FROM E-HEALTH-LITERACY TO E- OCCUPATIONAL HEALTH LITERACY

Transcription

1 FROM E-HEALTH-LITERACY TO E- OCCUPATIONAL HEALTH LITERACY JF Gehanno Rouen University Hospital France JF Gehanno août 13 - Diapositive 1

2 Background Ø Health literacy = ability to ú read, ú understand ú and use healthcare informa6on ú to make decisions and follow instruc6ons for treatment. Ø ehealth literacy = individual s ability to (Norman, 2006) ú search for informa6on in electronic environment ú find ú evaluate and appraise, ú Integrate and apply ú to afempt to address a par6cular health problem JF Gehanno août 13 - Diapositive 2

3 Core skills for ehealth Literacy Ø tradi6onal literacy ú reading and understanding wrifen passages Ø informa6on literacy ú skills to ar6culate informa6on needs, to locate, evaluate, and use informa6on, and to apply informa6on to create and communicate knowledge Ø computer literacy ú wide range of skills from basic knowledge of using a computer, such as opening a browser window, to par6cipa6ng in social networking ac6vi6es Ø media literacy ú ability to select, interpret, evaluate, contextualize, and create meaning from resources presented in a variety of visual or audio forms Ø scien6fic literacy ú familiarity with basic biological concepts and the scien6fic method, as well as the ability to understand, evaluate, and interpret health research findings using appropriate scien6fic reasoning Ø health literacy Norman & Skinners, JMIR 2006; Chan & Kaufman, JMIR 2011 JF Gehanno août 13 - Diapositive 3

4 e.occupational Health Literacy Ø Same principles but Ø Iden6fy a need for informa6on ú Health promo6on ú Effect of an exposure ú Impact of a disease Ø Search for informa6on Ø Iden6fy and access Ø Understand Ø Appraise quality & validity Ø Apply : ú change behaviour ú adapt to his own workplace context ú more complex JF Gehanno août 13 - Diapositive 4

5 Is ehealth literacy > to Health literacy Ø Health literacy : ability to use the informa6on Ø ehealth literacy : ability to search for and then use ú More ac6ve process Ø Does it mafer? Ø Effect of informa6on given to the pa6ent / worker (brochure, lecture ) ú «One size fits all» model ú Increases knowledge ú No impact on health, injuries Athma (Gibson CDSR 2002) Occupa6onal injuries (Shah, CDSR 2009; Rau6ainen CDSR 2008) Back pain (Verbeek, CDSR 2009) Not efficient in occupa6onal health (Robson., SJWEH 2012) JF Gehanno août 13 - Diapositive 5

6 EXEMPLE OF PASSIVE & USELESS JF Gehanno août 13 - Diapositive 6

7 Does involving the target make a difference? Ø Effect of ac6ve learning & tailored informa6on Ø Interac6ve Health Communica6on Applica6ons (IHCAs) ú 24 RCTs, impact on health (Murray et al., CDSR 2009) Ø Video games and Serious games (Primack, Am J Prev Med 2012) ú 1452 ar6cles examined ú Promising field Ø Wearing of hear protec6ons (El Dib, CDSR 2009) Ø Systema6c review on the impact of safety training (Burke, Am J Public Health, 2006) ú 95 studies, par6cipants ú Impact of training on accidents, injuries, diseases ú Passive : +0;2 ú Intermediate : ú Ac6ve : JF Gehanno août 13 - Diapositive 7

8 Key to efficacy Ø Ac6ve behaviour means befer results ú Self searching should be befer Ø People search to sa6sfy a perceived need ú Wilson model in informa6on behaviour research (Wilson 1999) Ø Do workers feel a need for informa6on or advice about occupa6onal hazards or diseases? ú New Zealand (Dryson, 1993) 38% needed informa6on ú Netherland 2011 (Rhebergen, 2012) 535 amployees 71% declared that they had have ques6ons on occupa6onal health and safetyduring the previous 12 months 42% had search for an answer, 50% found it JF Gehanno août 13 - Diapositive 8

9 Study in Upper Normandy (France) Ø One week Ø All employees attending an OHS service Ø Self questionnaire, given by the secretary before the consultation Ø 2641 answers ú 62% men, 38% women ú Mean age : 38 years (+/- 11) Rollin & Gehanno, Occ Med 2013 JF Gehanno août 13 - Diapositive 9

10 Health problems Health'problem' Yes$ 28%$ Linked'to'work' Very%high% 13%%?% 17%% Very%low% 22%% No$ 72%$ High% 24%% Low% 24%% JF Gehanno août 13 - Diapositive 10

11 Need for information about occupational diseases or occupational hazards Very%high% 2,86%% 4,77%% Occ%Hazards% Occ%Disease% High% 13,55%% 14,80%% Ø 50% needed information Medium% 32,46%% 33,34%% Low% None% 23,50%% 19,55%% 27,63%% 27,11%% N=2641 JF Gehanno août 13 - Diapositive 11

