eHealth Literacy Interventions: Scoping Review

电子健康素养干预措施:范围界定综述

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Abstract

BACKGROUND: Electronic resources have become a predominant modality for health information dissemination in recent years. eHealth literacy (eHL) means individuals' competencies to effectively acquire and use health information from electronic sources. Enhancing eHL is thus essential to facilitate individuals' effective engagement with electronic resources and promote improved health management. OBJECTIVE: This scoping review aimed to synthesize the characteristics of eHL interventions, thereby providing a reference for future intervention strategies. METHODS: A comprehensive search of PubMed, Embase, Cochrane Library, Web of Science, ProQuest, CINAHL, CNKI, VIP, Wan Fang Data, and Sino Med limited to Chinese and English-language studies published before August 2024 was conducted. The interventional studies included had the explicit primary objective of enhancing eHL. We also incorporated studies that assessed eHL as a secondary outcome or mediator influencing health behaviors or clinical outcomes. All publications were required to provide publicly accessible complete datasets. We excluded conference abstracts and protocols. Academic theses and dissertations were included if they underwent institutional quality assurance through rigorous academic review processes and met predefined eligibility criteria. RESULTS: A total of 35 studies were included in this review. The most prevalent eHL interventions (12/35, 34%) were delivered via mobile apps and devices in various settings, including educational institutions, public spaces, health care facilities, and community centers. These interventions predominantly focused on enhancing information literacy, health literacy, and computer literacy across the 6 domains of eHL: traditional, health, information, scientific, media, and computer literacy. A majority of the interventions were conducted on a weekly basis (6/13, 46%) and had a duration of 24 weeks (6/35, 17%). However, 77% (27/35) of interventions did not assess long-term effects. The primary outcomes of eHL interventions encompassed perceived eHL, actual eHealth knowledge and skills, health literacy, health behavior, and clinical outcomes, with 86% (30/35) indicating positive effects. The eHealth Literacy Scale was the most frequently used assessment tool. CONCLUSIONS: This study synthesizes the characteristics of eHL interventions. Current eHL interventions exhibit limitations in theoretical grounding, longitudinal tracking, and traditional or media literacy components. Overreliance on self-reported metrics constrains validity assessment. Future work should strengthen theoretical frameworks, integrate objective metrics, and enhance longitudinal designs.

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