Proposing a Transactional Model of eHealth Literacy: Concept Analysis
Electronic health (eHealth) literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information. Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health informati...
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| Veröffentlicht in: | Journal of medical Internet research 2018-10, Vol.20 (10), p.e10175-e10175 |
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| creator | Paige, Samantha R Stellefson, Michael Krieger, Janice L Anderson-Lewis, Charkarra Cheong, JeeWon Stopka, Christine |
| description | Electronic health (eHealth) literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information. Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth. This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts.
The objective of our study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC.
Walker and Avant's concept analysis method was used to guide the systematic review of eHealth literacy definitions (n=10), rating scales (n=6), models (n=4), and peer-reviewed model applications (n=16). Subsequent cluster analyses showed salient themes across definitions. Dimensions, antecedents, and consequences reflected in models and measures were extracted and deductively analyzed based on codes consistent with the TMC.
Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal. Despite the transactional capabilities of eHealth, the role of "communication" in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions.
The Transactional Model of eHealth Literacy and a corresponding definition are proposed. In this novel model, eHealth literacy comprises a hierarchical intrapersonal skillset that mediates the reciprocal effect of contextual factors (ie, user oriented and task oriented) on patient engagement in health care. More specifically, the intrapersonal skillset counteracts the negative effect of "noise" (or impediments) produced by social and relational contexts. Cutting across health and technology literacies, the intrapersonal skillset of eHealth literacy is operationalized through four literacies that correspond with discrete operative skills: (1) functional (ie, loca |
| doi_str_mv | 10.2196/10175 |
| format | Article |
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The objective of our study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC.
Walker and Avant's concept analysis method was used to guide the systematic review of eHealth literacy definitions (n=10), rating scales (n=6), models (n=4), and peer-reviewed model applications (n=16). Subsequent cluster analyses showed salient themes across definitions. Dimensions, antecedents, and consequences reflected in models and measures were extracted and deductively analyzed based on codes consistent with the TMC.
Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal. Despite the transactional capabilities of eHealth, the role of "communication" in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions.
The Transactional Model of eHealth Literacy and a corresponding definition are proposed. In this novel model, eHealth literacy comprises a hierarchical intrapersonal skillset that mediates the reciprocal effect of contextual factors (ie, user oriented and task oriented) on patient engagement in health care. More specifically, the intrapersonal skillset counteracts the negative effect of "noise" (or impediments) produced by social and relational contexts. Cutting across health and technology literacies, the intrapersonal skillset of eHealth literacy is operationalized through four literacies that correspond with discrete operative skills: (1) functional (ie, locate and understand); (2) communicative (ie, exchange); (3) critical (ie, evaluate); and (4) translational (ie, apply).</description><identifier>ISSN: 1438-8871</identifier><identifier>ISSN: 1439-4456</identifier><identifier>EISSN: 1438-8871</identifier><identifier>DOI: 10.2196/10175</identifier><identifier>PMID: 30279155</identifier><language>eng</language><publisher>Canada: Journal of Medical Internet Research</publisher><subject>Analysis ; Cognition ; Communication ; Conceptual analysis ; Conceptual models ; Cultural factors ; Female ; Health information ; Health literacy ; Health Literacy - methods ; Humans ; Information technology ; Internet ; Internet - standards ; Literacy ; Male ; Medical law ; Medical technology ; Multimedia ; Noise ; Original Paper ; Patients ; Personal health ; Skills ; Social media ; Social networks ; Systematic review ; Telemedicine - methods ; Transactions ; Web 2.0 ; Web portals</subject><ispartof>Journal of medical Internet research, 2018-10, Vol.20 (10), p.e10175-e10175</ispartof><rights>Samantha R Paige, Michael Stellefson, Janice L Krieger, Charkarra Anderson-Lewis, JeeWon Cheong, Christine Stopka. