Journal of Medical Internet Research · Journal of Medical Internet Research 10755 articles · JMIR Research Protocols 5262 articles · JMIR Formative ...

Background: Young and middle-aged adults are vulnerable to poor sleep quality. eHealth literacy, defined as the ability to effectively access and use digital health information, has been linked to improved health behaviors and may promote better sleep outcomes. However, its relationship with sleep quality remains unclear, especially across age groups. Age-related disparities in eHealth literacy may contribute to a digital health divide in sleep outcomes. Objective: This study aimed to examine the relationship between eHealth literacy and sleep quality among adults aged 18–59 years in Shanghai, as well as explore age-stratified effects. Methods: A cross-sectional study was conducted between October and December 2022 in three districts of Shanghai, with seven community health service centers randomly selected. Participants were recruited through convenience sampling to complete an online survey. eHealth literacy was assessed using the eHealth Literacy Scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index. Covariates included sociodemographic characteristics, health status, and health behaviors. Logistic regression models were applied to examine the relationship between eHealth literacy and sleep quality, with stratified analyses conducted by age (emerging adults [18-29 years], established adults [30-45 years], and middle-aged adults [46-59 years]). Results: A total of 1,810 participants completed the survey. The prevalence of poor sleep quality was 37.9%. Participants with eHealth literacy scores in the P25–P75 range (OR = 1.594, 95% CI: 1.216-2.089) and below P25 (OR = 1.584, 95% CI: 1.149-2.182) had a significantly higher likelihood of reporting poor sleep quality compared to those with scores above P75. Age-stratified analysis indicated that this association was significant only among emerging adults (OR [95% CI] = 2.491 [1.133-5.479] for P25–P75; OR [95% CI] = 2.975 [1.230-7.195] for < P25) and established adults (OR [95% CI] = 1.439 [1.001-2.067] for P25–P75). Conclusions: This study found that eHealth literacy was associated with sleep quality among younger participants but not middle-aged adults, highlighting the digital health divide in sleep health. These findings suggest that enhancing eHealth literacy may serve as an effective strategy for improving sleep outcomes. However, to ensure equitable health outcomes, interventions should be tailored to address the age-specific needs and varying levels of digital access across different groups.

Background: Type 2 #Diabetes is a prevalent chronic condition, particularly among older adults, and is associated with significant morbidity, mortality, and healthcare costs. Effective disease self-management is crucial for achieving glycemic control and preventing complications. Objective: This pilot #Study aims to evaluate the effectiveness of a structured, 5-week training program in improving eHealth literacy among older adults with type 2 #Diabetes, and to assess its impact on health literacy, self-efficacy, psychological well-being, and clinical outcomes. The primary outcome will be the change in eHealth literacy, as measured by the eHEALS scale, from baseline to post-intervention. In addition, a wide range of secondary outcomes will be examined to capture the program’s multidimensional impact: improvements in general health literacy, self-efficacy in #Diabetes management, psychological well-being, and quality of life; reductions in #Diabetes-related emotional distress, body weight, and BMI; and better metabolic control, as measured by HbA1c and lipid profile. Finally, participants’ experiences, satisfaction, and perceived benefits will be gathered to inform future scalability and refinement of the program. Methods: 200 community-dwelling adults aged≥60 years with type 2 #Diabetes, MMSE≥24, GDS

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Summary sentence The work reports on associations between eHealth Literacy (eHL) and Mental Health Literacy (MHL), hypothesizing a positive association between them. No significant association was identified between overall eHL and MHL. However, understanding online content correlated with knowledge (r = .18, P = .004) and lower stigma (r = -.15, P = .015). A distinction between perceived and actual knowledge is made.

Objectives Families of patients with cancer often experience significant psychological distress, yet family care remains insufficiently addressed in current healthcare systems. This study aimed to inv...

