Beyond technology acceptance-a focused ethnography on the implementation, acceptance and use of new nursing technology in a German hospital.

Introduction: Hospitalised patients could benefit from the emergence of novel technologies for nursing care. There are numerous technical products available, but these rarely find their way into practice. Further knowledge is required about the circumstances under which technology in nursing is accepted and used. In the research project "Centre for Implementing Nursing Care Innovations", technical innovations are implemented on a trauma surgery inpatient ward in Germany. After implementation, it was investigated: Which implemented technologies are accepted/rejected, and which factors influence the acceptance/rejection of technology for nurses? Material and methods: A focused ethnography was used, containing two approaches: First, participant observation was conducted to examine nurses' and patients' interaction with technologies. Observations were fixed in a field research diary and analysed using evaluative qualitative content analysis. Second, a questionnaire was used by nurses to provide information about the use frequency and technology suitability. The results of the study were consolidated and analysed using the UTAUT model. Results: Seven studied technologies can be summarised in four result categories: (1) A Mobilising mattress, a Special projector and a Sound pillow are accepted and used by nurses and patients, because they offer a way to provide high quality care with little additional effort. (2) A Fall prevention system is consistently used in patient care as a work obligation, but since nurses consider the system error-prone, acceptance is low. (3) An Interactive therapy ball is accepted but nurses cannot use it due to the high workload. (4) An App for nurse-patient communication and a work-equipment tracking system are not used or accepted because nurses do not see a practical benefit in the systems. Discussion: Acceptance or rejection of a product does not necessarily equate to use or non-use of the technology. Before implementation, technology acceptance among users occurs as prejudice-when users are given time to experiment with technology, intention-to-use can stabilize into sustained use. Accepted and used technologies can serve to mask problems (such as staff shortages) and encourage problematic developments, such as the reduction of contact time at the bedside. Therefore, technology acceptance should be qualified in asking to what accepted technology contributes.

Tuberculosis case fatality is higher in male than female patients in Europe: a systematic review and meta-analysis.

PURPOSE: Epidemiological TB data indicate differences in infection prevalence, progression rates, and clinical disease incidence between sexes. In contrast, evidence on sex-specific differential (post) TB case fatality in Europe has not been synthesized systematically. METHODS: We searched electronic databases and grey literature up to December 2020 for studies reporting sex-stratified TB death data for Europe. The JBI critical appraisal tools served for bias risk assessment and subgroup analyses for studying heterogeneity. Random-effects models meta-analyses enabled estimating pooled relative risks of sex-associated TB fatality. Considering associations of comorbidities and risk factors on fatality differences, we applied relative risk meta-regression. RESULTS: Based on 17,400 records screened, 117 studies entered quantitative analyses. Seventy-five studies providing absolute participant data with moderate quality and limited sex stratification reported 33 to 235,000 TB cases and 7 to 27,108 deaths. The pooled male-to-female TB fatality risk ratio was 1.4 [1.3-1.5]. Heterogeneity was high between studies and subgroups. Study time, concurrent comorbidities (e.g., HIV, diabetes, cancers), and mean participant ages showed no effect modification. We identified higher male TB fatality in studies with higher homelessness (coefficient 3.18, 95% CI [-0.59 to 6.94], p-value 0.10) and lower migrants proportion (coefficient - 0.24, 95% CI [- 0.5 to 0.04], p-value 0.09). CONCLUSION: We found 30-50% higher TB case fatality for males in Europe. Except for homelessness, migration, and a trend for some comorbidities, assessing effect modification could not reduce our meta-analysis' high heterogeneity. Public health authorities should take heed of this higher risk of dying in male patients' treatment services.

A qualitative interview study of patients' attitudes towards and intention to use digital interventions for depressive disorders on prescription.

