Exploring skill requirements for the Industry 4.0: a worker-oriented approach / Explorando habilidades requeridas para la Industria 4.0: Un enfoque orientado al trabajador

Emerging technologies are shaping the world of work, thus creating an increasingly digital industry, also known as “Industry 4.0”. Thus, examining skill requirements becomes essential to facilitate organizational adaptation to this technological revolution. The aim of this study was to explore the perception of skill requirements of workers of a highly technological manufacturing company. In Study 1 (n = 671), an exploratory factor analysis was carried out to identify relevant groups of skills. A year later, in Study 2 (n = 176), we confirmed the factor structure through a confirmatory factor analysis and we conducted a latent growth curve analysis to examine potential changes of the previous skill requirements due to the lockdown and the forced remote working during the COVID-19 pandemic. Findings showed that cognitive, functional business, strategic and managing people skills are considered as important resources for the industry 4.0, being the functional business skills increasingly relevant in time 2. Moreover, we identified differences between managers and subordinates regarding such skills. We discuss theoretical and practical implications for skills development in the digital age.(AU)

Tecnologías emergentes están dando forma al mundo del trabajo, creando así una industria cada vez más digital, también conocida como "Industria 4.0". Por tanto, examinar el requirimiento de habilidades se vuelve esencial para facilitar la adaptación organizacional a esta revolución tecnológica. El objetivo de este estudio fue explorar la percepción de las habilidades requeridas por los trabajadores de una empresa manufacturera altamente tecnológica. En el Estudio 1 (n = 671), se realizó un análisis factorial exploratorio para identificar grupos relevantes de habilidades. Un año después, en el Estudio 2 (n = 176), confirmamos la estructural factorial a través de un análisis factorial confirmatorio y realizamos un análisis de curva de crecimiento latente para examinar posibles cambios en las habilidades requeridas debido al confinamiento y el trabajo remoto forzado durante la pandemia del COVID-19. Los resultados mostraron que las habilidades cognitivas, funcionales del negocio, estratégicas y de gestión de personas se consideran recursos importantes para la industria 4.0, siendo las habilidades funcionales del negocio más relevantes en el tiempo 2. Además, identificamos diferencias entre gerentes y subordinados con respecto a tales habilidades. Discutimos las implicaciones teóricas y prácticas para el desarrollo de habilidades en la era digital.(AU)

Impact of Social Determinants and Digital Literacy on Telehealth Acceptance for Pediatric Cardiology Care Delivery during the Early Phase of the COVID-19 Pandemic.

OBJECTIVES: To determine whether telehealth acceptance by parents of children with heart disease is predicted by sociodemographic and/or by parental digital literacy, and to assess parental perceptions of telehealth usability and reliability. STUDY DESIGN: We conducted a single center study comparing telehealth acceptance versus visit cancellation/rescheduling for pediatric cardiology visits during the early phase of the COVID-19 pandemic. All parent/guardians who consented to survey completion received a validated survey assessing their digital literacy. Consenting parents who accepted telehealth received an additional validated survey assessing their perceptions of telehealth usability and reliability. RESULTS: A total of 849 patients originally were scheduled for in-person visits between March 30 and May 8, 2020. Telehealth acceptance was highest among younger, publicly insured, Hispanic patients with primary diagnoses of arrhythmia/palpitations, chest pain, dysautonomia, dyslipidemia and acquired heart disease. Among parents who completed surveys, a determinant of telehealth acceptance was digital literacy. Telehealth was determined to be a usable and reliable means for health care delivery. CONCLUSION: Although the potential for inequitable selection of telehealth due to sociodemographic factors exists, we found that such factors were not a major determinant for pediatric cardiology care within a large, diverse, free-standing pediatric hospital.

Friends from the Future: A Scoping Review of Research into Robots and Computer Agents to Combat Loneliness in Older People.

