The e-health literacy framework: A conceptual framework for characterizing e-health users and their interaction with e-health systems

In current e-health research and development there is a need for a broader understanding of the capabilities and resources required for individuals to use and benefit from e-health services, i.e. their e-health literacy. The aim of
this study was to develop a new conceptualisation of e-health literacy with consideration of the experiences of a wide range of stakeholders and in alignment with current technologies. Concept mapping was used to generate a comprehensive and grounded model of e-health literacy. Concept mapping workshop participants included patients, health professionals and medical informatics experts. Eight workshops, carried out in Denmark and United Kingdom, generated 450 statements, separated into 128 clusters. Through an inductive structured analysis, seven domains were identified: 1. Ability to process information, 2. Engagement in own health, 3. Ability to engage actively with digital services, 4. Feeling safe and in control, 5. Motivation to engage with digital services, 6. Having access to systems that work, and 7. Digital services that suit individual needs. These empirically derived domains form an e-health literacy framework (eHLF) and provide new insights into the user’s ability to understand, access and use e-health technologies. The eHLF offers a framework for evaluating an individual’s or a population’s capacity to understand, use and benefit from technology to promote and maintain their health. Such a framework also provides a potential checklist for the development and improvement of e-health services.

The Ophelia (OPtimise HEalth LIteracy and Access) process : using health literacy alongside grounded and participatory approaches to develop interventions in partnership with marginalised populations

This paper seeks to explore the potential of a newly developed, grounded and participatory approach to development of health-literacy and health-care access interventions for equity – the Ophelia (OPtimising HEalth LIteracy and Access) process (Batterham et al., 2014). The methodology involves undertaking a needs assessment of the target population using intensive qualitative and quantitative methods, developing vignettes of key sub-groups within the population based on their health literacy profile of strengths and weaknesses, and then engaging with frontline practitioners and community membersin developing realistic solutions (Batterham et al., 2014).

Psychosocial research with children in Iraq : current health practice and policy in a context of armed conflict

There is a need to show how psychosocial issues affect children in conflict areas like Iraq. Raising knowledge and awareness of children’s mental health status in Iraq has been difficult and the knowledge base has been limited by the shortage of resources, international sanctions and the isolation of Iraqi scholars. Many obstacles to research in Iraq exist but an agenda should be developed emphasising the need for high-quality contextualised psychosocial research. Health researchers in the country need to clarify basic population parameters and to provide culturally appropriate, evidence-based interventions for practitioners.

Rethinking the food security debate in Asia: Some missing ecological and health dimensions and solutions

Food security is a global and regional concern of rapidly increasing consequence. It is at risk of inattention because of competing crises, because of its theoretical amenability to previously effective, if temporary measures, most impressively with the so-called Green Revolution and because of the recourse to the global trade paradigm as a putative solution. We identify some missing or under-emphasised dimensions in this analysis, with particular reference to Asia, which in spite of recent growth-or in some cases because of it-faces particularly daunting food problems. Greater emphasis needs to be given to population size and distribution through more concerted family planning and enlightened migration policy; public policy to retain or encourage plant-based diets; integration of food, health and environmental approaches to create resilient regional food systems; and the incorporation of food into the broader human security agenda. While regional organisations, along with their NGO counterparts and nation states, have an over-arching role to strategise in this way, substantial progress could still be made at the community and household levels, especially with current technologies which can marshal their collective and coherent action.

