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In order to examine the relationship between health and eHealth literacy, we undertook a process of matching HLQ scales to eHEALS items by grouping related items with similar themes ( Table 1 ). eHEALS items 1, 2, and 3 related to Internet navigational skills and were thus grouped together. Likewise, items 6 and 7 both related to evaluation of resources found on the Internet. Items 4 and 5 represented distinct aspects of eHealth literacy and were therefore not grouped. Only item 8 of the eHEALS (“I feel confident in using information from the Internet to make health decisions”) was excluded as there was no HLQ scale that comparably assessed the confidence related to using health resources. Four key aspects of eHealth and health literacy were thus defined, and mean scores for items or item groups were then derived for each patient. For “navigating resources” and “skills to use resources,” the HLQ scales ranged from 1 to 5, and for “usefulness for oneself” and “critical evaluation,” they ranged from 1 to 4. This process was performed iteratively and via consensus between experts in clinical practice, research, and statistical analysis ( Table 1 ).

eHEALS: eHealth Literacy Scale.

HLQ: Health Literacy Questionnaire.

Univariate analyses were performed to compare patient demographic, socioeconomic, and technology use characteristics between the low (eHEALS<26) and high (eHEALS≥26) eHealth literacy groups. Chi-square test was used to compare the categorical variables, and independent t test was used to compare the means between the 2 groups. To determine predictors of low eHealth literacy, multiple-adjusted generalized estimating equation logistic regression model was used. Independent predictors included in the model were gender (female or male), age (<65 or 65-70 or >70 years), education (≤secondary or university or technical or vocational training), income (<Aus $1000 or Aus $1000-2000 or > Aus $2000 per week), CVD-related polypharmacy (active consumption of >3 medications related to CVD), private health care (yes or no), main electronic device used (desktop or laptop or mobile phone or tablet), and time spent on the Internet on any device (≤1 hour or >1 hour per day). These variables were included regardless of the statistical significance in the univariable comparison due to their clinical significance in relation to eHealth literacy. This analysis adjusted for the clustering effect of primary health care practices. The derived odds ratios (ORs) and corresponding 95% CIs were plotted in a forest plot. An adjusted analysis using the eHEALS score as a continuous variable was also done to see whether other predictors emerged. To test for the correlation between eHealth literacy and health literacy for the 4 literacy themes, multiple-adjusted generalized estimating equation linear regression models were used for each of the themes. The dependent variable, eHEALS score, was in a continuous form, and the corresponding continuous HLQ score was included in the model with the aforementioned covariates. Data were analyzed using SAS version 9.4 for Windows (SAS Institute Inc).

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The Faculty of Humanities of Leiden Universityhas a vacancy for a PhD candidate in Linguistics (specialisation African languages).
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Gesture Studies Conference in Cape Town, South Africa, July 4-8 2018

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We are happy to invite you to submit your papers to the 3rd Symposium on West African Languages (SyWAL2018) which will be held in Warsaw from 26th to 29th September, 2018. The first editio...
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Moonlight

The second feature from writer-director Barry Jenkins (MEDICINE FOR MELANCHOLY, IFFBoston 2008) follows its young protagonist from childhood to adulthood as he navigates both the dangers of drugs and violence in his depressed Florida neighbourhood, and his complex love for his best friend.

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Moonlight

The second feature from writer-director Barry Jenkins (MEDICINE FOR MELANCHOLY, IFFBoston 2008) follows its young protagonist from childhood to adulthood as he navigates both the dangers of drugs and violence in his depressed Florida neighbourhood, and his complex love for his best friend.

Appeared At
IFFBoston Fall Focus 2016
Manchester By The Sea

Casey Affleck, Michelle Williams and Kyle Chandler star in this emotionally overwhelming and critically acclaimed drama from writer-director Kenneth Lonergan (YOU CAN COUNT ON ME, MARGARET), about a reclusive handyman who must face his painful past when he returns to his Massachusetts hometown after the sudden death of his beloved older brother.

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Certain Women

Kelly Reichardt (WENDY AND LUCY, MEEK’S CUTOFF) directs Laura Dern, Michelle Williams, Kristen Stewart and Lily Gladstone in this tripartite portrait of striving, independent women whose lives intersect in suggestive and powerful ways.

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Lo And Behold: Reveries Of The Connected World

Werner Herzog’s existential exploration of the past, present, and future of the internet.

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Presenting Princess Shaw

Princess Shaw stuggles to make her music heard by posting her songs on YouTube. Then, one day, someone living 7,000 miles away discovers her.

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Second, the best intelligence leaders remember that the president is not their only “client.” The intelligence community also has a responsibility to provide unbiased intelligence support to the U.S. Congress — a co-equal branch of government — and to periodically provide frank and unvarnished analytic assessments to the American public. In each case, this has to done without regard to the White House’s policy preferences or its existing narrative. Just imagine the confusion, for example, if intelligence community leaders were to tell the president one thing about the direction of a particular global issue, and tell a markedly different story to Congress and the American public.

Third, to maintain a high standard of objectivity, the best leaders I’ve worked with have insisted on the highest possible analytic and information gathering tradecraft, and relied on structured analytic and decision-making processes to filter out actual or unconscious biases. In other words, during periods of great stress, our best leaders rely on sound tradecraft as their safe harbor.

And finally, they work to create an inclusive, collaborative workplace culture in which it’s okay to challenge existing assumptions and in which alternative viewpoints are both encouraged and rewarded. This is what researchers call “psychological safety,” and it has been repeatedly found to be essential in a variety of industries, from hospitals to high tech firms .

For many years, I believed that the coin of the realm for the intelligence community was our ability to acquire and analyze secrets. I thought that our secrets were the key to guaranteeing the intelligence community’s continuing influence and access to the president and to other senior policymakers. Over time, however, I have come to believe that while the intelligence community’s secrets are important, it’s our objectivity that is most essential to fulfilling our mission and enabling the best possible national security decision-making.

Regardless of the work you do, prize your objectivity, and work every day to preserve it.

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is the national intelligence fellow at the Council on Foreign Relations, a fellowship sponsored by the U.S. government. He is the former acting director of national intelligence. All opinions expressed in this commentary are solely those of the author.

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Comments

3 COMMENTS

Thank you for posting this article. I think staying objective is becoming increasingly more important and also harder. There is so much information out there it can be overwhelming at times and social media has created echo chambers where individuals are becoming less tolerant to opinions that do not align with theirs.

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