Digital Literacy for Older Adults

Overseen By Samantha Curriero, MPH

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Severe cognitive impairment, frequent hospitalization

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

20 Participants Needed

Trial Summary

What is the purpose of this trial?

The investigators propose a person-directed, values-based digital literacy intervention to address the community-identified barriers of health literacy, health communication and social support to improve quality of life and specific disease related metrics in the older adult's own home. This intervention will be a way to address the community-identified barriers of health literacy, health communication and social support to improve quality of life and specific disease related metrics in the older adult's own home.

Do I have to stop taking my current medications for this trial?

The protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that Digital Literacy for Older Adults is an effective treatment?

The available research shows that Digital Literacy for Older Adults is effective in improving health outcomes. One study highlights that digital health literacy interventions can be implemented on a large scale to enhance the health management of older adults. Another review found that higher electronic health literacy is linked to better health behaviors and knowledge among older adults. Additionally, digital communication tools have been shown to improve health literacy, leading to better health outcomes by facilitating patient education and self-management. These findings suggest that digital literacy programs can significantly benefit older adults by improving their ability to manage their health. ^{1 2 3 4 5}

What safety data exists for Digital Literacy for Older Adults?

The provided research does not directly address safety data for Digital Literacy for Older Adults or related interventions like Digital Literacy Intervention, Digital Health Literacy Intervention, or Digital Literacy Program. The studies focus on medication safety, adverse events, and patient safety systems, but do not provide specific safety data for digital literacy interventions. ^{6 7 8 9 10}

Is the Digital Literacy Intervention a promising treatment for older adults?

Yes, the Digital Literacy Intervention is promising for older adults. It helps them improve their digital skills, which are important for managing their health in today's tech-driven world. Studies show that such programs can empower older adults to find and use online health information effectively, making them feel more confident and informed about their health. ^{2 11 12 13 14}

Research Team

Melissa Hladek, PhD

Principal Investigator

Johns Hopkins School of Nursing

Eligibility Criteria

This trial is for older adults who want to improve their digital literacy to enhance health communication, social support, and quality of life. Participants should be interested in learning technology use at home.

Inclusion Criteria

English proficient

Willingness to improve digital literacy

I am 65 years old or older.

Exclusion Criteria

Severe cognitive impairment as defined by a 6-item Callahan Cognitive Screener

I have been hospitalized overnight more than 3 times in the last year.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive a digital literacy intervention with 4-6 home visits and 3-4 interim phone calls, tailored to individual needs.

9 weeks

4-6 home visits, 3-4 phone calls

Follow-up

Participants are monitored for changes in various health metrics and intervention outcomes.

4 weeks

Treatment Details

Interventions

• Digital Literacy Intervention

Trial Overview The study tests a personalized digital literacy program designed for older adults. It aims to overcome barriers in health literacy and communication by teaching technology skills at the participants' homes.

Participant Groups

Group I: Pilot Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Findings from Research

Digital health interventions (DHIs) show promise in improving health literacy and related constructs like knowledge and decision-making in patients undergoing arthroplasty, with 11 out of 13 studies indicating positive outcomes.

However, there is a lack of structured designs and standardized measures in the current research, highlighting the need for more rigorous studies to fully understand the effectiveness of DHIs in patient education for arthroplasty.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of digital health interventions to improve health literacy in surgical patients: a narrative review in arthroplasty. Davaris, MT., Bunzli, S., Trieu, J., et al.[2022]

Digital health literacy (DHL) interventions significantly improve eHealth literacy among older adults, with a standardized mean difference of 1.15, based on a meta-analysis of 7 studies involving 710 participants.

Face-to-face teaching methods and interventions guided by a conceptual framework were particularly effective, leading to notable increases in knowledge and self-efficacy, while skills development showed no significant improvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Digital Health Literacy Interventions in Older Adults: Single-Arm Meta-Analysis. Dong, Q., Liu, T., Liu, R., et al.[2023]

Older adults generally have low eHealth literacy, which is linked to better health behaviors and improved health knowledge, as shown in a review of 24 studies.

While higher eHealth literacy is associated with positive outcomes in behavioral and cognitive health, the connections to physical and psychosocial health outcomes are inconsistent, indicating a need for further research to understand these relationships.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Electronic health literacy and health-related outcomes among older adults: A systematic review. Xie, L., Zhang, S., Xin, M., et al.[2022]

Digital communication tools, like mobile health apps and telemedicine, significantly enhance health literacy, which can lead to improved health outcomes for patients.

These tools not only empower patients through better education and self-management but also improve clinical decision-making and communication among healthcare providers, although challenges like access and privacy must be addressed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Fitzpatrick, PJ.[2023]

Many adults in the U.S. and Canada struggle with literacy levels that hinder their ability to effectively use electronic health tools, which can limit the benefits of eHealth technologies.

The paper introduces a model of eHealth literacy that outlines essential skills needed to engage with health information online, providing resources for health practitioners to help improve their patients' literacy in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

eHealth Literacy: Essential Skills for Consumer Health in a Networked World. Norman, CD., Skinner, HA.[2022]

About one-third of the 251 adult patients surveyed at a public hospital clinic had low literacy levels, which significantly impacted their ability to correctly interpret prescription medication warning labels.

