eHealth Literacy in NHIS Subpopulations

Principal Investigator: Siobhan Maty, PhD
Student Investigator: Daryl Nault

Background: The Internet is a primary communication source for health information. Electronic health information (eHealth) is a juncture for public health, health services, health education, and web-based services. eHealth literacy as identified by Norman and Skinner (2006), is used to describe, required for an individual’s “ability to seek, find, understand, and appraise health information from electronic sources, and apply the knowledge gained to address or solve a health problem”.1,2 Six key literacies are classified as representing eHealth literacy as a construct: (1) traditional education, (2) computer skills, (3) information seeking, (4) health application, (5) scientific analysis, and (6) media evaluation literacies. For any eHealth modality to be effective, it is prerequisite for users to be comfortable with the technology used. The millennial generation was born in a time (1980-2000) when digital technology was first becoming widely available to the public. Millennials are the first generation to grow up with widespread Internet access, making them a population of interest when studying eHealth literacy. Supplement users, much like millennials, have been depicted as a healthy, well-educated group that also seeks much of their information from the Internet.3 The 2002-2012 National Health Interview Survey (NHIS) Alternative Health supplement data supports current evidence that supplement use rates have continued to increase over the past 30 years.4

Objectives: To explore, describe, and test the conceptual framework of eHealth literacy (eHL) within a nationally representative survey population.

Methods: Using a sample of 32,911 from the 2012 NHIS cross-sectional household survey, several analyses will be performed. Two of six eHL components, scientific and media literacy, are more abstract in their nature and, consequently, are difficult to measure with survey data. The analyses described in this protocol will use NHIS variables as a proxy to represent the four-eHL components that are measurable as independent variables. In order to capture a more complete view of eHL within a nationally representative subpopulation, self-reported health information source will be used as a variable to represent the best available approximation for abstract eHL’s. Initially, a Principal Components Analysis will assess whether or not independent variables suggestive of eHealth literacy appear to measure a similar construct. After key variables are identified, a cross tabulation of demographics and these key variables will be performed to elucidate differences between the millennial and non-millennial populations, as well as the millennial supplement users and non-supplement users. Logistic regression will be used to determine association between supplement use and eHealth literacy variables. Associations between eHealth literacy variables and sources supplement users report using to obtain information on their supplement of choice will also be investigated.