Background: Depressive disorders are an emerging public health topic. Due to their increasing prevalence, patients with depressive disorders suffer from the lack of therapeutic treatment. Digital health interventions may offer an opportunity to bridge waiting times, supplement, or even substitute in-person treatment. Among others, the Unified Theory of Acceptance and Use of Technology (UTAUT) explains that actual technology use is affected by users' behavioural intention. However, patients' perspectives on digital interventions are rarely discussed within the specific context of primary care provided by general practitioners (GP) and need further exploration. Method: A qualitative study design with semi-structured interviews was used to explore DTx-acceptance of patients with mild or moderate depression (n = 17). The audio-recorded interviews were transcribed verbatim, coded, and thematically analysed by qualitative content analysis. Results: Patients' performance expectancies reveal that DTx are not perceived as a substitute for face-to-face treatment. Effort expectancies include potential advantages and efforts concerning technical, motivational, and skill-based aspects. Moreover, we identified health status and experience with depressive disorders as other determinants and potential barriers to patients' DTx acceptance: Difficult stages of depression or long-time experience are perceived hurdles for DTx use. GPs' recommendations were just partly relevant for patients and varied according to patients' consultancy preferences. But still, GPs have a crucial role for access due to prescription. GPs' influence on patients' DTx acceptance varies between three situations: (1) pre-use for consultation, (2) pre-use for access and (3) during DTx-use. Further, GPs' guidance could be especially relevant for patients during DTx-use in routine care. Discussion: The UTAUT-based exploration suggests that acceptance determinants should be considered independently and embedded in personal and situational aspects. DTx require a healthcare professional to prescribe or diagnose the disease, unlike other digital offerings. We identified prescription- and depression-related determinants, exceeding existing theoretical constructs. GPs' guidance can compensate for some barriers to DTx use e.g., by increasing commitment and motivational support to strengthen patients' acceptance. Conclusion: We argue for a multidimensional integration of acceptance determinants for further development of health technology acceptance research. Future research should specify how DTx can be integrated into routine care to strengthen user acceptance.

Expectations of new technologies in nursing care among hospital patients in Germany - an interview study.

Introduction: New technologies will be increasingly available for nursing care, including robots, patient mobilisation devices, digital event detection or prevention equipment. Technologies are expected to support nurses, increase patients' safety and reduce costs. Yet, although these technologies will significantly shape patients' experience, we need to learn more about patients' perspectives regarding new technology in care. This study aims to investigate attitudes, expectations, worries and anticipated implementation effects of new assistive technology in nursing care by patients. Methods: Qualitative, guided, semi-open interviews were conducted. The recruitment was carried out in a trauma surgery ward of a university hospital in Germany. Eight different technologies were presented via video clips and additional information to the patients, followed by in-depth discussions. The interviews were analysed using qualitative evaluative content analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) Checklist was used to ensure study quality. Results: Study participants anticipate different outcomes for the implementation of new nursing technology: (1) For patients, they consider the potential for improvement in health and well-being as well as for their hospital stay experience, but also fear possible health risks or social or emotional factors like loss of autonomy or loneliness. (2) For professional nurses, participants expect relief from physically stressful work routines; however, they might be replaced by machines and lose their employment (3) For the nursing process, safety and quality improvements for care delivery may encounter a negative quantification of human life and risks of constant surveillance. Conclusion: Patients identify opportunities, challenges and shortcomings of nursing technology implementation. They describe nuanced and mixed accounts of patients' perspectives that are structured in a 'continuum of anticipated effects' of implementing technology in our article. The results can inform future implementation strategies.

How do parents access, appraise, and apply health information on early childhood allergy prevention? A focus group and interview study.

Background: When parents want to make health-related decisions for their child, they need to be able to handle health information from a potentially endless range of sources. Early childhood allergy prevention (ECAP) is a good example: recommendations have shifted from allergen avoidance to early introduction of allergenic foods. We investigated how parents of children under 3 years old access, appraise and apply health information about ECAP, and their respective needs and preferences. Methods: We conducted 23 focus groups and 24 interviews with 114 parents of children with varied risk for allergies. The recruitment strategy and a topic guide were co-designed with the target group and professionals from public health, education, and medicine. Data were mostly collected via video calls, recorded and then transcribed verbatim. Content analysis according to Kuckartz was performed using MAXQDA and findings are presented as a descriptive overview. Results: Parents most frequently referred to family members, friends, and other parents as sources of ECAP information, as well as healthcare professionals (HCPs), particularly pediatricians. Parents said that they exchanged experiences and practices with their peers, while relying on HCPs for guidance on decision-making. When searching for information online, they infrequently recalled the sources used and were rarely aware of providers of "good" health information. While parents often reported trying to identify the authors of information to appraise its reliability, they said they did not undertake more comprehensive information quality checks. The choice and presentation of ECAP information was frequently criticized by all parent groups; in particular, parents of at-risk children or with a manifested allergy were often dissatisfied with HCP consultations, and hence did not straightforwardly apply advice. Though many trusted their HCPs, parents often reported taking preventive measures based on their own intuition. Conclusion: One suggestion to react upon the many criticisms expressed by parents regarding who and how provides ECAP information is to integrate central ECAP recommendations into regular child care counseling by HCPs-provided that feasible ways for doing so are identified. This would assist disease prevention, as parents without specific concerns are often unaware of the ECAP dimension of issues such as nutrition.