BACKGROUND AND AIM: Loneliness is a common problem in older adults and contributes to poor health. This scoping review aimed to synthesize and report evidence on the effectiveness of interventions using social robots or computer agents to reduce loneliness in older adults and to explore intervention strategies. METHODS: The review adhered to the Arksey and O'Malley process for conducting scoping reviews. The SCOPUS, PUBMED, Web of Science, EMBASE, CINAHL, PsycINFO, ACM Digital Library and IEEE Xplore databases were searched in November, 2020. A two-step selection process identified eligible research. Information was extracted from papers and entered into an Excel coding sheet and summarised. Quality assessments were conducted using the Mixed Methods Appraisal Tool. RESULTS: Twenty-nine studies were included, of which most were of moderate to high quality. Eighteen were observational and 11 were experimental. Twenty-four used robots, four used computer agents and one study used both. The majority of results showed that robots or computer agents positively impacted at least one loneliness outcome measure. Some unintended negative consequences on social outcomes were reported, such as sadness when the robot was removed. Overall, the interventions helped to combat loneliness by acting as a direct companion (69%), a catalyst for social interaction (41%), facilitating remote communication with others (10%) and reminding users of upcoming social engagements (3%). CONCLUSION: Evidence to date suggests that robots can help combat loneliness in older adults, but there is insufficient research on computer agents. Common strategies for reducing loneliness include direct companionship and enabling social interactions. Future research could investigate other strategies used in human interventions (eg, addressing maladaptive social cognition and improving social skills), and the effects of design features on efficacy. It is recommended that more robust experimental and mixed methods research be conducted, using a combination of validated self-report, observational, and interview measures of loneliness.

The Mobile Health Readiness of People Receiving In-Center Hemodialysis and Home Dialysis.

BACKGROUND AND OBJECTIVES: Mobile health is the health care use of mobile devices, such as smartphones. Mobile health readiness is a prerequisite to successful implementation of mobile health programs. The aim of this study was to examine the status and correlates of mobile health readiness among individuals on dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A cross-sectional 30-item questionnaire guided by the Khatun mobile health readiness conceptual model was distributed to individuals on dialysis from 21 in-center hemodialysis facilities and 14 home dialysis centers. The survey assessed the availability of devices and the internet, proficiency, and interest in using mobile health. RESULTS: In total, 949 patients (632 hemodialysis and 317 home dialysis) completed the survey. Of those, 81% owned smartphones or other internet-capable devices, and 72% reported using the internet. The majority (70%) reported intermediate or advanced mobile health proficiency. The main reasons for using mobile health were appointments (56%), communication with health care personnel (56%), and laboratory results (55%). The main reported concerns with mobile health were privacy and security (18%). Mobile health proficiency was lower in older patients: compared with the 45- to 60-years group, respondents in age groups <45, 61-70, and >70 years had adjusted odds ratios of 5.04 (95% confidence interval, 2.23 to 11.38), 0.39 (95% confidence interval, 0.24 to 0.62), and 0.22 (95% confidence interval, 0.14 to 0.35), respectively. Proficiency was lower in participants with Hispanic/Latinx ethnicity (adjusted odds ratio, 0.49; 95% confidence interval, 0.31 to 0.75) and with less than college education (adjusted odds ratio for "below high school," 0.09; 95% confidence interval, 0.05 to 0.16 and adjusted odds ratio for "high school only," 0.26; 95% confidence interval, 0.18 to 0.39). Employment was associated with higher proficiency (adjusted odds ratio, 2.26; 95% confidence interval, 1.18 to 4.32). Although home dialysis was associated with higher proficiency in the unadjusted analyses, we did not observe this association after adjustment for other factors. CONCLUSIONS: The majority of patients on dialysis surveyed were ready for, and proficient in, mobile health. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER DIALYSIS MHEALTH SURVEY,: NCT04177277.

Healthcare providers' digital competency: a cross-sectional survey in a low-income country setting.

