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Current level of technology use, health and eHealth literacy in older Canadians with a recent fracture—a survey in orthopedic clinics

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Abstract

Summary

Among older adults who have recently sustained a fracture, there is substantial adoption of mobile technology. Furthermore, health and eHealth literacy level reported by participants supports the development of interactive eHealth interventions toward fostering better patient engagement in skeletal health management.

Introduction

Electronic health resources are increasingly used in the self-management of medical conditions. We aimed to identify the current level of technology adoption, health, and eHealth literacy among older adults with a recent fracture, to determine if the use of electronic interventions would be feasible and acceptable in this population.

Methods

Adults ≥ 50 years with recent fractures were invited to complete a self-administered survey composed of 21 questions, including an 8-item perceived eHealth literacy scale.

Results

A total of 401 participants completed the survey (women, 64%; ≥ 65 years, 59%; university education, 32%). Most participants reported no difficulty in reading printed health material (67%) and felt confident in filling out medical forms (65%). Younger age and higher levels of education were associated with higher health literacy. Most respondents (81%) owned at least one mobile device (smartphone, 49%; tablet, 45%). eHEALS scores were similar among men (29, IQR 24–32) and women (29, IQR 25–33), and between younger age group categories (50–64 years, 30; IQR 26–33; and 65–74 years, 29; IQR 25–32), but lower in the oldest age group (≥ 75 years, 24; IQR 21–29; p < 0.05). Compared with the youngest group, those ≥ 75 years had higher odds of an eHEALS < 26 (odds ratio, 4.2; 95% confidence interval 2.0–8.9) after adjusting for sex and education level.

Conclusion

There is significant adoption of mobile technology among older adults. Health and eHealth literacy reported by this study population supports the development of interactive eHealth interventions toward fostering better patient engagement in skeletal health management.

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References

  1. Mediati RD, Vellucci R, Dodaro L (2014) Pathogenesis and clinical aspects of pain in patients with osteoporosis. Clin Cases Miner Bone Metab 11(3):169–172

    PubMed  PubMed Central  Google Scholar 

  2. Leboime A, Confavreux CB, Mehsen N, Paccou J, David C, Roux C (2010) Osteoporosis and mortality. Joint Bone Spine 77(Suppl 2):S107–S112. https://doi.org/10.1016/s1297-319x(10)70004-x

    Article  PubMed  Google Scholar 

  3. Weycker D, Li X, Barron R, Bornheimer R, Chandler D (2016) Hospitalizations for osteoporosis-related fractures: economic costs and clinical outcomes. Bone Rep 5:186–191. https://doi.org/10.1016/j.bonr.2016.07.005

    Article  PubMed  PubMed Central  Google Scholar 

  4. Steinhubl SR, Muse ED, Topol EJ (2015) The emerging field of mobile health. Sci Transl Med 7(283):283rv283. https://doi.org/10.1126/scitranslmed.aaa3487

    Article  Google Scholar 

  5. O’Shea CJ, McGavigan AD, Clark RA, Chew DPB, Ganesan A (2017) Mobile health: an emerging technology with implications for global internal medicine. Intern Med J 47(6):616–619. https://doi.org/10.1111/imj.13440

    Article  PubMed  Google Scholar 

  6. Semple JL, Armstrong KA (2017) Mobile applications for postoperative monitoring after discharge. Cmaj 189(1):E22–e24. https://doi.org/10.1503/cmaj.160195

    Article  PubMed  PubMed Central  Google Scholar 

  7. Anderson M, Perrin A (2017) Tech adoption climbs among older adults. Pew Research Center. Internet & Technology http://www.pewinternet.org/2017/05/17/tech-adoption-climbs-among-older-adults/. Accessed 28 Dec 2019

  8. Statistics Canada (2017) Life in the fast lane: how are Canadians managing? 2016. https://www150.statcan.gc.ca/n1/daily-quotidien/171114/dq171114a-eng.htm?HPA=1. Accessed 28 Dec 2019

  9. Boulos MN, Brewer AC, Karimkhani C, Buller DB, Dellavalle RP (2014) Mobile medical and health apps: state of the art, concerns, regulatory control and certification. Online J Public Health Inform 5(3):229. https://doi.org/10.5210/ojphi.v5i3.4814

    Article  PubMed  PubMed Central  Google Scholar 

  10. Dicianno BE, Parmanto B, Fairman AD, Crytzer TM, Yu DX, Pramana G, Coughenour D, Petrazzi AA (2015) Perspectives on the evolution of mobile (mHealth) technologies and application to rehabilitation. Phys Ther 95(3):397–405. https://doi.org/10.2522/ptj.20130534