Promotion of physical activity-related health competence using digital workplace-based health promotion: protocol for a controlled before-and-after study.

Physical activity (PA) has a high potential to prevent chronic diseases. At the same time, many people in Germany do not achieve PA recommendations due to trends such as digitalisation and the COVID-19 pandemic and, as a result, working from home. There is a need for location-independent and time-independent interventions. Based on the model of physical activity-related health competence (PAHCO), a study design was developed for a digitally conducted, controlled, before-and-after-study targeting office workers. The intervention group receives video-based instructions with exercises that can be performed directly at the desk, complemented by anatomical explanations and advice on PA based on the PAHCO model. The control group only receives the exercises. The intervention period is 5 weeks. Follow-up is conducted after 3 months. The trial shall comprise 294 participants per group whose PA is recorded via questionnaire and online PA diary. Their PAHCO and health-related quality of life are also assessed. The present study aims to increase the health-enhancing PA of office workers independent of time and location. Trial registration number is DRKS00028053.

Synchronous online focus groups in health research: application and further development of methodology based on experiences from two mixed-methods research projects.

OBJECTIVES: Focus groups used for data collection in health research are increasingly conducted online. In two multi-center health research projects, we applied available methodological instructions for synchronous online focus groups (SOFGs). We describe necessary changes and specifications regarding the planning (recruitment, technology, ethics, appointments) and conduct (group composition, moderation, interaction, didactics) to enhance knowledge about the planning and conduct of SOFGs. RESULTS: Recruiting online proved to be challenging and necessitated direct and analogue recruiting, too. To ensure participation, less digital and more individual formats may be offered, e.g. telephone calls. Explaining verbally the specifics of data protection and anonymity in an online setting can foster participants' confidence to actively engage in the discussion. Two moderators, one moderating, one supporting technically, are advisable in SOFGs, however, due to limited nonverbal communication, roles and tasks need to be defined beforehand. Participant interaction is central to focus groups in general, but sometimes difficult to achieve online. Hence, smaller group size, sharing of personal information and moderators increased attention to individual reactions appeared helpful. Lastly, digital tools such as surveys and breakout rooms should be used with caution, as they easily inhibit interaction.

Correction: Lander et al. Health Literacy Development among People with Chronic Diseases: Advancing the State of the Art and Learning from International Practices. Int. J. Environ. Res. Public Health 2022, 19, 7315.

The authors would like to make corrections to a recently published paper [...].

Parental COVID-19-related health information practises, sources, evaluations and needs: A qualitative interview study.

BACKGROUND: Parents of infants and young children may have specific health information needs and preferences, as they are responsible for their children's health. COVID-19 posed many challenges for families, not least in terms of the constantly updated disease-prevention guidelines. However, little is known about parents' experiences with this unprecedented situation, that is, how and where they seek, use and evaluate COVID-19 (child)-specific health information. We aimed to find out more about this to provide insights to health (information) providers when communicating pandemic information to parents. METHODS: We conducted semistructured telephone interviews (August to October 2020) with a purposively selected sample of 20 German-speaking and 10 Arabic-speaking parents of children up to 4 years old. Recruitment occurred through multiple channels, including childcare institutions and social media. Qualitative content analysis of the interview transcripts illustrates the main differences between the two groups. RESULTS: By the time the interviews were conducted (mid-2020), some parents reported to seek information less actively or not at all, compared to the beginning of COVID-19. German speakers frequently used Google to obtain information, whereas Arabic speakers mentioned social media (particularly Facebook) as a central source. However, medical providers were the most trusted source for child health. Though determining the credibility of online information was difficult for some parents, others, mostly German speakers (middle-high education), were aware of some author-related criteria. When deciding on information use, parents often rely on their own judgement and gut instinct. Besides the necessity to disseminate information via multiple outlets to reach all parents, Arabic speakers desired audio-visual and translation tools to facilitate understanding. DISCUSSION AND PUBLIC CONCLUSION: Apart from education, language and knowledge of the health system and of the attributes of credible information may determine its quality and consequent decisions. There seems to be a considerable need to foster knowledge about reliable information sources, a greater understanding of the range of quality criteria and specific support for nonnative speakers, not least to better inform parents' decision-making. PATIENT AND PUBLIC CONTRIBUTION: A parent panel (n = 7) contributed to gathering ideas regarding recruitment, discussing initial results and the choice of topics and questions for a second interview phase.

