A study of the impact of the new digital divide on the ICT competences of rural and urban secondary school teachers in China.

Teachers' competence in information and communication technology (ICT) applications can lead to a deeper integration of technology into the curriculum and improve the quality of education. However, its application and distribution issues could result in resource inequality and social injustice. Based on the ICT competency framework for teachers, the study investigates the variables influencing teachers' ICT competency. A prediction model of teachers' ICT competency is built using empirical data from secondary school teachers in Hebei Province, China, both in urban and rural settings. The study results show that a new digital divide does exist between urban and rural teachers and that differences in digital environment and digital literacy reflecting the new digital divide have different degrees of impact on teachers' ICT competence. Age and subject also affect teachers' ICT competence. In the new era, we can start with knowledge acquisition, knowledge deepening and knowledge creation to improve teachers' ICT competence.

Why is health literacy an essential component of health of individuals with chronic kidney disease / Pourquoi la littératie en santé est une composante essentielle de la santé des individus ayant une maladie rénale chronique.

Health literacy (HL) is the ability of individuals to access, understand and use health information to improve their health. It is a multidimensional and contextual concept, whose definition has been enriched over time. Considered both as a health risk factor and a skill to be developed by individuals, HL also depends on the healthcare system in which patients have to navigate, and on healthcare professionals' awareness of this concept. In order to promote shared decision-making and thus individual empowerment in the healthcare, HL should be at the core of the concerns of nephrology care teams.

La littératie en santé (LS) est la capacité d'un individu à accéder à des informations en santé, à les comprendre et à les utiliser pour améliorer son état de santé. Il s'agit d'un concept pluridimensionnel et contextuel dont la définition s'est enrichie au fil du temps. Considérée à la fois comme un facteur de risque pour la santé et une aptitude à développer chez les individus, la LS dépend également du système de santé dans lequel les patients doivent naviguer et de la sensibilisation des professionnels de santé à ce concept. Afin de favoriser la décision partagée et ainsi l'émancipation des individus en matière de santé, la LS devrait être au cœur des préoccupations des équipes de néphrologie.

How does Google get its information?: Children's judgements about Google search.

Children frequently use Google to answer their questions, yet what they think about Google's capacity and limitations is unclear. This study explores children's beliefs about Google's capacity to answer questions. American children ages 9 and 10 (n = 44; 18 boys and 26 girls) viewed factual questions directed towards Google or a person. After viewing each question, they reported their confidence in the informant's accuracy, the time it would take the informant to obtain the answer and how the informant would obtain the answer. Finally, they generated questions that the internet would be capable or incapable of answering. Children believed Google would be more accurate and faster than a person at answering questions. Children consistently generated appropriate questions that the internet would be good at answering, but they sometimes struggled to generate questions that the internet would not be good at answering. Implications for children's learning are discussed.

Knowledge Transfer and Networking Upon Implementation of a Transdisciplinary Digital Health Curriculum in a Unique Digital Health Training Culture: Prospective Analysis.

Background: Digital health has been taught at medical faculties for a few years. However, in general, the teaching of digital competencies in medical education and training is still underrepresented. Objective: This study aims to analyze the objective acquisition of digital competencies through the implementation of a transdisciplinary digital health curriculum as a compulsory elective subject at a German university. The main subject areas of digital leadership and management, digital learning and didactics, digital communication, robotics, and generative artificial intelligence were developed and taught in a transdisciplinary manner over a period of 1 semester. Methods: The participants evaluated the relevant content of the curriculum regarding the competencies already taught in advance during the study, using a Likert scale. The participants' increase in digital competencies were examined with a pre-post test consisting of 12 questions. Statistical analysis was performed using an unpaired 2-tailed Student t test. A P value of <.05 was considered statistically significant. Furthermore, an analysis of the acceptance of the transdisciplinary approach as well as the application of an alternative examination method (term paper instead of a test with closed and open questions) was carried out. Results: In the first year after the introduction of the compulsory elective subject, students of human medicine (n=15), dentistry (n=3), and medical biotechnology (n=2) participated in the curriculum. In total, 13 participants were women (7 men), and 61.1% (n=11) of the participants in human medicine and dentistry were in the preclinical study stage (clinical: n=7, 38.9%). All the aforementioned learning objectives were largely absent in all study sections (preclinical: mean 4.2; clinical: mean 4.4; P=.02). The pre-post test comparison revealed a significant increase of 106% in knowledge (P<.001) among the participants. Conclusions: The transdisciplinary teaching of a digital health curriculum, including digital teaching methods, considers perspectives and skills from different disciplines. Our new curriculum facilitates an objective increase in knowledge regarding the complex challenges of the digital transformation of our health care system. Of the 16 student term papers arising from the course, robotics and artificial intelligence attracted the most interest, accounting for 9 of the submissions.