    Article  PubMed  Google Scholar 

  11. Lu C, Hu Y, Xie J, Fu Q, Leigh I, Governor S, Wang G (2018) The use of mobile health applications to improve patient experience: cross-sectional study in Chinese public hospitals. JMIR Mhealth Uhealth 6(5):e126. https://doi.org/10.2196/mhealth.9145

    Article  PubMed  PubMed Central  Google Scholar 

  12. Alexander JC, Joshi GP (2016) Smartphone applications for chronic pain management: a critical appraisal. J Pain Res 9:731–734. https://doi.org/10.2147/jpr.S119966

    Article  PubMed  PubMed Central  Google Scholar 

  13. Taylor K, Silver L (2019) Smartphone ownership is growing rapidly around the world, but not always equally. Pew Research Center http://www.pewglobal.org/2019/02/05/smartphone-ownership-is-growing-rapidly-around-the-world-but-not-always-equally/. Accessed March 14 2019

  14. Medlock S, Eslami S, Askari M, Arts DL, Sent D, de Rooij SE, Abu-Hanna A (2015) Health information-seeking behavior of seniors who use the internet: a survey. J Med Internet Res 17(1):e10. https://doi.org/10.2196/jmir.3749

    Article  PubMed  PubMed Central  Google Scholar 

  15. Norman C (2011) eHealth literacy 2.0: problems and opportunities with an evolving concept. J Med Internet Res 13(4):e125. https://doi.org/10.2196/jmir.2035

    Article  PubMed  PubMed Central  Google Scholar 

  16. Morris NS, MacLean CD, Chew LD, Littenberg B (2006) The single item literacy screener: evaluation of a brief instrument to identify limited reading ability. BMC Fam Pract 7:21. https://doi.org/10.1186/1471-2296-7-21

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chew LD, Bradley KA, Boyko EJ (2004) Brief questions to identify patients with inadequate health literacy. Fam Med 36(8):588–594

    PubMed  Google Scholar 

  18. Jeppesen KM, Coyle JD, Miser WF (2009) Screening questions to predict limited health literacy: a cross-sectional study of patients with diabetes mellitus. Ann Fam Med 7(1):24–31. https://doi.org/10.1370/afm.919

    Article  PubMed  PubMed Central  Google Scholar 

  19. Wallace LS, Rogers ES, Roskos SE, Holiday DB, Weiss BD (2006) Brief report: screening items to identify patients with limited health literacy skills. J Gen Intern Med 21(8):874–877. https://doi.org/10.1111/j.1525-1497.2006.00532.x

    Article  PubMed  PubMed Central  Google Scholar 

  20. Keene Woods N, Chesser AK (2017) Validation of a single question health literacy screening tool for older adults. Gerontol Geriatr Med 3:2333721417713095. https://doi.org/10.1177/2333721417713095

    Article  PubMed  PubMed Central  Google Scholar 

  21. National Cancer Institute (2014) Health information national trends survey. https://hints.cancer.gov/. Accessed 28 Dec 2019

  22. Hesse BW, Greenberg AJ, Peterson EB, Chou WS (2017) The Health Information National Trends Survey (HINTS): a resource for consumer engagement and health communication research. Stud Health Technol Inform 240:330–346

    PubMed  Google Scholar 

  23. Norman CD, Skinner HA (2006) eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res 8(2):e9. https://doi.org/10.2196/jmir.8.2.e9

    Article  PubMed  PubMed Central  Google Scholar 

  24. Norman CD, Skinner HA (2006) eHEALS: the eHealth literacy scale. J Med Internet Res 8(4):e27. https://doi.org/10.2196/jmir.8.4.e27

    Article  PubMed  PubMed Central  Google Scholar 

  25. Chung SY, Nahm ES (2015) Testing reliability and validity of the eHealth Literacy Scale (eHEALS) for older adults recruited online. Comput Inform Nurs 33(4):150–156. https://doi.org/10.1097/cin.0000000000000146

    Article  PubMed  PubMed Central  Google Scholar 

  26. Richtering SS, Hyun K, Neubeck L, Coorey G, Chalmers J, Usherwood T, Peiris D, Chow CK, Redfern J (2017) eHealth literacy: predictors in a population with moderate-to-high cardiovascular risk. JMIR Hum Factors 4(1):e4. https://doi.org/10.2196/humanfactors.6217

    Article  PubMed  PubMed Central  Google Scholar 

  27. Arcury TA, Sandberg JC, Melius KP, Quandt SA, Leng X, Latulipe C, Miller DP Jr, Smith DA, Bertoni AG (2018) Older adult internet use and eHealth literacy. J Appl Gerontol. https://doi.org/10.1177/0733464818807468

  28. Charan J, Biswas T (2013) How to calculate sample size for different study designs in medical research? Indian J Psychol Med 35(2):121–126. https://doi.org/10.4103/0253-7176.116232

