Health disparity research indicates that health illiteracy is associated with poorer health outcomes, greater risk of hospitalization, higher emergency room utilization, and increased death (Collins, Currie, Bakken, Vawdrey & Stone, 2012; Skopelja, Whipple & Richwine, 2013). Health information is increasingly being transitioned to online formats and according to Usher and Skinner (2010) the newest challenge that healthcare consumers face in taking control of their health is their ability to access, evaluate and incorporate the large amount of health information available on the Internet. Achieving a better understanding of the eHealth literacy levels of Aboriginal women and how they use technology to access health information may support better health outcomes in a variety of settings including the perinatal period which is important not only for the mother’s health, but her child’s as well. This mixed methods study explored the eHealth literacy knowledge, attitudes and skills of urban Aboriginal women in the perinatal period residing in a small city in British Columbia. A convergent parallel design was used to collect both qualitative and quantitative data from five study participants. Due to the small sample size study findings need to be interpreted with caution. The results may demonstrate that urban Aboriginal women in the perinatal period are comfortable and competent in accessing health information on the Internet. They identified the following as areas for improvement: (1) identifying if the information they retrieve is credible, (2) improving the cultural appropriateness of health information and websites, (3) improving access through continuing to build technology and search skills for Aboriginal women, and (4) supporting better access to the Internet and technology equipment for those Aboriginal women still affected by the digital divide. / Graduate

Introduktion: Teknikutvecklingen och digitaliseringen i samhället sker i en hög hastighet. Äldre vuxna är en grupp som ofta saknar den kompetens, kunskap och de färdigheter som är nödvändiga för att kunna nyttja de hälsoresurser och hälsoinformation som finns tillgängliga online. För att kunna engagera sig i e-hälsa och söka hälsoinformation online krävs det att de äldre vuxna har en viss nivå av eHealth literacy. eHealth literacy är förmågan att söka, hitta, förstå och värdera hälsoinformation från elektroniska källor, och tillämpa den kunskap som erhålls för att lösa ett hälsoproblem. Syfte: Syftet med litteraturöversikten var att belysa om det finns ett förhållande mellan eHealth literacy och hälsobeteenden samt hälsoutfall hos äldre vuxna, 55 år och äldre. Metod: Metoden som användes var en strukturerad litteraturöversikt. Analysmetoden som användes var en induktiv tematisk analys av 10 kvalitetsgranskade tidskriftsartiklar. Resultat: Den tematiska analysen genererade i 3 teman; Förbättrad livsstil, Engagemang i egenvård och eHealth literacy en mellanliggande faktor till hälsobeteenden och hälsorelaterad livskvalité. Resultatet visade att en ökad nivå av eHealth literacy hos äldre vuxna förbättrade deras hälsobeteenden, hälsobeslut och hälsoutfall i form av välmående och hälsorelaterad livskvalité. eHealth literacy hade både en direkt och en indirekt effekt på de studerade utfallen. Slutsats: Resultatet belyste betydelsen av att arbeta förebyggande och hälsofrämjande med äldres eHealth literacy förmåga för att i sin tur stärka deras hälsa, livskvalité och delaktighet i sin egenvård. eHealth literacy är en central faktor för äldres hälsa och för att de ska kunna nyttja de e-hälsotjänster som finns tillgängliga till sin fulla potential. / Introduction: Older adults often lack the skills and competence necessary to be able to use health resources and health information available online. To be able to get involved in digital health and search for health information online older adults are required to have a certain level of eHealth literacy. eHealth literacy is defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. Aim: The purpose of the literature review was to shed light on whether there is a relationship between eHealth literacy and health behaviors and health outcomes in older adults. Methods: The method used was a structured literature review. The method of analysis used was an inductive thematic analysis of 10 peer-reviewed journal articles. Results: The thematic analysis generated in 3 themes; Improved lifestyle, Commitment to self-care and eHealth literacy an intermediate factor to health behaviours and health-related quality of life. The results showed that an increased level of eHealth literacy in older adults improved their health behaviours, health decisions and health outcomes in terms of well-being and health-related quality of life. eHealth literacy had both a direct and an indirect effect on the outcomes studied. Conclusion: The results highlighted the importance of working health-promoting with the elderly's eHealth literacy to be able to strengthen their health and participation in their own healthcare. eHealth literacy is a key factor for the health of the elderly and for theme to be able to use the e-health services available to their full potential.

