{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T19:27:07Z","timestamp":1748633227034},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"DOI":"10.13039\/100000133","name":"The Agency for Healthcare Research and Quality","doi-asserted-by":"crossref","award":["R01 HS024091-01"],"award-info":[{"award-number":["R01 HS024091-01"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000133","name":"The Agency for Healthcare Research and Quality","doi-asserted-by":"crossref","award":["R21 HS024349-01"],"award-info":[{"award-number":["R21 HS024349-01"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000133","name":"The Agency for Healthcare Research and Quality","doi-asserted-by":"crossref","award":["P30-HS024379"],"award-info":[{"award-number":["P30-HS024379"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003The objective of this study is to investigate the relationships between health literacy and numeracy (HLN) and patient portal use, measured in inpatient and outpatient settings.<\/jats:p><jats:p>\n          Methods\u2003Using data collected as part of a pragmatic randomized controlled trial conducted across the inpatient population of a U.S.-based academic medical center, the present study evaluated the relationships between patients' perceptions of health literacy and their skills, interpreting medical information with metrics of engagement with patient portals.<\/jats:p><jats:p>\n          Results\u2003Self-reported levels of HLN for patients in the study sample (n\u2009=\u2009654) were not significantly associated with inpatient portal use as measured by frequency of use or the number of different inpatient portal functions used. Use of the outpatient version of the portal over the course of 6 months following hospital discharge was also not associated with HLN. A subsequent assessment of patients after 6 months of portal use postdischarge (response rate 40%) did not reveal any differences with respect to portal use and health numeracy; however, a significant increase in self-reported levels of health literacy was found at this point.<\/jats:p><jats:p>\n          Conclusion\u2003While previous studies have suggested that low HLN might represent a barrier to inpatient portal adoption and might limit engagement with outpatient portals, we did not find these associations to hold. Our findings, however, suggest that the inpatient setting may be effective in facilitating technology acceptance. Specifically, the introduction of an inpatient portal made available on hospital-provided tablets may have practical implications and contribute to increased adoption of patient-facing health information technology tools.<\/jats:p>","DOI":"10.1055\/s-0042-1751239","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T22:55:43Z","timestamp":1657148143000},"page":"692-699","source":"Crossref","is-referenced-by-count":12,"title":["Examining the Relationship between Health Literacy, Health Numeracy, and Patient Portal Use"],"prefix":"10.1055","volume":"13","author":[{"given":"Gennaro","family":"Di Tosto","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States"}]},{"given":"Daniel M.","family":"Walker","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States"},{"name":"Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States"}]},{"given":"Cynthia J.","family":"Sieck","sequence":"additional","affiliation":[{"name":"Center for Health Equity, Dayton Children's Hospital, Dayton, Ohio, United States"}]},{"given":"Lorraine","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Biomedical Education and Anatomy, College of Medicine, The Ohio State University, Columbus, Ohio, United States"}]},{"given":"Sarah R.","family":"MacEwan","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States"},{"name":"Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States"}]},{"given":"Megan E.","family":"Gregory","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States"},{"name":"Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States"}]},{"given":"Seth","family":"Scarborough","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States"}]},{"given":"Timothy R.","family":"Huerta","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States"},{"name":"Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States"},{"name":"Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States"}]},{"given":"Ann Scheck","family":"McAlearney","sequence":"additional","affiliation":[{"name":"CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States"},{"name":"Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States"}]}],"member":"194","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"e12779","DOI":"10.2196\/12779","article-title":"Patient portals facilitating engagement with inpatient electronic medical records: a systematic review","volume":"21","author":"R Dendere","year":"2019","journal-title":"J Med Internet Res"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"e15038","DOI":"10.2196\/15038","article-title":"Using patient portals to improve patient outcomes: systematic review","volume":"6","author":"H R Han","year":"2019","journal-title":"JMIR Human Factors"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1093\/jamia\/ocv025","article-title":"Disparities in registration and use of an online patient portal among older adults: findings from the LitCog cohort","volume":"22","author":"S G Smith","year":"2015","journal-title":"J Am Med Inform Assoc"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/heapro\/16.2.207","article-title":"Health literacy: communication for the public good","volume":"16","author":"S C Ratzan","year":"2001","journal-title":"Health Promot Int"},{"issue":"24","key":"ref5","doi-asserted-by":"crossref","first-page":"2283","DOI":"10.1056\/NEJMp1008755","article-title":"Improving Americans' health literacy","volume":"363","author":"R E Rudd","year":"2010","journal-title":"N Engl J Med"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1080\/10810730.2010.499988","article-title":"The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system-results from the diabetes study of northern California (DISTANCE)","volume":"15","author":"U Sarkar","year":"2010","journal-title":"J Health Commun"},{"issue":"10","key":"ref7","doi-asserted-by":"crossref","first-page":"e264","DOI":"10.2196\/jmir.6349","article-title":"Health literacy and health information technology adoption: the potential for a new digital divide","volume":"18","author":"M Mackert","year":"2016","journal-title":"J Med Internet Res"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1177\/0733464812447283","article-title":"The impact of numeracy ability and technology skills on older adults' performance of health management tasks using a patient portal","volume":"33","author":"J Taha","year":"2014","journal-title":"J Appl Gerontol"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/MLR.0000000000001043","article-title":"Inpatients sign on: an opportunity to engage hospitalized patients and caregivers using inpatient portals","volume":"57","author":"M M