    Article  PubMed  PubMed Central  Google Scholar 

  29. Tennant B, Stellefson M, Dodd V, Chaney B, Chaney D, Paige S, Alber J (2015) eHealth literacy and Web 2.0 health information seeking behaviors among baby boomers and older adults. J Med Internet Res 17(3):e70. https://doi.org/10.2196/jmir.3992

    Article  PubMed  PubMed Central  Google Scholar 

  30. Gordon NP, Hornbrook MC (2018) Older adults’ readiness to engage with eHealth patient education and self-care resources: a cross-sectional survey. BMC Health Serv Res 18(1):220. https://doi.org/10.1186/s12913-018-2986-0

    Article  PubMed  PubMed Central  Google Scholar 

  31. Dionigi RA (2015) Stereotypes of aging: their effects on the health of older adults. J Geriatr 2015:9. https://doi.org/10.1155/2015/954027

    Article  Google Scholar 

  32. AGE-WELL (2019) Attitudes of Canadians 65+ and 50–64 towards techonology, aging and health. https://agewell-nce.ca/archives/8713. Accessed 28 Dec 2019

  33. Cole-Lewis H, Kershaw T (2010) Text messaging as a tool for behavior change in disease prevention and management. Epidemiol Rev 32:56–69. https://doi.org/10.1093/epirev/mxq004

    Article  PubMed  Google Scholar 

  34. Ravn Jakobsen P, Hermann AP, Søndergaard J, Wiil UK, Clemensen J (2018) Development of an mHealth application for women newly diagnosed with osteoporosis without preceding fractures: a participatory design approach. Int J Environ Res Public Health 15(2):330. https://doi.org/10.3390/ijerph15020330

    Article  PubMed Central  Google Scholar 

  35. Yadav L, Haldar A, Jasper U, Taylor A, Visvanathan R, Chehade M, Gill T (2019) Utilising digital health technology to support patient-healthcare provider communication in fragility fracture recovery: systematic review and meta-analysis. Int J Environ Res Public Health 16(20). https://doi.org/10.3390/ijerph16204047

  36. Ryan P, Papanek P, Csuka ME, Brown ME, Hopkins S, Lynch S, Scheer V, Schlidt A, Yan K, Simpson P, Hoffman R (2018) Background and method of the striving to be strong study a RCT testing the efficacy of a m-health self-management intervention. Contemp Clin Trials 71:80–87. https://doi.org/10.1016/j.cct.2018.06.006

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors acknowledge the participants of the survey for their time and interest in the study. SNM is chercheur-boursier des Fonds de Recherche du Québec en Santé.

Details of contributors and guarantor

Authors’ roles: conception, design, analysis, drafting the article (CC, MW, SNM), interpretation of data (all authors); critically revising the article for important intellectual content (all authors); final approval of the version to be published (all authors); and agreement to be accountable for all aspects of the work (all authors). CC and SNM had full access to all the data in the study and take the responsibility for the integrity of the data and the accuracy of the data analysis.

Funding

This study was supported by an operating grant of the Canadian Institute of Health Research (201410PHE; application 337,797). The funding source had no role in the design of the study, analysis of the results, writing of the manuscript, or decision to submit for publication.

Author information

Authors and Affiliations

  1. Department of Medicine, Faculty of Medicine, McGill University, Montreal, Canada

    C. Cherid, N. E. Mayo & S. N. Morin

  2. The Research Institute of the McGill University Health Centre, 5252 Boulevard de Maisonneuve O, Room 3E-11, Montreal, Québec, H4A 3S5, Canada

    A. Baghdadli, M. Wall, N. E. Mayo, G. Berry, E. J. Harvey & S. N. Morin

  3. Department of Orthopedics, Faculty of Medicine, McGill University, Montreal, Canada

    G. Berry, E. J. Harvey, A. Albers & S. G. Bergeron

  4. St. Mary’s Hospital, Montreal, Canada

    A. Albers

  5. Jewish General Hospital, Montreal, Canada

    S. G. Bergeron

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  1. C. Cherid
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Correspondence to S. N. Morin.

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Conflicts of interest

Chams Cherid, Amel Baghdadli, Michelle Wall, Nancy Mayo, Gregory Berry, Edward J Harvey, Anthony Albers, and Stephane G Bergeron declare they have no conflict of interest. Suzanne N Morin has received a research grant from Amgen, paid to a research institution, in the context of other work.

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Cherid, C., Baghdadli, A., Wall, M. et al. Current level of technology use, health and eHealth literacy in older Canadians with a recent fracture—a survey in orthopedic clinics. Osteoporos Int 31, 1333–1340 (2020). https://doi.org/10.1007/s00198-020-05359-3

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  • DOI: https://doi.org/10.1007/s00198-020-05359-3

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