12 DO THEY RECEIVE INFORMATION? JF Gehanno août 13 - Diapositive 12

13 42% (n=995/2641) declared having receive information on their occupational risks over the last 24 months By#whom?# Employer* 571* OP* GP* 432* 416* Other* Other*memver*of*the*OHS* Occupa&onal*nurse* 141* 140* 166* JF Gehanno août 13 - Diapositive 13

14 How? oral" 905" Wri2en" 478" Video" 230" Other" 67" 0" 200" 400" 600" 800" 1000" JF Gehanno août 13 - Diapositive 14

15 And elsewhere Ø Study among Canadian workers (Smith, Injury Preven6on 2007) ú were in their first year of work ú Number having received a safety training in the last 12 months 12% of women 16% of men Ø So workers have needs, and receive not enough informa6on Ø Do they search? JF Gehanno août 13 - Diapositive 15

16 Do workers search for information? Ø Upper Normandy ú 2641 employees ú 33% had search at least once 2% > 5 6mes JF Gehanno août 13 - Diapositive 16

17 Factors related to the need for information about occupational hazards or diseases and to the search for information (multiple logistic regression analysis) Factor Info need Search for info Age (year) NS * < ( ) 1.4 ( ) ( ) 1.9 ( ) ( ) 2.6 ( ) Search increases with age Related to health status? JF Gehanno août 13 - Diapositive 17

18 Factors related to the need for information about occupational hazards or diseases and to the search for information (multiple logistic regression analysis) Factor Info need Search for info Perceived health status NS ** Bad Good 0.7 ( ) 0.6 ( ) Number of medical consultation per year * * ( ) 2.3 ( ) ( ) 2.5 ( ) Perceived exposure to occupational hazards *** *** No yes 4.0 ( ) 1.7 ( ) JF Gehanno août 13 - Diapositive 18

19 WHERE DO THEY SEARCH? ELECTRONIC OR HUMAN SOURCES JF Gehanno août 13 - Diapositive 19

20 Where do/ould you search for an answer? GP# Internet# OP# Occupa:onal#nurse# Trade#union# Yes# No# General#media# Employer# 0%# 20%# 40%# 60%# 80%# 100%# N=2641 JF Gehanno août 13 - Diapositive 20

21 Level of trust in the provider of information! GP# Occupa<onal#physiician# Occupa<onal##nurse# Internet# General#media# Trade#union# Very#low# Low# High# Very#High# Employer# N=2641 0%# 20%# 40%# 60%# 80%# 100%# JF Gehanno août 13 - Diapositive 21

22 Relation between trust and use? JF Gehanno août 13 - Diapositive 22

23 Why do they trust their GP? Ø EMUTOM : mean dura6on of occupa6onal medicine to undergraduate medical students in Europe ú Europe (135 medical schools) : 25,5h (EMUTOM team, 2013) Ø Con6nuous medical educa6on in occupa6onal medicine through medical literature ú Analysis of 10 years of the main journals (Gehanno & Rollin, Occ Env Med 2012) NEJM, JAMA, Lancet, BMJ ar6cles ú Occupa6onal medicine: 44th out of 73 medical speciali6es JF Gehanno août 13 - Diapositive 23

24 So Ø Workers need informa6on on occupa6onal hazards and occupa6onal diseases Ø The need is higher for sick people and for those who perceive to be exposed to occupa6onal hazards Ø Few really seach ú Not asking the right person Ø They search on media they don t trust Ø What are the barriers to ehealth literacy? JF Gehanno août 13 - Diapositive 24

25 Barriers to e-health literacy Ø First : need to feel a need to search ú Problem for primary preven6on ú Feeling a need searching finding Ø Underlying assump6on : people have the skills to use such resources to their op6mal level but ú > 40% of US adults have basic literacy levels below what is considered necessary to op6mally par6cipate in civil society (Na6onal Center for educa6on sta6s6cs, 1999) ú 8% of blue collar workers & 15% of unemployed in France can not read and understand Ø We can train people ú It works for older people (Xie, J Med Internet Med Res 2011) Ø Appraise quality & validity? Ø Gaissmaier, EASOM summer school Berlin 2012 JF Gehanno août 13 - Diapositive 25

26 Google «hepatitis B vaccine», 1rst page JF Gehanno août 13 - Diapositive 26

27 ? JF Gehanno août 13 - Diapositive 27

28 Need to guide the workers? Ø Guide the workers through the dedalus ú Provide them with reliable informa6on Ø Netherlands : Distance service to answer OHS ques6ons of workers ú Experts ú Informa6on reliable (Rhebergen et al., Occ Env Med 2011) ú Workers are sa6sfied (Rhebergen et al;, BMC Med Inf Decis Mak 2011) JF Gehanno août 13 - Diapositive 28

29 JF Gehanno août 13 - Diapositive 29

30 Improve e-health literacy and then? How to sit at a computer? Sit up tall This DVD is fascinating JF Gehanno août 13 - Diapositive 30

31 From e-health literacy to health promotion : need for environmental changes JF Gehanno août 13 - Diapositive 31

32 THANK YOU FOR YOUR ATTENTION JF Gehanno août 13 - Diapositive 32