Associations between digital literacy, health literacy, and digital health behaviors among rural residents: evidence from Zhejiang, China.

OBJECTIVE: Within the digital society, the limited proficiency in digital health behaviors among rural residents has emerged as a significant factor intensifying health disparities between urban and rural areas. Addressing this issue, enhancing the digital literacy and health literacy of rural residents stands out as a crucial strategy. This study aims to investigate the relationship between digital literacy, health literacy, and the digital health behaviors of rural residents. METHODS: Initially, we developed measurement instruments aimed at assessing the levels of digital literacy and health literacy among rural residents. Subsequently, leveraging micro survey data, we conducted assessments on the digital literacy and health literacy of 968 residents in five administrative villages in Zhejiang Province, China. Building upon this foundation, we employed Probit and Poisson models to empirically scrutinize the influence of digital literacy, health literacy, and their interaction on the manifestation of digital health behaviors within the rural population. This analysis was conducted from a dual perspective, evaluating the participation of digital health behaviors among rural residents and the diversity to which they participate in such behaviors. RESULTS: Digital literacy exhibited a notably positive influence on both the participation and diversity of digital health behaviors among rural residents. While health literacy did not emerge as a predictor for the occurrence of digital health behavior, it exerted a substantial positive impact on the diversity of digital health behaviors in the rural population. There were significant interaction effects between digital literacy and health literacy concerning the participation and diversity of digital health behaviors among rural residents. These findings remained robust even after implementing the instrumental variable method to address endogeneity issues. Furthermore, the outcomes of robust analysis and heterogeneity analysis further fortify the steadfastness of the aforementioned conclusions. CONCLUSION: The findings suggest that policymakers should implement targeted measures aimed at enhancing digital literacy and health literacy among rural residents. This approach is crucial for improving rural residents' access to digital health services, thereby mitigating urban-rural health inequality.

Inequities in Technology Access and Digital Health Literacy Among Patients With Dermatologic Conditions: Cross-Sectional Analysis of the National Health Interview Survey.

Certain sociodemographic factors are associated with low technology access and digital healthy literacy.

Inspecting the "health poverty trap" mechanism: self-reinforcing effect and endogenous force.

INTRODUCTION: The term "health poverty trap" describes a vicious cycle in which developing countries or regions become trapped in low levels of health and poverty during the process of modernization. Although significant progress has been made in alleviating poverty in China, there is still a need to further enhance the living conditions of its impoverished population. METHODS: This research utilizes the data of the three national representative panel surveys from 2014 to 2020. The primary objective is to gain a better understanding of the intricate relationship between health and poverty. To examine the self-reinforcing effects of the cumulative cycle between health and poverty, we employ unconditional quantile regression analysis. RESULT: The low-income group exhibits lower overall health status compared to the average level. Economic constraints partially hinder the ability of low-income individuals to access healthcare resources, thereby reinforcing the cyclical relationship between health and poverty. Additionally, the unique psychological and behavioral preferences of individuals in health poverty act as indirect factors that further strengthen this cycle. Health poverty individuals can generate endogenous force to escape the "health poverty trap" by enhancing their confidence levels and digital literacy. CONCLUSIONS: The research examines the coexistence of health gradients and economic inequality among Chinese residents. Additionally, the study explores the endogenous force mechanism of escaping the health poverty trap from psychological and behavioral perspectives. This research also offers insights into optimizing government poverty alleviation programs to effectively address this issue.

