Date Presented 03/27/20
Americans with disabilities encounter barriers to using electronics. This may preclude the ability to manage one’s health. Lack of provider intervention that addresses barriers to health management is an occupational injustice to people with disabilities. OT has a vital role in assessing technology use, assessing health literacy, creating interventions, and tracking health outcomes. This study examines electronic health literacy and technology use on an acute rehab unit.
Primary Author and Speaker: Madeline Runyen
Contributing Authors: Molly Benner
PURPOSE: According to the Centers for Disease Control and Prevention, 80% of adults use the internet as the primary mode of learning about health. Healthcare systems are moving towards electronic platforms. However, there is a disproportionate use of electronic health (ehealth) resources occurring within higher income, educated, white, age <65 years, and non-Hispanic communities (Health Literacy Evidence Reviews, 2019). Americans with disabilities are 28% less likely to use the internet as compared to Americans without a disability (Anderson & Perrin, 2017). Access to health resources correlates with access to technology. Electronic health literacy is defined as “the ability to seek, find, understand, and appraise health information from electronic sources [to] apply the knowledge gained to [address] or [solve] a health problem (Norman & Skinner, 2006)”. This study aims to understand ehealth management and the barriers that exist.
Research questions included:
How common is technology use for health management?
What barriers exist regarding technology use?
DESIGN: Data extracted serves as a preliminary needs assessment. Ten subjects participated in the study ranging in ages 31-81 with 70% of subjects over the age of 60. The quantitative data describe technology use in relation to ehealth literacy. Convenience sampling was used.
METHODS: Data was obtained via interviews with verbal consent. The study adapted questions from the E-Health Literacy Scale which examined ehealth literacy and technology use.
RESULTS: Results showed that 100% of subjects owned at least 1 internet accessible device with 80% of subjects reporting daily use and 20% reporting weekly use. Ninety percent of subjects reported often or using the internet to learn more about their health. Fifty percent of subjects reported sometimes needing help to understand their health information and 20% reported often. Further, 60% of subjects reported interest in learning how to use the online portal to communicate with providers, schedule appointments, manage medications, and access health information. During open-ended discussion, subjects reported visual, musculoskeletal, and low ehealth literacy as common barriers to technology use. Several subjects suggested adaptations for visual impairments and upper extremity deficits be implemented on the unit.
CONCLUSIONS: A majority of patients use the internet regularly to engage in their health. Occupational therapists (OTs) have a vital role in promoting access and education regarding electronics relative to health management. OTs can target ehealth literacy interventions specific to a patient’s diagnosis at all levels of care. Specifically, OTs working in the inpatient setting have a unique opportunity to address ehealth relative to a patient’s admitting diagnosis. This can increase a patient’s engagement and maintenance of their health from the onset. By systematically addressing ehealth the field of occupational therapy may provide individualized and direct interventions that have the potential to reduce readmissions and poor adherence due to barriers that patient’s need help to overcome.
Following the study, an inservice was provided on the literature, health assessments, high tech, and low tech adaptations. Limitations in the study include small sample size, self report bias, investigator bias, lack of standardization, and the possible presence of cognitive deficits relative to diagnosis. Further research is indicated to gather a larger sample of data and determine the best interventions.
References
Anderson, M. & Perrin, A. (April 7, 2017). Disabled Americans are less likely to use technology. Retrieved from https://www.pewresearch.org/fact-tank/2017/04/07/disabled-americans-are-less-likely-to-use-technology/
Chung, S.Y. & Nahm, E.S. (2015). Testing reliability and validity of the ehealth literacy scale (eHEALS) for older adults recruited online. Computers, Informatics, Nursing. 33(4): 150–156. doi:10.1097/CIN.0000000000000146
(October 24, 2019). Health Literacy Evidence Reviews. Retrieved from https://www.cdc.gov/healthliteracy/researchevaluate/evidence-research.html
Norman, C.D & Skinner, H.A. (2006). EHealth Literacy: essential skills for consumer health in a networked world. Journal of Medical Internet Research. 8(2) doi: 10.2196/jmir.8.2.e9