Patients with low literacy were 3.4 times less likely to understand these labels correctly, highlighting the need for clearer, simpler warning labels that are easier for all patients to comprehend, especially those with lower literacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Low literacy impairs comprehension of prescription drug warning labels. Davis, TC., Wolf, MS., Bass, PF., et al.[2022]

Providing numeric information about the likelihood of adverse events (AEs) in medications improves risk comprehension among consumers, as shown in a survey of 905 participants, where those given numeric formats were less likely to overestimate risks.

While numeric formats generally increased willingness to use medications, older adults with lower numeracy skills showed less change in their willingness, suggesting that while numeric information is beneficial, its impact may vary by age and numeracy level.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Numbers matter to informed patient choices: a randomized design across age and numeracy levels. Peters, E., Hart, PS., Tusler, M., et al.[2022]

A prototype electronic Global Trigger Tool was developed to improve the identification of adverse events in hospitals, addressing limitations of existing methods that rely on retroactive chart reviews.

Feedback from six health professionals highlighted the need for better tracking of adverse events and suggested features for a user-friendly interface, paving the way for integration into electronic health record systems to enhance patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Usability Testing of a System to Detect Adverse Events and Medical Mistakes. Blakeney, EA., Dardas, T., Zierler, BK., et al.[2023]

The Safety Optimizer is a comprehensive Web-based program designed to enhance patient safety in acute care settings, featuring seven modules that assess organizational risk and implement risk-reduction strategies.

Currently in use at over 30 healthcare organizations, the program provides valuable resources such as incident reporting and adherence assessments, although it is still too early to measure its quantitative impact on patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Web-based program for implementing evidence-based patient safety recommendations. Greengold, NL.[2019]

A new patient-centered taxonomy for categorizing adverse events (AEs) and near misses in emergency departments (EDs) was developed, focusing on specific harms like hypoxia and hemorrhage rather than general errors.

Testing of this taxonomy showed high inter-rater reliability, with 92% agreement at the category level, indicating it can effectively enhance quality and safety assessments in EDs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Critical Review, Development, and Testing of a Taxonomy for Adverse Events and Near Misses in the Emergency Department. Griffey, RT., Schneider, RM., Todorov, AA., et al.[2020]

The Everyday Digital Literacy Questionnaire (EDLQ) was developed and validated for assessing digital literacy in older adults, demonstrating strong psychometric properties with a sample of 1016 participants in South Korea.

The EDLQ consists of 22 items across three domains: information and communication, content creation and management, and safety and security, showing high internal consistency and a strong correlation with established measures of eHealth literacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Everyday Digital Literacy Questionnaire for Older Adults: Instrument Development and Validation Study. Choi, J., Choi, S., Song, K., et al.[2023]

A study involving 146 older adults (ages 56-91) showed that a 2-week eHealth literacy intervention significantly improved participants' knowledge, skills, and confidence in using online health resources, regardless of whether they learned collaboratively or individually.

Participants reported positive changes in their engagement with health care after the intervention, indicating that the program was well-received and effective in enhancing eHealth literacy among older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of an eHealth literacy intervention for older adults. Xie, B.[2021]

The HeLP MN Seniors pilot program successfully improved health literacy among older adults, as participants reported feeling more empowered to ask questions and effectively find online health information after attending the workshops.

The program's curriculum was refined based on participant feedback and evaluation, resulting in a model educational program that can be utilized by other communities to enhance health information literacy in seniors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Health literacy for older adults: using evidence to build a model educational program. Aspinall, EE., Beschnett, A., Ellwood, AF.[2022]

A study involving 99 older adults (ages 63-90) found that both multimedia tutorials and paper-based materials significantly improved eHealth literacy, including knowledge of computer terms and skills in using the Internet.

Participants showed a more positive attitude towards the multimedia tutorial compared to the paper-based control, suggesting that multimedia approaches may be more effective in engaging older adults in eHealth literacy training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing the Effects of eHealth Tutorials on Older Adults' eHealth Literacy. De Main, AS., Xie, B., Shiroma, K., et al.[2023]

References

1. Australia pubmed.ncbi.nlm.nih.gov

The role of digital health interventions to improve health literacy in surgical patients: a narrative review in arthroplasty. [2022]

2. Canada pubmed.ncbi.nlm.nih.gov

Effectiveness of Digital Health Literacy Interventions in Older Adults: Single-Arm Meta-Analysis. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Electronic health literacy and health-related outcomes among older adults: A systematic review. [2022]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. [2023]

5. Canada pubmed.ncbi.nlm.nih.gov

eHealth Literacy: Essential Skills for Consumer Health in a Networked World. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Low literacy impairs comprehension of prescription drug warning labels. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Numbers matter to informed patient choices: a randomized design across age and numeracy levels. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Development and Usability Testing of a System to Detect Adverse Events and Medical Mistakes. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

A Web-based program for implementing evidence-based patient safety recommendations. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Critical Review, Development, and Testing of a Taxonomy for Adverse Events and Near Misses in the Emergency Department. [2020]

11. Canada pubmed.ncbi.nlm.nih.gov

Everyday Digital Literacy Questionnaire for Older Adults: Instrument Development and Validation Study. [2023]

12. Canada pubmed.ncbi.nlm.nih.gov

Effects of an eHealth literacy intervention for older adults. [2021]

13. United States pubmed.ncbi.nlm.nih.gov

Health literacy for older adults: using evidence to build a model educational program. [2022]

14. United States pubmed.ncbi.nlm.nih.gov

Assessing the Effects of eHealth Tutorials on Older Adults' eHealth Literacy. [2023]