Correction: Awareness, Information-Seeking Behavior, and Information Preferences About Early Childhood Allergy Prevention Among Different Parent Groups: Protocol for a Mixed Methods Study.

[This corrects the article DOI: 10.2196/25474.].

Digitization in health-related self-help - Results of an online survey among self-help organizations in Germany.

Background: Nowadays, much hope and expectations are associated with digitization in the health sector. The digital change also affects health-related self-help. A nationwide survey of self-help organizations (SHOs) aimed to show chances and limitations in the use of interactive IT tools like webforums, online meetings or social media as well as digital infrastructures for their organizational management. In this survey, we also determined whether SHO staff themselves have support and qualification needs with regard to this topic. Design: The online survey was conducted between 14 November and 8 December 2019, i.e., immediately before the outbreak of the Covid-19 pandemic. The questionnaire consisted of 50 questions consisting of 180 single items which could be answered in 30-40 min. After two reminder letters, 119 questionnaires of the SHOs were gathered and analysed. Results: SHOs already have a lot of experience with digital media/tools (e.g., own homepage, social media, cloud computing). Some tools are attested a "high" or "very high" benefit by more than 80% of users. Perceived benefits, however, are also facing a number of problems, ranging from lack of resources to data protection issues. Despite, or even because of the limits of digitization, there is great desire and need for support and further training in SHOs (and self-help groups). Conclusions: At many points in the survey it was shown that digital media can be a useful extension of "traditional" collective self-help. Taking into account the risks and limitations associated with digital tools, SHOs can be central stakeholders in digitization in health-related self-help. Patient or Public Contribution: The study was financially supported by the Federal Ministry of Health, Germany. A detailed representation of the results is publicly available at: https://www.uke.de/dish.

Determining the need for additional training among hospital infection-control workforce - results from a multicentric survey within the multiresistance network of southern Lower Saxony (MRNS), Germany.

Infection-control nurses (ICN) and infection-control link physicians (ICLP) are both responsible for infection prevention practices in hospitals. However, their topic-specific education levels and extent of engagement in infection-control issues are diverse, creating potential needs for additional training. We aimed at determining the potential need for additional training in infection-control among ICN, ICLP and medical Chief Executive Officers (CEO) in hospitals of the Multiresistance Network of southern Lower Saxony (MRNS), via structured surveys (n=48; 55.1%). Our data suggest that the majority of ICN as well as ICLP have unmet needs for consultation and training on the topics of hospital hygiene and infection control. We observed a higher need for advice/additional information among ICLP than among ICN, e.g., concerning outbreaks (p=0.032), multidrug resistance (p=0.005) or antimicrobial stewardship (p=0.020). Therefore, future training programs might require targeting workforce-specific topics as part of their curricula. Furthermore, the improvement of the knowledge of ICN and ICLP for the implementation of infection control could contribute to improved prevention of the transmission of infectious diseases.

Health Literacy Development among People with Chronic Diseases: Advancing the State of the Art and Learning from International Practices.

Chronic diseases account for a considerable part of the strain on health care systems [...].

Moving towards patient-centered care and shared decision-making in Germany.

The main focus of this paper is to describe the development and current state of policy, research and implementation of patient-centered care (PCC) and shared decision-making (SDM) in Germany. What is the current state in health policy? Since 2013, the Law on Patients' Rights has standardized all rights and responsibilities regarding medical care for patients in Germany. This comprises the right to informed decisions, comprehensive and comprehensible information, and decisions based on a clinician-patient partnership. In addition, reports and action plans such as the German Ethics Council's report on patient well-being, the National Health Literacy Action Plan, or the National Cancer Plan emphasize and foster PCC and SDM on a policy level. There are a number of public organizations in Germany that support PCC and SDM. How are patients and the public involved in health policy and research? Publishers and funding agencies increasingly demand patient and public involvement. Numerous initiatives and organizations are involved in publicizing ways to engage patients and the public. Also, an increasing number of public and research institutions have established patient advisory boards. How is PCC and SDM taught? Great progress has been made in introducing SDM into the curricula of medical schools and other health care providers' (HCPs) schools (e.g., nursing, physical therapy). What is the German research agenda? The German government and other public institutions have constantly funded research programs in which PCC and SDM are important topics. This yielded several large-scale funding initiatives and helped to develop SDM training programs for HCPs in different fields of health care and information materials. Recently, two implementation studies on SDM have been conducted. What is the current uptake of PCC and SDM in routine care, and what implementation efforts are underway? Compared to the last country report from 2017, PCC and SDM efforts in policy, research and education have been intensified. However, many steps are still needed to reliably implement SDM in routine care in Germany. Specifically, the further development and uptake of decision tools and countrywide SDM trainings for HCPs require further efforts. Nevertheless, an increasing number of decision support tools - primarily with support from health insurance funds and other public agencies - are to be implemented in routine care. Also, recent implementation efforts are promising. For example, reimbursement by health insurance companies of hospital-wide SDM implementation is being piloted. A necessary next step is to nationally coordinate the gathering and provision of the many PCC and SDM resources available.

