eHealth Literacy

The overall aim of eCardiacRehab trial is to meet rehabilitation needs of patients with coronary artery disease (CAD) regardless of their access to traditional place-based rehabilitation by developing and evaluating the efficacy and cost effectiveness of an interdisciplinary and comprehensive home-based hybrid programme. eCardiacRehab address patient- and system level challenges to increase access to cardiac rehabilitation (CR). We give particular attention to older patients, women, and those with comorbidities or mental health challenges. The vision of the hybrid home-based eCardiacRehab programme is to make CR available to all. eCardiacRehab is a prospective, multicentre randomized open-label blinded end point evaluation (PROBE) trial. The primary endpoint is a hierarchical composite endpoint using a win-ratio framework combining cardiovascular (CV) death, unplanned contacts to the Emergency Department (ED) for observation or admission (\>24 hours) for CV disease, and quality of life. Inclusion criteria are adult Scandinavian speaking patients (≥ 18 years) who have a Norwegian national identification number, with CAD treated with Percutaneous Coronary Intervention (PCI), are living at home, and have internet available to them and providing signed informed consent. Exclusion criteria are patients with severe aortic stenosis, severe arrhythmias, expected lifetime less than one year as determined by study personnel, otherwise clinically unstable, not fully revascularized, awaits PCI or coronary artery bypass graft operation (CABG) or inability to comply with the study protocol due to any physical disability, somatic disease, cognitive impairment or mental health challenges as determined by study personnel.

Purpose This study is a randomized controlled experimental trial aiming to evaluate the effects of mentoring-based digital literacy training delivered by young migrants on older migrants' eHealth literacy and their ability to seek and verify health information in digital environments. The study will be conducted among young and older Ahiska Turkish migrants living in the Üzümlü district of Erzincan province. Method The study will be conducted in two phases. In the first phase, young migrants will receive digital literacy training that includes mentoring skills. In the second phase, these individuals will provide training to older migrants. The sample size has been determined based on a power analysis and will consist of a total of 80 participants. Data will be collected using the eHealth Literacy Scale and the Digital Health Information Seeking and Verification Scale. Data will be analyzed using SPSS software, and appropriate parametric and/or non-parametric tests will be applied. Training sessions will be conducted in controlled environments, in small groups, and tailored to participants' needs. Participant follow-up will be maintained throughout the process to support the sustainability of the intervention. Research Hypotheses Primary Hypothesis * H0: Mentoring-based digital literacy training delivered by young migrants has no effect on older migrants' levels of eHealth literacy and digital literacy. * H1: Mentoring-based digital literacy training delivered by young migrants has a significant effect on older migrants' levels of eHealth literacy and digital literacy. Secondary Hypothesis * H0: Mentoring-based digital literacy training delivered by young migrants has no effect on older migrants' eHealth literacy levels. * H2: Mentoring-based digital literacy training delivered by young migrants has a significant effect on older migrants' eHealth literacy levels. Third Hypothesis * H0: Mentoring-based digital literacy training delivered by young migrants has no effect on older migrants' digital literacy levels. * H3: Mentoring-based digital literacy training delivered by young migrants has a significant effect on older migrants' digital literacy levels.

The PI will assess the feasibility and acceptability of an eHealth literacy intervention with Spanish-preferred older adult Latinos. This proposal will generate novel data to justify a future R01 proposal to advance aging research with high-risk populations and assess the efficacy of the intervention.

Metabolic and bariatric surgery (MBS) is in increasing demand due to the growing prevalence of severe obesity and the cumulating evidence of long-term benefits on weight loss, cardiometabolic and functional health outcomes, and quality of life for individuals living with severe obesity. The time spent on the waiting list for an MBS follow the same trend with an estimated waiting time of more than 18 months and rising. The lack of resources and multidisciplinary capabilities among MBS centers impacts the quality of care and outcomes, which greatly contributes to delayed surgery. In 2023, 31% of patients who had an initial appointment with the MBS nurse at the Quebec Heart and Lung Institute - Laval University(IUCPQ) did not proceed with the surgery due to fear, uncertainty, or timing issues. Additionally, 49% reported that their concerns (e.g., financial, home support) were not addressed before MBS. These data highlight the urgent need to implement strategies to optimize wait time and ensure that MBS preparation is tailored to patients' expectations. Telehealth has significantly impacted surgical preparation, including for MBS, by enhancing accessibility, reducing dropout rates, and maintaining clinical outcomes that are comparable to traditional in-person visits but it requires real-time multidisciplinary execution, limiting the applicability for MBS waiting list patients. An interesting complement to telehealth intervention is online education platforms which offer digital flexibility, a significant advantage over in-person session. To date, most MBS online resources are fee-based or driven by commercial interests and lack of clinical evidence, which raises concerns about their efficacy and safety for users who are seeking reliable support during their MBS journey. A free online education platform could optimize the time spent on the MBS waiting list by increasing patients' readiness for MBS, furnishing invaluable insights into the patient journey to MBS, and empowering individuals undergoing MBS. The IUCPQ is in the process of working on the care trajectory of patients with obesity. The Healthcare Direction and the Bariatric Surgery Clinic decided to use a platform called Precare. This platform offers personalized educational content as well as a calendar and appointment management system. It has been accredited by the Quebec Ministry of Health and Social Services. The present research focuses on the pilot testing the implementation and effectiveness of the PreCare solution for patients awaiting bariatric surgery at the IUCPQ. The objectives of the research proposal are: 1) To assess the usability and acceptability of the Precare platform using a mixed design methodology; 2) To evaluate the logistical feasibility of using the platform in a clinical setting; 3) To determine whether extensive self-questionnaire assessments may impact the use of the Precare platform; 4) To explore barriers and facilitators to enhance patient engagement and knowledge retention; and 5) To derive estimates variables related to gender, ethnicity, cultural background, learners and psychological profiles for future phases. Our hypotheses are: 1. The Precare platform will exhibit high usability and acceptability. 2. Testing the Precare platform in real clinical settings is viable and will yield promising results for improving patient readiness for Metabolic and Bariatric Surgery.