with young people: reflections and lessons learned

AbstractBackgroundThis paper describes and critically reflects on how children and young people (CYP) acted as public advisors to co-produce health information materials about Long Covid for younger audiences. This work was underpinned by the Lundy model, a framework which provides guidance on facilitating CYP to actively contribute to matters which affect them.MethodsCo-production activity sessions took place with CYP in schools as well as video conferences with a CYP stakeholder group and CYP with Long Covid. Activities encouraged CYP to focus on the content, format and design of materials and used problem-based and collaborative learning to encourage engagement with the project. Using a range of methods and open discussion, CYP co-designed a series of Long Covid health information materials for younger audiences.ResultsSixty-six CYP (aged 10-18), and two young adults were involved. CYP co-designed specifications for the final materials and provided feedback on early designs. The project led to the development of a series of health information materials targeted at CYP: a short social media campaign with six short videos and a twelve-page illustrated leaflet about Long Covid; released on social media and distributed in local area. All the CYP were positive about the project and their involvement.DiscussionInvolving CYP led to the development of innovative and engaging information materials (influence). Developing rapport was important when working with CYP and this was facilitated by using approaches and activities to establish an environment (space) where the CYP felt comfortable sharing their views (voice) and being listened to (audience) by the adults in the project. Working with external groups who are willing to share their expertise can help the meaningful involvement of voices ‘less heard’.Public ContributionOne CYP co-applicant contributed to the project design and facilitation of PPIE sessions, 64 CYP were involved in the PPIE sessions to design and feedback on materials. Two young adult media producers worked with CYP to produce these materials, another CYP supported this process. Three public contributors were involved in the preparation of this manuscript.<br/

Coproducing health information materials with young people: reflections and lessons learned

BackgroundThis paper describes and critically reflects on how children and young people (CYP) acted as public advisors to co-produce health information materials about Long Covid for younger audiences. This work was underpinned by the Lundy model, a framework which provides guidance on facilitating CYP to actively contribute to matters which affect them.MethodsCo-production activity sessions took place with CYP in schools as well as video conferences with a CYP stakeholder group and CYP with Long Covid. Activities encouraged CYP to focus on the content, format and design of materials and used problem-based and collaborative learning to encourage engagement with the project. Using a range of methods and open discussion, CYP co-designed a series of Long Covid health information materials for younger audiences.ResultsSixty-six CYP (aged 10-18), and two young adults were involved. CYP co-designed specifications for the final materials and provided feedback on early designs. The project led to the development of a series of health information materials targeted at CYP: a short social media campaign with six short videos and a twelve-page illustrated leaflet about Long Covid; released on social media and distributed in local area. All the CYP were positive about the project and their involvement.DiscussionInvolving CYP led to the development of innovative and engaging information materials (influence). Developing rapport was important when working with CYP and this was facilitated by using approaches and activities to establish an environment (space) where the CYP felt comfortable sharing their views (voice) and being listened to (audience) by the adults in the project. Working with external groups who are willing to share their expertise can help the meaningful involvement of voices ‘less heard’.Public ContributionOne CYP co-applicant contributed to the project design and facilitation of PPIE sessions, 64 CYP were involved in the PPIE sessions to design and feedback on materials. Two young adult media producers worked with CYP to produce these materials, another CYP supported this process. Three public contributors were involved in the preparation of this manuscript

Symptom patterns and life with post-acute COVID-19 in children aged 8-17: a mixed methods studyprotocol.

BACKGROUND: While there is a substantial body of knowledge about acute COVID-19, less is known about long-COVID, where symptoms continue beyond four weeks. AIM: This study aims to describe longer-term effects of COVID-19 infection in children and young people (CYP) and identify their needs in relation to long-COVID. DESIGN & SETTING: This study comprises an observational prospective cohort study and a linked qualitative study, identifying participants aged 8-17 years in the West Midlands of England. METHOD: CYP will be invited to complete online questionnairesto monitor incidences and symptoms of Covid-19 over a 12-month period. CYP who have experienced long-term effects of COVID will be invited to interview, and those currently experiencing symptoms will be asked to document their experiences in a diary. Professionals who work with CYP will be invited to explore the impact of long-COVID on the wider experiences of CYP, in a focus group. Descriptive statistics will be used to describe the incidence and rates of resolution of symptoms, and comparisons made between exposed and non-exposed groups. Logistic regression models will be used to estimate associations between candidate predictors and the development of long-COVID, and linear regression will be used to estimate associations between candidate predictors. Qualitative data will be analysed thematically using the constant comparison method. CONCLUSION: This study will describe features and symptoms of long-COVID and explore the impact of long-COVID within the lives of CYP and their families, to provide better understanding of long-COVID and inform clinical practice