How do health professionals translate evidence on early childhood allergy prevention into health literacy-responsive practice? A protocol for a mixed-method study on the views of German health professionals.

INTRODUCTION: Paediatricians, general practitioners (GPs) and midwives in primary care are important sources of information for parents on early childhood allergy prevention (ECAP). Research has shown that preventive counselling by health professionals can be effective in improving patients' health literacy (HL) and health behaviour. Providing effective advice relies on two factors. First, health professionals need be up-to-date with research evidence on ECAP, to consider popular misconceptions and fears and to translate this knowledge into clear recommendations for parents (knowledge translation). Second, they need to know and apply counselling techniques and create a practice setting which accommodates parental HL needs (health literacy-responsive care). The objective of this study is to explore and assess how German health professionals take up and translate ECAP evidence into appropriate recommendations for parents, how they consider HL in counselling and practice organisation and what barriers and enablers they find in their performance of HL-responsive ECAP. METHODS AND ANALYSIS: The study has a sequential mixed-method design, in two phases. In the first phase, qualitative semi-structured expert interviews will be conducted with health professionals (paediatricians, GPs and midwives) at primary care level and professional policy level. Data collection is ongoing until January 2022. In the second phase, based on the qualitative results, a standardised questionnaire will be developed, and pilot-tested in a wider population of German health professionals. The findings of both phases will be integrated. ETHICS AND DISSEMINATION: The study has received ethical approval from the Ethics Committee of the University of Regensburg (18-1205-101). The results will be published in international peer-reviewed open access journals and via presentations at scientific conferences. The results will also be shared with German health professionals, decision-makers and potential funders of interventions.

[What support does a mobile, assistive app provide for informal caregivers? A qualitative analysis of the MoCaB app user experience]. / Unterstützung pflegender Angehöriger durch eine mobile, assistive App. Eine qualitative Analyse der Perspektive von Nutzerinnen und Nutzern der App MoCaB.

BACKGROUND: In the joint project "Mobile Care Backup" funded by the German Federal Ministry of Education and Research, the smartphone-based app "MoCaB" was developed in close cooperation with informal caregivers. It provides individualized, algorithm-based information and can accompany and support caring relatives in everyday life. After a multi-step development, informal caregivers tested the MoCaB app in a home setting at the end of the research project. The goal was to find out how the test persons evaluate MoCaB and in which form the app can provide support to informal caregivers. METHODS: Eighteen test persons caring for relatives participated in a four-week test of MoCaB. Guideline-based qualitative interviews to record usage behavior and experiences with the app were conducted after two and four weeks of testing, transcribed and analyzed using qualitative content analysis. RESULTS: The test persons described the care-related information as helpful. The individualized, algorithm-based mode of information delivery and the exercises provided for family caregivers were generally rated as helpful, but their use depends on the individual usage style. Three dimensions can describe the effects of MoCaB: 1) expansion of care-relevant knowledge, 2) stimulation of self-reflection, and 3) behavior towards the care recipients. DISCUSSION: With few exceptions, the testing caregivers felt that the MoCaB app was enriching. The support dimensions have an effect at different points in everyday life and vary in intensity, depending on the duration of the existing care activity and the individual preferences of the users. CONCLUSION: The way in which caregivers used the app was not always consistent with the expected behaviors. This demonstrates the relevance of open-ended, qualitative research methods in the evaluation of health apps.

[Cyberchondria - A New Behavioral Syndrome?] / Cyberchondrie ­ ein neues Verhaltenssyndrom?