Background: Effective blood pressure (BP) monitoring is vital for the management of hypertension, allowing timely adjustments in treatment. This #Study focuses on the development and implementation of an innovative, locally designed eHealth technology, the HeartCare@Home system, to enhance the control and management of hypertension in outpatient noncommunicable disease (NCD) clinics in Rwanda. The HeartCare@Home system comprises a mobile health #App that incorporates rapid SMS technology, an integrated dashboard for signal reception at the clinic office level, and a clinical decision support algorithm. Objective: This #Study aims to assess the clinical efficacy, feasibility, and acceptability of a novel eHealth technology, the HeartCare@Home system, that uses home and clinic-based automated BP monitoring with real-time management of elevated BP in an outpatient NCD clinic in Rwanda. Methods: This pilot #Study will use an interventional design with a crossover approach to test the clinical efficacy of the HeartCare@Home system at the NCD clinic of Kibagabaga District Hospital. A total of 140 patients with hypertension will take part in the #Study. All enrolled patients will be allocated to either the interventional group or the standard of care group. The follow-up for each group will be 6 months (3 months in each group follow-up). The data for the intervention group will be generated by our mobile health #App, while data for the control group (standard care) will be retrieved from usual patient files at the NCD clinic. Data extraction sheets will be used for standard care data retrieval. The Feasibility of Intervention Measure and Acceptability of Intervention Measure tools will be used to cross-sectionally evaluate the feasibility and acceptability of the HeartCare@Home system. Data will be summarized with descriptive statistics. A paired sample 2-tailed t test will be used to test for differences between the pre- and postintervention records for hypertension control. Results: This #Study will yield a technical infrastructure, the HeartCare@Home system, to support the control and management of hypertension in outpatient NCD clinics. It will introduce a new model of health care delivery through innovative technology that enables home-based BP monitoring. This will offer a unique technology to enable elevated BP control and timely hypertension management and will also ensure a real-time communication linkage between patients and the appropriate level of care. Furthermore, the findings from the assessment of the clinical efficacy, feasibility, and acceptability of the HeartCare@Home system will inform possible scalability of the system to more NCD clinics. The #Study is currently in the implementation stage. Conclusions: The HeartCare@Home project will address the important gap of low BP control rates in patients with hypertension, which has contributed to delayed consultations and increased cardiovascular mortality. Such eHealth technology infrastructure may also be scalable to other settings.

En un sector tan dinámico como el de la salud, la comunicación digital ha cobrado una importancia ...

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Background: Policymakers increasingly promote eHealth as a way to improve healthcare efficiency. However, digitalization risks excluding individuals and groups who cannot fully engage with eHealth—for example, due to limited digital literacy or restricted access to resources. Targeted support, such as skills training, personalized guidance, or system-level initiatives, may help, but evidence on how such support is organized and whether it is effective remains limited. Objective: This scoping review aimed to map proposed strategies to promote eHealth inclusion, identify concrete support interventions, and report evidence on their outcomes Methods: This scoping review followed Arksey and O’Malley’s framework and the PRISMA-ScR guidelines. We searched PubMed, Scopus, Web of Science, and Embase for peer-reviewed studies published from 2014 onwards. We included empirical studies reporting on support to enhance eHealth inclusion. In total, 40 studies met the criteria: 19 examined support strategies and 21 evaluated targeted interventions. Strategies and interventions were categorized by actors at the micro level (interpersonal, such as family members, friends, or peers), meso level (organizations, such as healthcare organizations or community organizations), and macro level (policy or system). Results: Support strategies and interventions addressed a range of eHealth types, including video consultations, mobile health applications, and patient portals. Strategy studies often emphasized interpersonal support from family, friends, or peers, whereas interventions more often involved healthcare providers. Intervention outcomes, as identified during analysis, were grouped into adoption, use, skills, and attitudes. Adoption-focused interventions led by healthcare organizations showed limited effectiveness. Interventions targeting use partly demonstrated positive effects, such as increased completion of video visits, whereas outcomes related to attitudes were mixed. Nearly all multi-actor interventions—combining efforts across micro, meso, and macro levels—effectively improved eHealth skills, including digital and eHealth literacy. Examples include programs linking healthcare providers with community organizations, and initiatives pairing students with older adults, both of which improved these skills. Regional differences were also observed: healthcare providers played a dominant role in studies from the United States, community organizations were more prominent in African contexts, and multi-actor approaches were common in European studies. Conclusions: Overall, interventions yielded mixed results, but multi-actor collaborations frequently improved eHealth skills. These findings underscore the value of combining interpersonal, organizational, and policy-level efforts when designing support structures. For healthcare organizations, initiatives led solely by healthcare actors may suffice for promoting the use of specific applications (such as video consultations), but they seem insufficient for fostering broader eHealth literacy. Future research should address the sustainability and scalability of multi-actor interventions and how health system contexts and cultural factors shape their outcomes. Clinical Trial: Open Science Framework (OSF) 0.17605/OSF.IO/YRWFD; https://osf.io/6qmcj/overview