BACKGROUND: Healthcare providers across all clinical practice settings are progressively relying and adapting information communication technologies to perform their professional activities. In this era of technology, healthcare providers especially in lower income countries should have at least basic digital competency if a successful application of technology is to be achieved. The aim of this study was to assess digital competency of healthcare providers among seven public health centers in North-West Ethiopia. METHODS: A cross-sectional study design was applied to assess the basic digital competency of healthcare providers working in seven public health centers in North-west Amhara regional state, Ethiopia. Self-administered questionnaire adopted from the European commission's digital competency framework for assessing digital competency were used. A multivariable logistic regression was performed to identify factors associated with basic digital competency with p-value< 0.05 as a rule out for statistical significance. The strength of association was explained in terms of coefficient estimate, adjusted odds ratio and a 95% confidence interval (CI). RESULT: From the total of 193 healthcare providers included in the study, 167 of them responded which is a response rate of 86.5%. The majority of respondents 88 (52.7%) were males and the mean age was 28.2 years with a standard deviation of 5.5 years. The result indicated that all items demonstrated an adequate level of internal consistency with Cronbach alpha > 0 .7. Healthcare providers in those public health centers reported that problem solving, safety and communication are the most common challenges encountered. The multivariable logistic regression model indicated that factors such as sex, educational status, profession type, monthly income and years of experience are statistically significant predictors. CONCLUSION: Basic digital competency level of healthcare providers working in public health centers in this setting is relatively low. The results highlight the need to improve digital competency among healthcare providers focusing on the identified skill gaps.

Digital divide, skills and perceptions on digitalisation in the European Union-Towards a smart labour market.

The new technologies, the digitalisation of processes and automation of work will change the manner of doing business, working and living. The effects of digitalisation on the economy, society and quality of life imply significant challenges of the labour market. All the participants will be concerned: authorities, companies and ordinary people. The objective of this research is to analyse the perceptions of the EU citizens about digitalisation and to highlight the differences among specific socio-demographic groups. The analysis is grounded on a composite methodology, comprising several statistical and econometric methods that provide scientific support to achieved conclusions: statistical analysis (with the primary goal to shed light on the EU citizens' perceptions about their digital technology skills), TwoStep Cluster Analysis (TSCA) (with the purpose to identify the 'digital vulnerable groups' and then the 'digital vulnerable countries' in terms of the exposure to digital divide) and logistic regression (with the main aim to quantify the impact of the relevant factors on citizens' perceptions about digitalisation). We identified a group of respondents evaluating themselves as having meagre digital skills, very afraid that robots could steal their jobs and with low usage of the internet. They are elderly, with a low level of education, manual workers or not working, with a relatively low level of income and little Internet use. The originality of our approach is given by the fact that we focused on investigating if digital divide leads to the creation of vulnerable groups (citizens and/or countries) and if there are specific patterns in terms of the perception on being skilled in the use of digital technologies in daily life or at work and of the understanding that robots replace human on the labour market. We aim to find relevant factors for the labour market to assume targeted measures that should be taken for a better match of supply and demand on the labour market and for creating a smart labour market. It is highly needed to increase the people's confidence in their skills level and to make the most of digitalisation of the societies. The results show consistent patterns in term of socio-demographic characteristics and perception towards digitalisation. The latter will have a meaningful impact on the economy and the society in the European Union in the next period. That is why a positive attitude towards digitalisation is essential for transforming this relatively new challenge into an excellent opportunity for the future.

Exploring Canadian pharmacy students' e-health literacy: a mixed method study

BACKGROUND: While much has been described about technology use by digital natives in general, understanding of pharmacy student's knowledge and understanding of technology is lacking. OBJECTIVE: This study explores the current state of pharmacy students' self-rated digital health literacy in British Columbia, Canada, and seeks to identify future opportunities for technology training in pharmacy education and in practice. METHODS: A mixed methods design using surveys and semi-structured interviews was conducted. An online, validated survey (eHEALS) was conducted among currently enrolled 2nd to 4th year pharmacy students at the University of British Columbia. An additional interview was offered to consenting participants to further explore the use of technology in daily lives, pharmacy practicums, and implications on future pharmacy curricula. Both quantitative and qualitative thematic analysis was done of all data. RESULTS: A total of 30 pharmacy students completed the eHEALS survey and 5 completed interviews. Most participants were 2nd year students (50%), were 25 years and younger (80%), and female (87%). Ranking of digital health literacy was lower than expected with participants stating they know what (87%), where (87%) and how to find (77%) health resources on the Internet. Even less students (77%) rated that they have the skills to evaluate the health resources that they find on the Internet and only 53% felt confident in using information from the Internet to make health decisions. Most students mentioned that they had limited technology related training at school and would like more training opportunities throughout their program and connect what they have learned at school to their practice. CONCLUSIONS: These results expose significant and surprising gaps in student understanding of technology despite modifications seen in the entry-to-practice PharmD curriculum. Regional differences and digital health literacy of practicing pharmacists are areas that require better understanding and hold significant impact as practice evolves

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Student Nurses' Digital Literacy Levels: Lessons for Curricula.