Investigation of cyberchondria is still in its infancy. Preliminary research suggests that cyberchondria is likely to represent a distinct behavioral syndrome which is closely associated with health anxiety/hypochondria and extensive online searching for health information and/or digital self-tracking. The internet is characterized by anonymous, readily, convenient space-time-independent accessibility and availability of an almost unmanageable amount of information that may increase the reassurance-seeking safety behavior of individuals with heightened health anxiety. Cyberchondria also appears to be related to low self-esteem, anxiety sensitivity, intolerance of uncertainty, compulsivity and metacognitive beliefs. At present, it is unclear of whether individuals with cyberchondria suffer from extensive health-related online searching behavior only or also from other forms of internet use disorders. The link between cyberchondria and e-health literacy, defined as perceived skills at finding, evaluating, and applying online health information to health problems, is poorly recognized. At present, there are no standardized therapeutic interventions for cyberchondria available. Treatment should address the maladaptive health- or illness-related assumptions and beliefs by using existing, well established approaches for hypochondria. Furthermore, it should target the problematic internet use and enable individuals with cyberchondria to reflect their subjective e-health literacy and promote a functional use of health resources from the internet.

Awareness, Information-Seeking Behavior, and Information Preferences About Early Childhood Allergy Prevention Among Different Parent Groups: Protocol for a Mixed Methods Study.

BACKGROUND: In early childhood allergy prevention (ECAP), parents act on behalf of their children. Parental health literacy and the availability of high-quality information, both online and offline, are crucial for effective ECAP. Recent research highlights three main points. First, parents need sufficient health literacy to discriminate between high-quality and low-quality information. Second, ECAP information behaviors may vary between phases of childhood development and according to individual circumstances. Third, to strengthen user-centeredness of available services, a better overview of parents' information practices and needs and how they handle uncertainties is required. OBJECTIVE: This study aims to explore why, how, and when parents search for and apply ECAP-specific health information and which individual (eg, understanding of advice) and organizational challenges (eg, information services, information complexity, and changing recommendations) they perceive and how they handle them. This study also aims to assess the needs and preferences that parents express for future information formats and contents. The findings should inform the practical design of ECAP information as well as formats and channels specific to different parent groups. METHODS: The above-named issues will be explored with parents in four German cities as one element in our efforts to cover the spectrum of perspectives. Based on a mixed methods design, including qualitative and quantitative assessments, the first year serves to prepare focus groups, a piloted focus group guide, a short standardized survey adapted from the European Health Literacy Project, recruitment channels, and the recruitment of participants. After conducting 20 focus groups in the second year, data will be analyzed via a constant comparison method in the third year. Based on this, practice implications on channels (ie, Where?), formats (ie, How?), and contents (ie, What?) of ECAP-specific information will be derived and discussed with parents and associated project partners before its dissemination to relevant ECAP actors (eg, childcare institutions and pediatricians). RESULTS: The study began with preselection of recruitment channels, drafting of recruitment and study information for potential participants, and agreement on a first full version of the guideline. Then, a detailed contact list was compiled of health professionals, administrative and social institutions, and relevant social media channels (N=386) to be approached for assistance in contacting parents. The recruitment was postponed due to COVID-19 and will start in January 2021. CONCLUSIONS: ECAP is a relevant example for assessing how users (ie, parents) handle not only health information but the various and continuous changes, uncertainties, and controversies attached to it. So far, it is unclear how parents implement the respective scientific recommendations and expert advice, which is why this study aims to inform those who communicate with parents about ECAP information. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25474.

Health literacy in the general population in the context of epidemic or pandemic coronavirus outbreak situations: Rapid scoping review.

OBJECTIVE: The aim of this rapid scoping review, for which only studies from the general population were considered, was to describe the extent of existing research on HL in the context of previous coronavirus outbreaks (SARS-CoV-1, MERS-CoV and SARS-CoV-2). METHODS: We searched major databases and included publications of quantitative and qualitative studies in English and German on any type of research on the functional, critical and communicative domains of HL conducted in the context of the three outbreaks in the general population. We extracted and tabulated relevant data and narratively reported where and when the study was conducted, the design and method used, and how HL was measured. RESULTS: 72 studies were included. Three investigated HL or explicitly referred to the concept of HL, 14 were guided by health behaviour theory. We did not find any study designed to develop or psychometrically evaluate pandemic/epidemic HL instruments, or relate pandemic/epidemic or general HL to a pandemic/epidemic outcome, or any controlled intervention study. Type of assessment of the domains of HL varied widely. CONCLUSION: Theory-driven observational studies and interventions, examining whether pandemic-related HL can be improved are needed. PRACTICE IMPLICATIONS: The development and validation of instruments that measure pandemic-related HL is desirable.