The digital divide in rural and regional communities: a survey on the use of digital health technology and implications for supporting technology use.

OBJECTIVE: A digital divide exists for people from rural and regional areas where they are less likely and confident to engage in digital health technologies. The aim of this study was to evaluate the digital health literacy and engagement of people from rural and regional communities, with a focus on identifying barriers and facilitators to using technology. RESULTS: Forty adults living in rural/regional areas completed a survey consisting of the eHealth Literacy Scale (eHEALS) with additional items surveying participants' experience with a range of digital health technologies. All participants had used at least one digital health technology. Most (80%) participants had an eHEALS score of 26 or above indicating confidence in online health information. Commonly reported barriers to digital health technology use centred on product complexity and reliability, awareness of resources, lack of trust, and cost. Effective digital health technology use is becoming increasingly important, there may be a need to prioritise and support people with lower levels of digital health literacy. We present opportunities to support community members in using and accessing digital health technology.

Measuring the Digital Competence of Health Professionals: Scoping Review.

BACKGROUND: Digital competence is listed as one of the key competences for lifelong learning and is increasing in importance not only in private life but also in professional life. There is consensus within the health care sector that digital competence (or digital literacy) is needed in various professional fields. However, it is still unclear what exactly the digital competence of health professionals should include and how it can be measured. OBJECTIVE: This scoping review aims to provide an overview of the common definitions of digital literacy in scientific literature in the field of health care and the existing measurement instruments. METHODS: Peer-reviewed scientific papers from the last 10 years (2013-2023) in English or German that deal with the digital competence of health care workers in both outpatient and inpatient care were included. The databases ScienceDirect, Scopus, PubMed, EBSCOhost, MEDLINE, OpenAIRE, ERIC, OAIster, Cochrane Library, CAMbase, APA PsycNet, and Psyndex were searched for literature. The review follows the JBI methodology for scoping reviews, and the description of the results is based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. RESULTS: The initial search identified 1682 papers, of which 46 (2.73%) were included in the synthesis. The review results show that there is a strong focus on technical skills and knowledge with regard to both the definitions of digital competence and the measurement tools. A wide range of competences were identified within the analyzed works and integrated into a validated competence model in the areas of technical, methodological, social, and personal competences. The measurement instruments mainly used self-assessment of skills and knowledge as an indicator of competence and differed greatly in their statistical quality. CONCLUSIONS: The identified multitude of subcompetences illustrates the complexity of digital competence in health care, and existing measuring instruments are not yet able to reflect this complexity.

I feel blue- teacher, can you help me? A study on the effect of digital literacies on language learners' technostress, on-line engagement, autonomy, and academic success.

This phenomenological study explored the experiences of language learners in the digital age, specifically investigating the intersection of digital literacy, technostress, online engagement, autonomy, and academic success. Twenty participants, selected through purposive sampling, shared Chinese as their native language and were between 18 and 20 years old, with five participants being female. Employing interviews and document analysis, the study aimed to understand the subjective meanings, emotions, and perceptions associated with these phenomena. The findings revealed the multifaceted nature of technostress, the crucial role of digital literacy in shaping online engagement and autonomy, and the nuanced impact on academic success. These qualitative insights contribute to a deeper understanding of the complex relationships in the digital language learning landscape. The study has implications for educators, materials developers, syllabus designers, and policy-makers, providing practical insights to enhance language learning experiences in the digital era. Future research may further explore specific dimensions uncovered in this study to adapt educational practices to the evolving digital terrain.

Understanding university students' attitudes and preferences for internet-based mental health interventions.

