Differences in digital health literacy and future anxiety between health care and other university students in England during the COVID-19 pandemic.

BACKGROUND: This study investigates university students' digital health literacy and web-based information-seeking behaviours during the early stages of the COVID-19 pandemic in England. It compares undergraduate and postgraduate students in non-health related subjects with health care students, many of whom were preparing for, or working in, frontline roles. The survey was conducted as part of a wider study by the COVID-HL research consortium. METHODS: A cross-sectional study was conducted among n = 691 university students aged ≥18 years from 25 universities across England using an adapted digital survey developed by COVID-HL. Data were collected regarding sociodemographic characteristics and specific measures drawn from the Future Anxiety Scale and the Digital Health Literacy Instrument (DHLI). These had been adapted for use in an English setting and to the specific context of the COVID-19 pandemic. Other data collected included students' anxiety or worries about the future using the Dark Future Scale as well as behaviours in online information-seeking. Data were analysed using correlations to test for relationships between constructs and also between group comparisons to test for differences between students studying health and non-health related subjects. RESULTS: Across digital health literacy dimensions, there was no significant difference between students studying health-related subjects and other students. Health care students did report greater difficulties in relation to how to behave online. They also relied less on public body sources for information about the pandemic. A significant difference was found between the two student populations in relation to their anxiety about the future with health care students reporting fewer fears about the future. CONCLUSIONS: Although digital health literacy is well developed in university students, a significant proportion of students still face difficulties with evaluating online information which may frustrate public health efforts. This could be addressed by ensuring health students' curriculum in particular encompasses digital health literacy.

eHealth literacy during the COVID-19 pandemic: seeking, sharing, suspicion amongst older and younger UK populations.

The containment of infectious diseases is most successful when at-risk populations have a high level of relevant health literacy (HL). To achieve this both literacy needs and patterns of knowledge sharing must be understood within the context of the disease being studied. It is also important to understand these processes from both offline (HL) and online (eHL) perspectives and amongst demographics with access to different types of information and social capital, and who have different levels of vulnerability. This paper discusses the insights gained over a series of 30 interviews with the UK residents aged either 19 - 30 years of age or older than 70 years-focussing on how they seek, understand, evaluate and convey information about COVID-19 during the current pandemic. Using thematic analysis, we identified themes around motivations to seek information, the information journey, digital choice and engagement, dilemmas and challenges of managing and appraising information, and sharing information. There was little difference in the eHL between the two age groups who both had high levels of education and were sophisticated digital citizens. The COVID-19 pandemic highlights three dominant processes in managing complex and uncertain information: some individuals may suffer from information fatigue but there was no evidence of any impact on their behaviours; others seek and share information across many networks; and there were strikingly high levels of distrust leading to complex processes of meaning-making demanding critical health literacy skills.

Barriers and facilitators to implementing and sustaining peer support in kidney care.

INTRODUCTION: Peer support offers informational, appraisal and emotional support for people with kidney disease, is recommended in national policy, yet has low engagement levels. This paper reports results of a national survey and qualitative interviews in the UK with the aim of increasing understanding of peer support availability and its barriers and facilitators. LITERATURE REVIEW: A recent narrative review highlighted the barriers and facilitators to peer support uptake among people with kidney disease however called on further studies to be conducted. MATERIAL AND METHODS: The survey, adapted from a 2012 version, was sent to all 83 UK kidney units. Semistructured interviews were conducted with staff, recipients and supporters from two units. RESULTS: Forty-four units completed the survey, and 10 staff, 7 patients and 2 peer supporters were interviewed. The most common facilitators were promotion with staff and having peer support champions. Barriers included lack of staff time, guidance/information, other projects taking priority and too few supporters. DISCUSSION: Little progress has been made since 2012; a proportion of units without peer support remains significant, with similar barriers identified in 2020. Services could be designed to limit the time needed for their creation and maintenance through having simpler referrals and designating staff liaisons. IMPLICATIONS FOR CLINICAL PRACTICE: Peer support programmes should have passionate staff and volunteers, involve recipients in the design, recruit an array of supporters and establish evaluations to determine the progress/outcomes. A resource toolkit was developed in response to this project. CONCLUSION: Findings from the national survey and qualitative interviews showed that more peer support optimisation and prioritisation is needed to ensure benefits are maximised.

A narrative review of peer support barriers and facilitators in kidney care.

INTRODUCTION: Patients with chronic kidney disease often experience emotional/mental challenges and benefit from peer support, as it provides insight/information from others with the same condition. Previous studies show it is effective in improving health outcomes and aids in treatment decisions. LITERATURE REVIEW: There is low peer support uptake among patients with chronic kidney disease in the United Kingdom and staff do not utilise peer support services fully. Few studies within the United Kingdom have focused on peer support barriers/facilitators, so this narrative review aimed to understand them from staff and patient perspectives. MATERIALS AND METHODS: A comprehensive search strategy and inclusion/exclusion criteria were applied with a two-step process of article selection employed using two reviewers. Thematic analysis was applied. RESULTS: Five articles were included and six themes emerged. Low referrals and difficulty matching were staff barriers; concern regarding the relationship dynamic and the format/delivery were patient barriers. Promotion of the service aided the uptake from staff, while patients valued inclusivity. DISCUSSION: Increased promotion of peer support benefits through training/awareness may improve staff referrals and there should be greater exposure nationally. A flexible format is essential to ensure ample opportunity for access. CONCLUSION: This review highlights the current literature on peer support barriers/facilitators. Further study is needed to evidence which approaches best overcome staff- and patient-barriers.