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.10.2018.</rights><rights>COPYRIGHT 2018 Journal of Medical Internet Research</rights><rights>2018. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Samantha R Paige, Michael Stellefson, Janice L Krieger, Charkarra Anderson-Lewis, JeeWon Cheong, Christine Stopka. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.10.2018. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492t-17f7f1177dff24534427498f20775841c7a86ae6cb30ff5959291bc8af79a2fe3</citedby><cites>FETCH-LOGICAL-c492t-17f7f1177dff24534427498f20775841c7a86ae6cb30ff5959291bc8af79a2fe3</cites><orcidid>0000-0003-3976-2996 ; 0000-0001-9950-9170 ; 0000-0001-6141-5099 ; 0000-0002-5976-8343 ; 0000-0001-6033-7180 ; 0000-0003-1717-4114</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,727,780,784,864,885,12846,27924,27925,30999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30279155$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paige, Samantha R</creatorcontrib><creatorcontrib>Stellefson, Michael</creatorcontrib><creatorcontrib>Krieger, Janice L</creatorcontrib><creatorcontrib>Anderson-Lewis, Charkarra</creatorcontrib><creatorcontrib>Cheong, JeeWon</creatorcontrib><creatorcontrib>Stopka, Christine</creatorcontrib><title>Proposing a Transactional Model of eHealth Literacy: Concept Analysis</title><title>Journal of medical Internet research</title><addtitle>J Med Internet Res</addtitle><description>Electronic health (eHealth) literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information. Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth. This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts.
The objective of our study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC.
Walker and Avant's concept analysis method was used to guide the systematic review of eHealth literacy definitions (n=10), rating scales (n=6), models (n=4), and peer-reviewed model applications (n=16). Subsequent cluster analyses showed salient themes across definitions. Dimensions, antecedents, and consequences reflected in models and measures were extracted and deductively analyzed based on codes consistent with the TMC.
Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal. Despite the transactional capabilities of eHealth, the role of "communication" in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions.
The Transactional Model of eHealth Literacy and a corresponding definition are proposed. In this novel model, eHealth literacy comprises a hierarchical intrapersonal skillset that mediates the reciprocal effect of contextual factors (ie, user oriented and task oriented) on patient engagement in health care. More specifically, the intrapersonal skillset counteracts the negative effect of "noise" (or impediments) produced by social and relational contexts. Cutting across health and technology literacies, the intrapersonal skillset of eHealth literacy is operationalized through four literacies that correspond with discrete operative skills: (1) functional (ie, locate and understand); (2) communicative (ie, exchange); (3) critical (ie, evaluate); and (4) translational (ie, apply).</description><subject>Analysis</subject><subject>Cognition</subject><subject>Communication</subject><subject>Conceptual analysis</subject><subject>Conceptual models</subject><subject>Cultural factors</subject><subject>Female</subject><subject>Health information</subject><subject>Health literacy</subject><subject>Health Literacy - methods</subject><subject>Humans</subject><subject>Information technology</subject><subject>Internet</subject><subject>Internet - standards</subject><subject>Literacy</subject><subject>Male</subject><subject>Medical law</subject><subject>Medical technology</subject><subject>Multimedia</subject><subject>Noise</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Personal health</subject><subject>Skills</subject><subject>Social media</subject><subject>Social networks</subject><subject>Systematic review</subject><subject>Telemedicine - methods</subject><subject>Transactions</subject><subject>Web 2.0</subject><subject>Web