Internet-based interventions are recognised as a practical approach to address mental health issues. The acceptance and utilisation of such interventions are closely linked to user attitudes and preferences. This study aims to examine the predictors of university students' attitudes towards internet-based interventions. Additionally, it seeks to elucidate students' preferences regarding crucial features of these interventions, such as the format, delivery mode, content type, and structural components, to understand better what makes these interventions appealing and practical for university students. A total of 273 university students (comprising 68 % females and 32 % males) participated in the study. The data collection instruments employed were the Personal Information Form, Internet-Based Intervention Preference Survey, E-therapy Attitude Measure (ETAM), Digital Literacy Scale, Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 (GAD-7). The data were analysed utilising descriptive statistics, Pearson correlation analysis, and multiple linear regression analysis. The multiple regression analysis revealed digital literacy as a predictive factor for attitudes towards internet-based interventions. Demographic variables, such as age and gender, and psychological variables, such as depression and anxiety levels, were found not to be associated with attitudes towards these interventions. While students are actively seeking mental health information online, a significant majority remain unaware of internet-based interventions. They show a preference for interventions offering greater human interaction, including face-to-face guidance and video content featuring people. Participants favour completing one or two sessions of the intervention weekly. Desired features of internet-based interventions include self-assessment scales, relatable characters, voice relaxation exercises, practical daily life activity tasks, and weekly reminders throughout the process. In conclusion, initiatives aimed at enhancing digital literacy levels could foster more positive attitudes towards internet-based interventions among students. Developers creating Internet-Based Interventions (IBI) for university students should consider these preferences.

Meta-analysis: eHealth literacy and attitudes towards internet/computer technology.

OBJECTIVE: To explore the relationship between eHealth literacy and attitudes towards internet/computer (I/C) technology use in healthcare. METHODS: Analysis of data from 16 cross-sectional studies, involving literature search from databases like PubMed, EBSCO, JMIR, up to April 2023. Studies were selected based on a quantitative cross-sectional design, with no restrictions on participant characteristics. RESULTS: A significant positive correlation (0.36; 95% CI 0.37-0.38, p < 0.05) was found between eHealth literacy and positive attitudes towards I/C technology use. Age and regional differences, especially in participants over 50 and from Asian and Middle Eastern countries, were notable. CONCLUSION: Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions.

Defining the Dimensions of Diversity to Promote Inclusion in the Digital Era of Health Care: A Lexicon.

The pandemic provided a stark reminder of the inequities faced by populations historically marginalized by the health care system and accelerated the adoption of digital health technologies to drive innovation. Digital health technologies' purported promises to reduce inefficiencies and costs, improve access and health outcomes, and empower patients add a new level of urgency to health equity. As conventional medicine shifts toward digital medicine, we have the opportunity to intentionally develop and deploy digital health technologies with an inclusion focus. The first step is ensuring that the multiple dimensions of diversity are captured. We propose a lexicon that encompasses elements critical for implementing an inclusive approach to advancing health care quality and health services research in the digital era.

Nursing students' preparedness for the digitalised clinical environment in Australia: An integrative review.

AIM: The aim of this integtrative review is to examine the literature on nursing students preparedness for the digitalised clinical setting. BACKGROUND: Digital literacy skills ensure nursing students can provide quality and safe care to patients in a digitalised clinical setting. DESIGN: Integrative review of the literature. METHODS: The integrative review of the literature incorporated Whittemore and Knafl's (2005) framework and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2021 statement. A review of the literature comprised of a search of the following databases: ERIC, Scopus, CINAHL, Medline, Cochrane Library and Google Scholar from 2010-2022. Data were critically appraised using the Critical Appraisal Skills Programme (CASP), the Mixed Method Tool (MMAT) and Joanna Biggs Institute (JBI). RESULTS: The literature reported on nine studies from 2010 to 2022. The four themes identified using Braun and Clarke's thematic analysis were curriculum design, education and training, digital literacy level and professional digital literacy competency standard framework. Major findings include the need for the development and integration of a professional digital literacy competency standard framework embedded into nursing curricula to equip nursing students with appropriate digital literacy skills to navigate digitalised healthcare settings. CONCLUSION: Current registered nurses and preregistration nurses are required to be upskilled with the understanding and knowledge of health informatics and its role in the clinical setting. This will enable future registered nurses to keep up with the rapidly evolving technological clinical environment.