The rapid uptake of technology is changing the way health professionals provide care to patients and communities. While this presents opportunities to improve, enhance, and positively transform care and treatment, graduates must have the requisite knowledge, skills, and attitudes to make effective use of the technology and data available to them. This research explored nursing students' self-reported digital literacy levels. We undertook a student survey at one university in Australia, utilizing the validated Self-Assessment Nursing Informatics Competencies Scale-SF30 instrument. Overall, 90% of students rated their basic computer knowledge and skills as at least "competent" including performing basic troubleshooting, using the Internet, and conducting online literature searches. However, only 55% of students considered their overall applied computer skills as at least "competent," which included using applications for diagnostic coding and to extract data from clinical data sets. Students have digital literacy in everyday settings; however, their ability to translate this into practice is limited, restricting their access to and use of digital tools in the workplace. Our findings provide the opportunity to address practice issues related to digital literacy and to embed appropriate content in curricula to enable the delivery of improved patient care and the appropriate use of data in various settings.

A Randomized Trial to Train Vulnerable Primary Care Patients to Use a Patient Portal.

BACKGROUND: Patient portals are becoming ubiquitous. Previous research has documented substantial barriers, especially among vulnerable patient subgroups such as those with lower socioeconomic status or limited health literacy (LHL). We tested the effectiveness of delivering online, video-based portal training to patients in a safety net setting. METHODS: We created an online video curriculum about accessing the San Francisco Health Network portal, and then randomized 93 English-speaking patients with 1+ chronic diseases to receive 1) an in-person tutorial with a research assistant, or 2) a link to view the videos on their own. We also examined a third, nonrandomized usual care comparison group. The primary outcome was portal log-in (yes/no) 3 to 6 months post-training, assessed via the electronic health record. Secondary outcomes were self-reported attitudes and skills collected via baseline and follow-up surveys. RESULTS: Mean age was 54 years, 51% had LHL, 60% were nonwhite, 52% were female, 45% reported fair/poor health, and 76% reported daily Internet use. At followup, 21% logged into the portal, with no differences by arm (P = .41), but this was higher than the overall clinic rate of 9% (P < .01) during the same time period. We found significant prepost improvements in self-rated portal skills (P = .03) and eHealth literacy (P < .01). Those with LHL were less likely to log in post-training (P < .01). CONCLUSIONS: Both modalities of online training were comparable, and neither mode enabled a majority of vulnerable patients to use portals, especially those with LHL. This suggests that portal training will need to be more intensive or portals need improved usability to meaningfully increase use among diverse patients.

A Mixed-Methods Study of Users' Journey Mapping Experience and Acceptance of Telehealthcare Technology in Taiwan.

Background: The integration of telehealthcare technologies into geriatric care has clear advantages, but poses challenges for key stakeholders, including the telehealthcare service industry, smart device developers, marketers and, of course, users. The purpose of this study was to gain insight into user experience and acceptance of telehealthcare technology in Taiwan. Materials and Methods: Taking an integrated mixed-methods approach, 51 participants-33 women (64.71%) and 18 men (35.29%) (mean age: 52.1 years)-were examined before, during, and after using a telehealthcare device. A questionnaire was used to assess users' acceptance of the technology. Interviews were conducted to gather feedback. Results: The quantitative analysis revealed that (1) effort expectancy and relatives significantly influenced users' behavior intentions, (2) error and memorability significantly affected users' satisfaction, and (3) intention and satisfaction significantly affected users' behavior. The qualitative analysis revealed two key implications. First, participants generally were not satisfied with the telehealthcare device. Second, participants suggested the redesign of the telehealthcare device to reduce operating errors and time consumption to meet users' needs. Conclusions: Contemporary telehealthcare devices do not meet users' needs. Participants were made to adapt to the equipment rather than the equipment tailored to meet their needs. Although there were key benefits from home telehealthcare, the systems require enhanced technology, improved usability, and an expanded scale of services backed by government before widespread implementation can successfully proceed.