Kelly","year":"2019","journal-title":"Med Care"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"e221","DOI":"10.2196\/resprot.6355","article-title":"High Touch and High Tech (HT2) Proposal: transforming patient engagement throughout the continuum of care by engaging patients with portal technology at the bedside","volume":"5","author":"A S McAlearney","year":"2016","journal-title":"JMIR Res Protoc"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"e10957","DOI":"10.2196\/10957","article-title":"Patient engagement as measured by inpatient portal use: methodology for log file analysis","volume":"21","author":"T Huerta","year":"2019","journal-title":"J Med Internet Res"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"e16849","DOI":"10.2196\/16849","article-title":"Metrics for outpatient portal use based on log file analysis: algorithm development","volume":"22","author":"G Di Tosto","year":"2020","journal-title":"J Med Internet Res"},{"issue":"08","key":"ref13","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1111\/j.1525-1497.2006.00532.x","article-title":"Brief report: screening items to identify patients with limited health literacy skills","volume":"21","author":"L S Wallace","year":"2006","journal-title":"J Gen Intern Med"},{"issue":"08","key":"ref14","first-page":"588","article-title":"Brief questions to identify patients with inadequate health literacy","volume":"36","author":"L D Chew","year":"2004","journal-title":"Fam Med"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1111\/j.1475-6773.2004.00269.x","article-title":"Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers","volume":"39","author":"J H Hibbard","year":"2004","journal-title":"Health Serv Res"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1080\/03610911003650383","article-title":"How big is a big odds ratio? interpreting the magnitudes of odds ratios in epidemiological studies","volume":"39","author":"H Chen","year":"2010","journal-title":"Commun Stat Simul Comput"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses","volume":"41","author":"F Faul","year":"2009","journal-title":"Behav Res Methods"},{"key":"ref20","first-page":"1","article-title":"Mice: multivariate imputation by chained equations in R","volume":"45","author":"S van Buuren","year":"2011","journal-title":"J Stat Softw"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1186\/1471-2458-14-1207","article-title":"The evolution of health literacy assessment tools: a systematic review","volume":"14","author":"S V Altin","year":"2014","journal-title":"BMC Public Health"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1093\/jamia\/ocw098","article-title":"Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?","volume":"24","author":"L Tieu","year":"2017","journal-title":"J Am Med Inform Assoc"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1055\/s-0038-1676971","article-title":"Technology access, technical assistance, and disparities in inpatient portal use","volume":"10","author":"L V Grossman","year":"2019","journal-title":"Appl Clin Inform"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1089\/tmj.2019.0065","article-title":"Exploring the digital divide: age and race disparities in use of an inpatient portal","volume":"26","author":"D M Walker","year":"2020","journal-title":"Telemed J E Health"},{"key":"ref25","first-page":"1871","article-title":"Health literacy, education levels, and patient portal usage during hospitalizations","volume":"2015","author":"S E Davis","year":"2015","journal-title":"AMIA Annu Symp Proc"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s40615-018-00550-z","article-title":"Association between health literacy and medication adherence among hispanics with hypertension","volume":"6","author":"M Lor","year":"2019","journal-title":"J Racial Ethn Health Disparities"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1055\/s-0041-1730324","article-title":"The my diabetes care patient portal intervention: usability and pre-post assessment","volume":"12","author":"W Martinez","year":"2021","journal-title":"Appl Clin Inform"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1055\/s-0041-1730026","article-title":"Disparities in telemedicine access: a cross-sectional study of a newly established infrastructure during the COVID-19 pandemic","volume":"12","author":"V Hsiao","year":"2021","journal-title":"Appl Clin Inform"},{"issue":"02","key":"ref29","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3122\/jabfm.2019.02.180263","article-title":"A randomized trial to train vulnerable primary care patients to use a patient portal","volume":"32","author":"C R Lyles","year":"2019","journal-title":"J Am Board Fam Med"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1186\/s12913-018-3801-7","article-title":"Using co-design to develop interventions to address health literacy needs in a hospitalised population","volume":"18","author":"R L Jessup","year":"2018","journal-title":"BMC Health Serv Res"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1055\/s-0042-1743561","article-title":"Improving provisioning of an inpatient portal: perspectives from nursing staff","volume":"13","author":"A A Gaughan","year":"2022","journal-title":"Appl Clin Inform"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.2196\/medinform.8026","article-title":"Patient portal utilization among ethnically diverse low income older adults: observational study","volume":"5","author":"T A Arcury","year":"2017","journal-title":"JMIR Med Inform"},{"issue":"03","key":"ref33","doi-asserted-by":"crossref","first-page":"e99","DOI":"10.2196\/jmir.7099","article-title":"Patient portals as a tool for health care engagement: a mixed-method study of older adults with varying levels of health literacy and prior patient portal use","volume":"19","author":"T Irizarry","year":"2017","journal-title":"J Med Internet Res"},{"issue":"03","key":"ref34","doi-asserted-by":"crossref","first-page":"e11421","DOI":"10.2196\/11421","article-title":"Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital","volume":"21","author":"S Sadasivaiah","year":"2019","journal-title":"J Med Internet Res"},{"issue":"10","key":"ref35","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.2105\/AJPH.2017.303933","article-title":"Legal, practical, and ethical considerations for making online patient portals accessible for all","volume":"107","author":"C R Lyles","year":"2017","journal-title":"Am J Public Health"}],"container-title":["Applied Clinical Informatics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1751239.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T22:56:41Z","timestamp":1657148201000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1751239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":33,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,5,25]]},"published-print":{"date-parts":[[2022,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1751239","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1869-0327"],"issn-type":[{"value":"1869-0327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}