Technology and health inequities in diabetes care: How do we widen access to underserved populations and utilize technology to improve outcomes for all?

Digital health technologies are being utilized increasingly in the modern management of diabetes. These include tools such as continuous glucose monitoring systems, connected blood glucose monitoring devices, hybrid closed-loop systems, smart insulin pens, telehealth, and smartphone applications (apps). Although many of these technologies have a solid evidence base, from the perspective of a person living with diabetes, there remain multiple barriers preventing their optimal use, creating a digital divide. In this article, we describe many of the origins of these barriers and offer recommendations on widening access to digital health technologies for underserved populations living with diabetes to improve their health outcomes.

When Seeing Isn't Believing: Navigating Visual Health Misinformation through Library Instruction.

Visual misinformation poses unique challenges to public health due to its potential for persuasiveness and rapid spread on social media. In this article, librarians at the University of Pittsburgh Health Sciences Library System identify four types of visual health misinformation: misleading graphs and charts, out of context visuals, image manipulation in scientific publications, and AI-generated images and videos. To educate our campus's health sciences audience and wider community on these topics, we have developed a range of instruction about visual health misinformation. We describe our strategies and provide suggestions for implementing visual misinformation programming for a variety of audiences.

Validity and reliability of the Chinese version of digital health readiness questionnaire among hypertension patients in rural areas of China.

Introduction: Digital health has the potential to support health care in rural areas by overcoming the problems of distance and poor infrastructure, however, rural areas have extremely low use of digital health because of the lack of interaction with technology. There is no existing tool to measure digital health literacy in rural China. This study aims to test and validate the digital health readiness questionnaire for assessing digital readiness among patients in rural China. Methods: Due to the different Internet environments in China compared to Belgium, a cultural adaptation is needed to optimize the use of Digital Health Readiness Questionnaire in China. Then, a prospective single-center survey study was conducted in rural China among patients with hypertension. Confirmatory factor analysis was computed to test the measurement models. Results: A total of 330 full questionnaires were selected and included in the analysis. The model-fit measures were used to assess the model's overall goodness of fit (Chi-square/degrees of freedom = 5.060, comparative fit index = 0.889, Tucker-Lewis index (TLI) = 0.869, root mean square error of approximation (RMSEA) = 0.111, standardized root mean square residual (SRMR) = 0.0880). TLI is a little bit lower than the borderline (more than 0.9) and RMSEA is higher than it (less than 0.08 means good model fit). We deleted two items 2 and 4 and the result shows a better goodness of fit (Chi-square/degrees of freedom = 4.897, comparative fit index = 0.914, TLI = 0.895, RMSEA = 0.109, SRMR = 0.0765). Conclusion: To increase applicability and generalizability in rural areas, it should be considered to use the calculation of only the parts Digital skills, Digital literacy and Digital health literacy which are equally applicable in a Belgian population as in a rural Chinese population.

Examining technology use and mental health among parents with newborns in the intensive care unit during the COVID-19 pandemic: A cross-sectional study.

Objectives: To investigate the relationship between pandemic-related stressors, mental health, and technology use among parents of hospitalized infants during the COVID-19 pandemic. Methods: A cross-sectional study of 47 participants who had an infant in the Neonatal Intensive Care Unit (NICU) during the pandemic was completed. Participants ranked several statements on a Likert scale to assess mental health, technology use, and COVID-19-related stress during their infant's stay in the NICU. Results: Mental health wellness scores were negatively associated with COVID-19-related stress (rs - 0.40, p = .015). The most prevalent stressor was hospital visitation restriction. Higher COVID-19-related stress was associated with greater use of text and video chat [(rs0.35, p = 0.016) and (rs0.33, p = .025)]. Enjoyment of technology use and access to technology were positively associated with higher mental health wellness scores [(rs0.42, p = .003) and (rs0.38, p = .009)]. Conclusions: Social uses of technology were valuable in a cohort of parents with infants hospitalized during the COVID-19 pandemic. Innovation: Technology is a tool that can help parents cope with the stress of having a hospitalized infant. Digital literacy and technology access should be promoted in the post-pandemic landscape to help parents of infants in the NICU attain more benefit from these resources.