Evaluation of usability of a neonatal health information system according to the user's perception / Avaliação da usabilidade de um sistema de informação em saúde neonatal segundo a percepção do usuário

ABSTRACT Objective: To measure the level of satisfaction regarding the usability of a neonatal health information system and identify if demographic factors can influence the usability of a health information system. Methods: A cross-sectional, exploratory study was carried out with a convenience sample of 50 users of the Brazilian Neonatal Research Network. The instrument chosen for the usability evaluation was the System Usability Scale between February and March 2017. The statistical analysis of the collected variables was carried out in order to describe the sample, to quantify the level of satisfaction of the users and to identify the variables associated with the level of satisfaction. Results: The female gender represented 75% of the sample. The mean age was 52.8 years; 58% had a doctoral degree, average time of graduation was 17 years, with area of practice in medicine (neonatology), with intermediate knowledge in computer science (74%) and mean system use time of 52 months. Regarding usability, 94% rated the system as "good", "excellent" or "better than imaginable". The usability of the system was not associated with age, gender, education, profession, area of practice, knowledge in computer science and time of system use. Conclusion: The level of satisfaction of the computerized health system user was considered good. No demographic factors were associated with the satisfaction of the users.

RESUMO Objetivo: Mensurar o grau de satisfação de profissionais de saúde quanto à usabilidade de um sistema de informação em saúde neonatal e identificar os fatores que podem influenciar na satisfação do usuário frente à usabilidade. Métodos: Estudo transversal e exploratório realizado com 50 profissionais de saúde integrantes dos centros da Rede Brasileira de Pesquisas Neonatais. Para avaliação da usabilidade foi utilizado o instrumento System Usability Scale entre fevereiro e março de 2017. Realizou-se a análise estatística descritiva e inferencial das variáveis coletadas, com a finalidade de descrever a amostra, quantificar o grau de satisfação dos usuários e identificar as variáveis associadas ao grau de satisfação do usuário em relação à usabilidade. Resultados: Da população avaliada, 75% era do sexo feminino, com idade média 52,8 anos, 58% com pós-graduação (doutorado); tempo médio da última formação de 17 anos; área de atuação em medicina (neonatologia), grau intermediário de conhecimento em informática e tempo de utilização média do sistema de 52 meses. Quanto à usabilidade, 94% avaliaram o sistema como "bom", "excelente" ou "melhor impossível". A usabilidade do sistema não foi associada a idade, sexo, escolaridade, profissão, área de atuação, nível de conhecimento em informática e tempo de uso do sistema. Conclusões: O grau de satisfação do usuário do sistema informatizado de saúde foi considerado bom. Não foram identificados fatores demográficos que influenciassem sua avaliação.

EVALUATION OF USABILITY OF A NEONATAL HEALTH INFORMATION SYSTEM ACCORDING TO THE USER'S PERCEPTION.

OBJECTIVE: To measure the level of satisfaction regarding the usability of a neonatal health information system and identify if demographic factors can influence the usability of a health information system. METHODS: A cross-sectional, exploratory study was carried out with a convenience sample of 50 users of the Brazilian Neonatal Research Network. The instrument chosen for the usability evaluation was the System Usability Scale between February and March 2017. The statistical analysis of the collected variables was carried out in order to describe the sample, to quantify the level of satisfaction of the users and to identify the variables associated with the level of satisfaction. RESULTS: The female gender represented 75% of the sample. The mean age was 52.8 years; 58% had a doctoral degree, average time of graduation was 17 years, with area of practice in medicine (neonatology), with intermediate knowledge in computer science (74%) and mean system use time of 52 months. Regarding usability, 94% rated the system as "good", "excellent" or "better than imaginable". The usability of the system was not associated with age, gender, education, profession, area of practice, knowledge in computer science and time of system use. CONCLUSION: The level of satisfaction of the computerized health system user was considered good. No demographic factors were associated with the satisfaction of the users.