Title: Hälsa i sociala medier - En kvalitativ studie om hur hälsoinformatörer upplever och påverkas  av hälsobudskap i sociala medier. Title: Health in social media - A qualitative study of how health communicators perceive and are affected by health messages in social media. Author: Anna Hedström Institute: Karlstad University. Faculty of health, nature and engineering sciences. Tutor: Owe Stråhlman Date: 150615 Number of pages: 34 Keywords: eHealth literacy, health communication, health informers, health literacy, health messages, media literacy, social media   Background: With an increased interest in diet and exercise, also health and fitness messages have increased in both traditional and social media. The general guidelines on physical activity and diet are forgotten as training tips increase in the media. Research shows that it is common for individuals to retrieve information from the media when it comes to their own health. In doing so media literacy, health literacy and eHealth literacy becomes increasingly important for health communicators and for those who receive health information.   Objectives: The aim of this study was to examine health communicators’ experiences of health messages in social media, and how they are affected by them.   Method: Qualitative interviews were chosen as a method to collect data. Six individuals participated in the study, four of them were females and two were men. The criterion for participation was to somehow work to inform about health. To analyze the data collected, qualitative contained analysis were used.   Results: The analysis revealed four categories; the health informer experiences of social media content, social media's impact on customers, social media's impact on the health informer work and the health informers use of social media in their work. The results show that health informers experience a certain lack of knowledge among health messages in social media and that many of them are too extreme. These health informers experience that their customers are more well-informed now than a few years ago, due to the use of Facebook, Instagram and blogs. Using social media to search information about diet and exercise is good because it is easily accessible and it is fast, but if one does not have the knowledge of what should be weeded out, these advantages can easily become disadvantages. Respondents feel that it has become a larger equality on diet and exercise that they believe may be due to health messages disseminated on social media. Health communicators can work with to get their customers to be more critical of what they read.   Conclusion: The conclusion of the result is that the health communicators indirectly affected by health messages on social media by their clients that often come with questions about things they read or want help to look like some bloggers they follow. Health communicators work is affected in the way that they need to take advantage of social media to help its customers as well as possible and they must also talk to their customers about the source criticism and that they should focus on what feels good for the customer .

Increasing lifestyle-related ill health, escalating health care costs, expanding health inequalities within and between nations, and an aging population are challenges facing governments globally. Governments, especially in industrialized countries like Sweden, are investing in health promotion and health communication, especially in ICT-supported health communication as a way to increase health literacy and empowerment at individual and population levels. Studies show that many eHealth communication efforts are narrow in scope, medical oriented and therefore not enough to address the complexity of lifestyle-related ill health and equity issues. This thesis proposes integrating health promotion values and principles in the design process of eHealth systems for health promotion in order to develop usable, sustainable, engaging, eHealth resources that are adaptable to their context of use and user’s skills. The overall aim of this thesis was study the participatory development process of an interactive ICT-supported health communication channel for health promotion and enhancing health literacy in PHC context. Participatory Action Research (PAR) with a multi-phase and multi-method approach was used in this thesis. A model entitled Spiral Technology Action Research’ (STAR) was used to guide the development of the health channel. This design process was framed in three developmental and evaluation phases corresponding to formative, process and outcome evaluation. A total of 146 participants consisting of professionals from primary health care services, information technology and academia, and local citizens participated in the project’s different phases. A triangulation of methods was used to collect the data; survey, document analysis, participatory observations with field notes, individual interviews, focus groups, think aloud protocols and log statistics. Qualitative and quantitative content analyses were used to analyse data. The results revealed that integrating health promotion values and principles in the design process proved to be valuable not only to the content of the channel, but also in PHC practice. The different design phases yielded valuable results that built into each other and contributed to an eHealth channel that was perceived as relevant to the local people’s need for health communication; accessible and user friendly. The results also indicated that an Internet based interactive health channel, could be a valuable resource for enhancing health literacy if users are involved in the design.

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