Awareness and level of digital literacy among students receiving health-based education.

BACKGROUND: Being digitally literate allows health-based science students to access reliable, up-to-date information efficiently and expands the capacity for continuous learning. Digital literacy facilitates effective communication and collaboration among other healthcare providers. It helps to navigate the ethical implications of using digital technologies and aids the use of digital tools in managing healthcare processes. Our aim in this study is to determine the digital literacy level and awareness of our students receiving health-based education in our university and to pave the way for supporting the current curriculum with courses on digital literacy when necessary. METHOD: Students from Acibadem University who were registered undergraduate education for at least four years of health-based education, School of Medicine, Nutrition and Dietetics, Nursing, Physiotherapy and Rehabilitation, Psychology, Biomedical Engineering, Molecular Biology, and Genetics were included. The questionnaire consisted of 24 queries evaluating digital literacy in 7 fields: software and multimedia, hardware and technical problem solving, network and communication/collaboration, ethics, security, artificial intelligence (A.I.), and interest/knowledge. Two student groups representing all departments were invited for interviews according to the Delphi method. RESULTS: The survey was completed by 476 students. Female students had less computer knowledge and previous coding education. Spearman correlation test showed that there were weak positive correlations between the years and the "software and multimedia," "ethics," "interest and knowledge" domains, and the average score. The students from Nursing scored lowest in the query after those from the Nutrition and Dietetics department. The highest scores were obtained by Biomedical Engineering students, followed by the School of Medicine. Participants scored the highest in "network" and "A.I." and lowest in "interest-knowledge" domains. CONCLUSION: It is necessary to define the level of computer skills who start health-based education and shape the curriculum by determining which domains are weak. Creating an educational environment that fosters females' digital knowledge is recommended. Elective courses across faculties may be offered to enable students to progress and discuss various digital literacy topics. The extent to which students benefit from the digital literacy-supported curriculum may be evaluated. Thus, health-based university students are encouraged to acquire the computer skills required by today's clinical settings. REGISTRATION: This study was approved by Acibadem University and Acibadem Healthcare Institutions Medical Research Ethics Committee (ATADEK) (11 November 2022, ATADEK registration: 2022-17-138) All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from the participants.

Integrating digital literacies and scientific communication in a multimedia anatomy group assignment to advance contextual learning.

Anatomists are facing a new generation of learners who will study and work in a technology-rich environment. Indeed, digital technologies are tremendously changing how information and knowledge are communicated and retrieved. However, it remains unclear whether an anatomy assessment can be designed to promote contextual learning through integrating a digital communication strategy. To investigate this, assessment methods were diversified in the first-year neuroanatomy and third-year regional anatomy curricula through implementing a multimedia human anatomy group assignment integrating digital literacies and scientific communication. Through completing this multimedia assignment, students demonstrated their anatomy knowledge transfer using a range of approaches. The main mode of presentations chosen in the two anatomy units were non-animated video presentations (~50%), animated video presentations (~30%), storyboards (~10%), podcasts (~3%), and filmed videos (~3%). A 5-point Likert scale learning and teaching survey was conducted for a total of 195 undergraduate health science students to evaluate students' perception of this group assignment. The majority of students (70-80%) strongly agreed or agreed that the multimedia group assignment helped their teamwork skills. Students who produced animated videos significantly outperformed those who adopted the non-animated presentations during the end-of-semester theory examination (p < 0.05). This study demonstrates that an anatomy group assignment integrating digital literacy and scientific communication is an effective assessment strategy associated with a positive learning experience and outcome. This inquiry-based assignment promotes learning through assessment, allowing students to not only consolidate and extend anatomy knowledge but also developing effective digital communication skills, providing new insights into non-didactic anatomy assessments.