The Moderating Effect of Geographic Area on the Relationship Between Age, Gender, and Information and Communication Technology Literacy and Problematic Internet Use.

This study investigated the relationship between adolescents' problematic Internet use (PIU) and demographic characteristics such as age, gender, and information and communication technology (ICT) literacy and the moderating effect of geographic area on this relationship using a cross-sectional research design. The study sample comprised 2160 adolescents from the Chongqing area of China and consisted of 47.3 percent boys (N = 1022) and 52.7 percent girls (N = 1138). Participants anonymously completed a 38-item questionnaire that examined their Internet use, behaviors, and attitudes, ICT literacy, parents' education level, and other demographic information. The results showed that the geographic area in which respondents lived (urban vs. rural), gender, age, father's education, mother's education, and ICT literacy had significant relationships with PIU. Moreover, hierarchical multiple regression analyses indicated that geographic area was found to be a significant moderator for both age and gender in their relationship with PIU. These findings suggest that it is essential to address differences between urban and rural areas when seeking to mitigate PIU among adolescents.

Predictors of Osteopathic Medical Students' Readiness to Use Health Information Technology.

CONTEXT: The advent of health information technology (HIT) tools can affect the practice of modern medicine in many ways, ideally by improving quality of care and efficiency and reducing medical errors. Future physicians will play a key role in the successful implementation of HIT. However, osteopathic medical students' willingness to learn, adopt, and use technology in a health care setting is not well understood. OBJECTIVE: To understand osteopathic medical students' knowledge, attitudes, and behaviors regarding HIT and to identify factors that may be related to their readiness to use HIT. METHODS: Using a cross-sectional approach, quantitative surveys were collected from students attending a large osteopathic medical school. Multivariate regression modeling was used to determine whether knowledge, attitudes, behaviors, and personal characteristics were associated with students' readiness to use HIT in future clinical practice. RESULTS: Six hundred four students responded to at least 70% of the survey and were included in the analysis. Multivariate modeling successfully explained the 26% of variance in predicting students' readiness to use HIT (F8,506=22.6, P<.001, R2=0.263). Greater self-efficacy, openness to change (in academic/work settings), favorable attitudes toward HIT use, mobile technology use, younger age, being male, and prior exposure to technology were associated with readiness to use HIT. CONCLUSION: Understanding students' level of HIT readiness may help guide medical education intervention efforts to better prepare future osteopathic physicians for HIT engagement and use. Innovative approaches to HIT education in medical school curricula that include biomedical informatics may be necessary.

Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies.

BACKGROUND: eHealth is developing rapidly and brings with it a promise to reduce social health inequalities (SHIs). Yet, it appears that it also has the potential to increase them. OBJECTIVES: The general objective of this review was to set out how to ensure that eHealth contributes to reducing SHIs rather than exacerbating them. This review has three objectives: (1) identifying characteristics of people at risk of experiencing social inequality in health; (2) determining the possibilities of developing eHealth tools that avoid increasing SHI; and (3) modeling the process of using an eHealth tool by people vulnerable to SHI. METHODS: Following the EPPI approach (Evidence for Policy and Practice of Information of the Institute of Education at the University of London), two databases were searched for the terms SHIs and eHealth and their derivatives in titles and abstracts. Qualitative, quantitative, and mixed articles were included and evaluated. The software NVivo (QSR International) was employed to extract the data and allow for a metasynthesis of the data. RESULTS: Of the 73 articles retained, 10 were theoretical, 7 were from reviews, and 56 were based on empirical studies. Of the latter, 40 used a quantitative approach, 8 used a qualitative approach, 4 used mixed methods approach, and only 4 were based on participatory research-action approach. The digital divide in eHealth is a serious barrier and contributes greatly to SHI. Ethnicity and low income are the most commonly used characteristics to identify people at risk of SHI. The most promising actions for reducing SHI via eHealth are to aim for universal access to the tool of eHealth, become aware of users' literacy level, create eHealth tools that respect the cultural attributes of future users, and encourage the participation of people at risk of SHI. CONCLUSIONS: eHealth has the potential to widen the gulf between those at risk of SHI and the rest of the population. The widespread expansion of eHealth technologies calls for rigorous consideration of interventions, which are not likely to exacerbate SHI.