portals</subject><issn>1438-8871</issn><issn>1439-4456</issn><issn>1438-8871</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpt0l9rFDEQAPAgiq21X0EWRNCHq5ls_mx8EI6j2sJVBetzyOUm15S9zTXJlt63N7W17YnkISH5zSQZhpBDoEcMtPwIFJR4RvaBt92k6xQ8f7LeI69yvqSUUa7hJdlrKVMahNgnxz9S3MQchlVjm_Nkh2xdCXGwfXMWl9g30Td4grYvF808FEzWbT81szg43JRmWt02h_yavPC2z3h4Px-QX1-Oz2cnk_n3r6ez6XziuGZlAsorD6DU0nvGRcs5U1x3nlGlRMfBKdtJi9ItWuq90EIzDQvXWa-0ZR7bA_L5Lu9mXKxx6XAoyfZmk8Lapq2JNpjdkyFcmFW8NpK10FFaE7y_T5Di1Yi5mHXIDvveDhjHbBiArA-UHCp9-w-9jGOqH65KAFNKScUe1cr2aMLgY73X3SY1UyV1KwRwWdXRf1QdS1wHFwf0oe7vBHzYCaim4E1Z2TFnc_rz2659d2ddijkn9A_1AGpue8P86Y3q3jwt3oP62wztb0R3r3Q</recordid><startdate>20181001</startdate><enddate>20181001</enddate><creator>Paige, Samantha R</creator><creator>Stellefson, Michael</creator><creator>Krieger, Janice L</creator><creator>Anderson-Lewis, Charkarra</creator><creator>Cheong, JeeWon</creator><creator>Stopka, Christine</creator><general>Journal of Medical Internet Research</general><general>Gunther Eysenbach MD MPH, Associate Professor</general><general>JMIR Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISN</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CNYFK</scope><scope>DWQXO</scope><scope>E3H</scope><scope>F2A</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1O</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3976-2996</orcidid><orcidid>https://orcid.org/0000-0001-9950-9170</orcidid><orcidid>https://orcid.org/0000-0001-6141-5099</orcidid><orcidid>https://orcid.org/0000-0002-5976-8343</orcidid><orcidid>https://orcid.org/0000-0001-6033-7180</orcidid><orcidid>https://orcid.org/0000-0003-1717-4114</orcidid></search><sort><creationdate>20181001</creationdate><title>Proposing a Transactional Model of eHealth Literacy: Concept Analysis</title><author>Paige, Samantha R ; 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Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth. This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts.
The objective of our study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC.
Walker and Avant's concept analysis method was used to guide the systematic review of eHealth literacy definitions (n=10), rating scales (n=6), models (n=4), and peer-reviewed model applications (n=16). Subsequent cluster analyses showed salient themes across definitions. Dimensions, antecedents, and consequences reflected in models and measures were extracted and deductively analyzed based on codes consistent with the TMC.
Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal. Despite the transactional capabilities of eHealth, the role of "communication" in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions.
The Transactional Model of eHealth Literacy and a corresponding definition are proposed. In this novel model, eHealth literacy comprises a hierarchical intrapersonal skillset that mediates the reciprocal effect of contextual factors (ie, user oriented and task oriented) on patient engagement in health care. More specifically, the intrapersonal skillset counteracts the negative effect of "noise" (or impediments) produced by social and relational contexts. Cutting across health and technology literacies, the intrapersonal skillset of eHealth literacy is operationalized through four literacies that correspond with discrete operative skills: (1) functional (ie, locate and understand); (2) communicative (ie, exchange); (3) critical (ie, evaluate); and (4) translational (ie, apply).</abstract><cop>Canada</cop><pub>Journal of Medical Internet Research</pub><pmid>30279155</pmid><doi>10.2196/10175</doi><orcidid>https://orcid.org/0000-0003-3976-2996</orcidid><orcidid>https://orcid.org/0000-0001-9950-9170</orcidid><orcidid>https://orcid.org/0000-0001-6141-5099</orcidid><orcidid>https://orcid.org/0000-0002-5976-8343</orcidid><orcidid>https://orcid.org/0000-0001-6033-7180</orcidid><orcidid>https://orcid.org/0000-0003-1717-4114</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Cognition Communication Conceptual analysis Conceptual models Cultural factors Female Health information Health literacy Health Literacy - methods Humans Information technology Internet Internet - standards Literacy Male Medical law Medical technology Multimedia Noise Original Paper Patients Personal health Skills Social media Social networks Systematic review Telemedicine - methods Transactions Web 2.0 Web portals |
| title | Proposing a Transactional Model of eHealth Literacy: Concept Analysis |
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