The relationship among social capital, eHealth literacy and health behaviours in Chinese elderly people: a cross-sectional study

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Abstract

Background

Social capital has been linked to health behaviours, but the underlying mechanism is unclear. Previous studies have found that health literacy played the role of a mediator in the relationships among social capital, individual physical activity and nutrition. But it is not clear whether eHealth literacy mediates the impact of social capital on health behaviours. Therefore, our research aimed to explore the relationships among social capital (structural and cognitive social capital), eHealth literacy, and the health behaviours of elderly people, and to analyse the mediating effect of eHealth literacy, while providing a theoretical basis for a health behaviour intervention for elderly people.

Methods

From January to February 2019, we conducted a cross-sectional survey of 1201 Chinese people aged over 60 years using the Chinese Shortened Social Capital Scale (contains two subscales of structural social capital and cognitive social capital), eHealth Literacy Scale, and Health-Promoting Lifestyle Profile. We used structural equation modelling to test a hypothetical mediation model.

Results

The mean scores of social capital was 72.07 (SD = 13.03), 17.24 (SD = 9.34) for eHealth literacy, and 112.23 (SD = 23.25) for health behaviours. Social capital and eHealth literacy were significantly correlated with health behaviours, and social capital and structural social capital were significantly correlated with eHealth literacy. Lastly, eHealth literacy mediated the relationship between structural social capital and health behaviours.

Conclusions

eHealth literacy was an important mediating factor for elderly people’s structural social capital and health behaviours. Therefore, social capital and eHealth literacy must be considered when designing and implementing health behaviour intervention programmes for elderly people.

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Health literacy and public health: A systematic review and integration of definitions and models

Karen Kristine Sørensen, Stephan Van den Broucke, James Fullam … (2012)

Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.

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Mediation analysis.

David P. MacKinnon, Amanda Fairchild, Matthew S Fritz (2007)

Mediating variables are prominent in psychological theory and research. A mediating variable transmits the effect of an independent variable on a dependent variable. Differences between mediating variables and confounders, moderators, and covariates are outlined. Statistical methods to assess mediation and modern comprehensive approaches are described. Future directions for mediation analysis are discussed.

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eHEALS: The eHealth Literacy Scale

Cameron Norman, Harvey A Skinner (2006)

Background Electronic health resources are helpful only when people are able to use them, yet there remain few tools available to assess consumers’ capacity for engaging in eHealth. Over 40% of US and Canadian adults have low basic literacy levels, suggesting that eHealth resources are likely to be inaccessible to large segments of the population. Using information technology for health requires eHealth literacy—the ability to read, use computers, search for information, understand health information, and put it into context. The eHealth Literacy Scale (eHEALS) was designed (1) to assess consumers’ perceived skills at using information technology for health and (2) to aid in determining the fit between eHealth programs and consumers. Objectives The eHEALS is an 8-item measure of eHealth literacy developed to measure consumers’ combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. The objective of the study was to psychometrically evaluate the properties of the eHEALS within a population context. A youth population was chosen as the focus for the initial development primarily because they have high levels of eHealth use and familiarity with information technology tools. Methods Data were collected at baseline, post-intervention, and 3- and 6-month follow-up using control group data as part of a single session, randomized intervention trial evaluating Web-based eHealth programs. Scale reliability was tested using item analysis for internal consistency (coefficient alpha) and test-retest reliability estimates. Principal components factor analysis was used to determine the theoretical fit of the measures with the data. Results A total of 664 participants (370 boys; 294 girls) aged 13 to 21 (mean = 14.95; SD = 1.24) completed the eHEALS at four time points over 6 months. Item analysis was performed on the 8-item scale at baseline, producing a tight fitting scale with α = .88. Item-scale correlations ranged from r = .51 to .76. Test-retest reliability showed modest stability over time from baseline to 6-month follow-up (r = .68 to .40). Principal components analysis produced a single factor solution (56% of variance). Factor loadings ranged from .60 to .84 among the 8 items. Conclusions The eHEALS reliably and consistently captures the eHealth literacy concept in repeated administrations, showing promise as tool for assessing consumer comfort and skill in using information technology for health. Within a clinical environment, the eHEALS has the potential to serve as a means of identifying those who may or may not benefit from referrals to an eHealth intervention or resource. Further research needs to examine the applicability of the eHEALS to other populations and settings while exploring the relationship between eHealth literacy and health care outcomes.

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Author and article information

Contributors

Yong-Tian Yin:

ORCID: http://orcid.org/0000-0002-8757-3519

yinyongtian@sdutcm.edu.cn

Li-Jun Chen: chlj_2008@aliyun.com

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 6 January 2021

Publication date PMC-release: 6 January 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 45

Affiliations

[1 ]GRID grid.464402.0, ISNI 0000 0000 9459 9325, School of Acupuncture and Tuina, , Shandong University of Traditional Chinese Medicine, ; Jinan, 250355 China

[2 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, Department of Social Medicine and Health Service Management, Xiangya School of Public Health, , Central South University, ; Changsha, 410078 China

[3 ]GRID grid.464402.0, ISNI 0000 0000 9459 9325, School of Nursing, , Shandong University of Traditional Chinese Medicine, ; Jinan, 250355 China

[4 ]GRID grid.464402.0, ISNI 0000 0000 9459 9325, School of Ophthalmology and Optometry, , Shandong University of Traditional Chinese Medicine, ; Jinan, 250355 China

[5 ]GRID grid.464402.0, ISNI 0000 0000 9459 9325, School of Chinese Medicine, , Shandong University of Traditional Chinese Medicine, ; Jinan, 250355 China

Author information

Yong-Tian Yin http://orcid.org/0000-0002-8757-3519

Article

Publisher ID: 10037

DOI: 10.1186/s12889-020-10037-4

PMC ID: 7789238

PubMed ID: 33407275

SO-VID: 373cc482-080f-4153-9ce6-1bdf20c904f2

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Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 9 May 2020

Date accepted : 9 December 2020

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ScienceOpen disciplines: Public health

Keywords: social capital,ehealth literacy,health behaviours,elderly people

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ScienceOpen disciplines: Public health

Keywords: social capital, ehealth literacy, health behaviours, elderly people

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The relationship among social capital, eHealth literacy and health behaviours in Chinese elderly people: a cross-sectional study

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Most cited references 62

Health literacy and public health: A systematic review and integration of definitions and models

Mediation analysis.

eHEALS: The eHealth Literacy Scale

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