# Usability and potential impact of a web-based literacy-oriented intervention for community-dwelling patients with complex care needs: a mixed methods case report

## TL;DR

This study explores a web-based tool to help patients with complex health needs improve their ability to find and use online health information.

## Contribution

The study introduces and evaluates a new web-based intervention combining a website, video, and game to improve ehealth literacy.

## Key findings

- The website and video were found to be usable and helpful by participants.
- The game had lower usability and received negative feedback.
- Some participants showed improved ehealth literacy and knowledge after the intervention.

## Abstract

Community-dwelling patients with complex care needs (hereafter “patients”) seek information to choose optimal care. However, patients with low ehealth literacy often have difficulty finding trustworthy, easy-to-understand information. Improving their ehealth literacy can lead to multiple positive health outcomes. This study aimed to describe patients' perceptions of the usability and potential impacts of a web-based, ehealth literacy–oriented intervention.

To support patients in finding, appraising, and using online health information (the three core principles of ehealth literacy) we developed the Online Health Information Aid (OHIA), which includes a website, an educational video, and a game. An evaluation was conducted with five patients who received the intervention. Pre-intervention (Day 1) and post-intervention (Day 30) data were collected. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using content analysis. Quantitative and qualitative results were compared in a joint display. Participants included three women and two men aged 46 to 71 years (mean age: 62) with two to 11 chronic health conditions (mean: 5) and two to 20 medications (mean: 10). Participants found the website usable (e.g., “good tool”). For the video, usability scores were high (67%-96%; mean: 79%) with positive comments (e.g., “good and helpful”). However, the game's usability was lower (40%-78%; mean: 60%), and comments were negative (e.g., “complex and not readable”). For three participants, ehealth literacy levels (n=2) and/or knowledge for appraising online health information (n=2) increased post-intervention. However, they did not perceive any impact of the intervention.

These results suggest that the OHIA intervention, specifically the website and the video, is a promising approach to improving ehealth literacy among people with lower education, and a family income below or around the poverty line, including patients with complex care needs.