Short form health surveys and related variants in spinal cord injury research : a systematic review

CONTEXT: 'Short Form' health surveys - such as the SF-36 and SF-12 - are widely used in medical research. Spinal cord injury (SCI) is no exception, despite oft-cited concerns regarding measurement properties for populations with physical impairment.OBJECTIVE: To provide a comprehensive overview of the use of Short Form health surveys and their variants within the SCI literature.METHODS: Papers published between database inception and September 2012 were identified from 11 electronic databases; a supplementary reference list search was also conducted. Data extraction focused on details regarding the range of different Short Form surveys and variants used in SCI research, the respective frequency of use, the nature of reporting (complete versus partial reporting) and the method of survey administration.RESULTS: One hundred seventy-four papers were identified. Thirty-six-item Short Form health surveys were frequently administered as complete instruments (n = 82); in 69 of these 82 studies (84%), it was not clearly stated which 36-item version had been used (e.g. SF-36v1, SF-36v2, RAND-36). Data for individual items and domains were often reported (29% of identified studies), indicating significant partial use of standardized measures. Modified variants of standardized health surveys were administered in 12 studies.CONCLUSION: Although standardized Short Form health surveys are common within SCI research, attempts to add, delete, or modify items have resulted in a number of variants, often with minimal supportive psychometric evidence. Using established, generic outcome measures is appealing for a number of reasons. However, validity is paramount and requires further explicit consideration within the SCI research community.

Changes in Australian injecting drug users’ mental health problems and service uptake from 2006-2012

Purpose– The purpose of this paper is to assess changes in rates of mental health problems and service utilisation for Australian regular injecting drug users (IDUs) from 2006 to 2012. Design/methodology/approach – Data were taken from Illicit Drug Reporting System national surveys with 914 regular IDUs in 2006 and 883 in 2012. Changes in rates of self-reported mental health problems and service use were assessed. Findings – Rates of self-reported mental health problems increased from 38.3 per cent in 2006 to 43.7 per cent in 2012 – mainly due to increases in anxiety rates. Conversely, there was a decrease in mental health service use from 70.2 to 58.4 per cent by 2012. However, there was a proportional increase in the use of psychologists. These trends remained after controlling for socio-demographic and medical differences between the 2006/2012 samples. K10 scores for 2012 participants validated the use of the self-report measures. Practical implications – Reductions in stigma, improvements in mental health literacy, and modest increases in anxiety may explain increases in self-report of mental health problems. Stagnant service utilisation rates in an expanding population willing to self-report may explain decreasing service use. The introduction of key mental health reforms also may have contributed, particularly with the increase in psychologist access. This paper highlights the need for improved population monitoring of mental health in disadvantaged groups such as IDUs. Originality/value – This paper is the first to assess changes in mental health outcomes over time in Australian IDUs. This examination covered a critical era in the mental health landscape, with significant increases in public awareness campaigns and major mental health reforms.

Health beliefs and practices in three generations of Greek Australian women in Melbourne.

This research explores the health beliefs of three generations of Greek Australian women in Melbourne. It describes their experience of illness and wellbeing in the context of a culture-specific understanding of health with strong cultural, religious, and linguistic bases that derive from the community’s Greek heritage.

Optimising health literacy and access of service provision to community dwelling older people with diabetes receiving home nursing support

Background. Health literacy is the ability to access, understand, and use information and services for good health. Among people with chronic conditions, health literacy requirements for effective self-management are high. The Optimising Health Literacy and Access (Ophelia) study engaged diverse organisations in the codesign of interventions involving the Health Literacy Questionnaire (HLQ) needs assessment, followed by development and evaluation of interventions addressing identified needs. This study reports the process and outcomes of one of the nine organisations, the Royal District Nursing Service (RDNS).

Methods. Participants were home nursing clients with diabetes. The intervention included tailored diabetes self-management education according to preferred learning style, a standardised diabetes education tool, resources, and teach-back method.

Results. Needs analysis of 113 quota-sampled clients showed difficulties managing health and finding and appraising health information. The service-wide diabetes education intervention was applied to 24 clients. The intervention was well received by clients and nurses. Positive impacts on clients' diabetes knowledge and behaviour were seen and nurses reported clear benefits to their practice.

Conclusion. A structured method that supports healthcare services to codesign interventions that respond to the health literacy needs of their clients can lead to evidence-informed, sustainable practice changes that support clients to better understand effective diabetes self-management.