Do eHealth literacy and socio-demographics predict patients' preferences for use of eHealth programmes after percutaneous coronary intervention?
Authors: Brors G , Instenes I , Hjertvikrem N , Dalen H , Fridlund B , Norman C D , Palm P , Wentzel-Larsen T , Norekval T M 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): The Western Norway Health Authority

Background
Evidence supports the use of electronic health (eHealth) programmes for patients with coronary artery disease. To date, there has been little attention toward patients’ preferences for the use of eHealth programmes, and their associations with eHealth literacy and socio-demographic factors post percutaneous coronary intervention (PCI).

Purpose
To determine how eHealth literacy and socio-demographics are associated with patients’ preferences for use of eHealth programmes assessed 12-month post PCI.

Methods
An observational cohort study recruited 3417 adult patients treated by PCI at three Norwegian and four Danish university hospitals, June 2017-May 2019. Socio-demographic data and self-reported outcomes on eHealth literacy (eHealth literacy scale) were assessed at baseline. De novo questions on preferences for use of eHealth programmes were collected 12-month post PCI. Hierarchical logistic regression models were performed.

Results
The majority of patients were men (78%), and the mean age was 66 years. Almost 40% were interested in participating in eHealth programmes. The odds of being interested in accessing a webpage with quality ensured information, health applications and online chat function with healthcare providers increased with 2-3% for each point higher eHealth literacy score, which indicates better eHealth literacy. After controlling for age, education and gender (Step 2), eHealth literacy no longer remained a significant predictor for patients’ preferences. Males had 49% higher odds for interest in a webpage with quality ensured information than females. Females had 33-34% higher odds for interest in an online chat function with healthcare providers and an individually tailored text message. The odds for interest in a webpage with quality ensured information, health applications, online chat function with healthcare providers and individually tailored text messages, decreased with 2-5% per year higher age. For individual tailored feedback on email, the odds for interes was 1% higher per year higher age. Educational level above primary school was a robust predictor for the interest in a webpage with quality ensured information (63-240%). Compared to those with primary school education level, those with college/university education had 67% higher odds for interest in short online information videos, 123% higher odds for interest in online chat function with healthcare providers and 61% higher odds for interest in individually tailored feedback on email compared to patients’ whit primary school. Patients with high school and college/university education had 34-57% lower odds for interest in individually tailored text messages than those with primary school.

Conclusions
Age, educational level and gender were important predictors of patients’ preferences for using eHealth programmes post PCI. These results are important for the further development of personalized eHealth programmes.