Exploring the Measurement Properties of the eHealth Literacy Scale (eHEALS) Among Baby Boomers: A Multinational Test of Measurement Invariance.

BACKGROUND: The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. OBJECTIVE: The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. METHODS: Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. RESULTS: We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). CONCLUSIONS: To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and random samples drawn from an increasingly important cohort. The results give increased confidence to researchers using the scale in a range of eHealth assessment applications from primary care to health promotions.

Validating an electronic health literacy scale in an older hispanic population.

AIM: To examine the validity of the Spanish version of an instrument used to measure electronic health literacy (eHEALS) with an older Hispanic population from a number of Spanish-language countries living in New York City in the United States (US). BACKGROUND: Although the Internet is available globally, complex skills are needed to use this source of valuable health-related information effectively. Electronic health literacy is a multifactorial concept that includes health literacy but also requires technology skills. DESIGN: Cross-sectional. METHOD: Recruitment occurred at a Senior Organization located in a largely Hispanic neighbourhood in New York City (N = 100). Participants completed eHEALS and selected items from the Health Information National Trends Survey (HINTS) which assesses how adults use different communication channels, including the Internet, to obtain vital health information. Data from the US HINTS sample (N = 162) were matched to the Senior Organization sample on age range and Hispanic ethnicity. The average Senior Organization participant was 68 years old, female, born in one of six different Spanish-language countries, and completed high school while the average HINTS participant was 67 years old, female and had high school or less education. RESULTS: Although there was no relationship with the two HINTS subscales and electronic health literacy, there were significant relationships between electronic health literacy and health status and confidence in self-care. CONCLUSIONS: Inadequate electronic health literacy is a barrier to positive health outcomes. The Spanish version of eHEALS could be used as a screening instrument to identify gaps and tailored interventions could be developed to increase consumer confidence in using the Internet for reliable health-related information. RELEVANCE TO CLINICAL PRACTICE: Knowledge in self-management is related to positive health outcomes; all persons irrespective of their electronic health literacy should be able to use all sources of health information to enhance their self-care.

Use of information and communication technology and retention of health workers in rural post-war conflict Northern Uganda: findings from a qualitative study.

BACKGROUND: Information and communication technologies have become a vital infrastructural asset for use in the retention of rural health workers. However, little is known about the potential influence of ICT use, perceptions of health workers on ICT in healthcare delivery, and contribution of ICT to health care providers' retention in rural and remote areas in rural post-war and conflict situations of northern Uganda. METHODS: Data from interviews were transcribed, coded and thematically analysed. RESULTS: Participants generally exhibited low confidence, knowledge and low ICT skills. Majority of participants, however, perceived ICT as beneficial in relation to job performance and health care provider retention in rural areas. Common barriers for the implementation and use of ICT in health centres were inadequate ICT knowledge and skills, poor Internet networks, inadequate computers, inadequate power supply, lack of Internet Modems and expensive access to outside computer centres. CONCLUSIONS: This qualitative study showed low confidence, poor knowledge and skills in ICT usage but positive perceptions about the benefits and contributions of ICT. These findings suggest the need for specific investment in ICT infrastructural development for health care providers in remote rural areas of northern Uganda.

Digital literacy of youth and young adults with intellectual disability predicted by support needs and social maturity.

This study investigated relationships between digital propensity and support needs as well as predictors of digital propensity in the context of support intensity, age, gender, and social maturity. A total of 118 special education teachers rated the support intensity, digital propensity, and social maturity of 352 students with intellectual disability. Leveraging the Digital Propensity Index, Supports Intensity Scale, and the Social Maturity Scale, descriptive statistics, correlations, multiple regressions, and regression analyses were employed. The findings revealed significant relationships between digital propensity and support needs. In addition, significant predictors of digital propensity were found with regard to support intensity, age, gender, and social maturity.