Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women
Abstract
:1. Introduction
2. Materials and Methods
2.1. Recruitment and Procedure
2.1.1. Focus Groups
2.1.2. Communities of Practice for the Development of MOOCs
2.2. Measures
Quantitative Measures
- −
- Experience during the co-creation process was assessed with 3 self-developed items, with a 4-point Likert scale from 0 (totally disagree) to 4 (totally agree) (see items in Section 3.2.1).
- −
- The acceptability of the MOOCs was assessed through a 3 open questions and 11-item questionnaire on a 3 or 4-point Likert scale developed specifically for the IC-Health project and based on previous related studies [37] that assessed ease of navigation, objectives and language clarity, appropriateness of learning activities and quizzes, and other characteristics of the MOOCs (see items in Section 3.2.2).
- −
- Self-perceived DHL was assessed before and after the MOOCs development. We used 8 items selected from 3 validated questionnaires: 5 items of the eHealth literacy scale (eHEALS) [38], 2 items of the eHealth impact questionnaire (eHIQ-Part 1) [39], and 2 item of the health literacy questionnaire (HLQ) [40] (see items in Section 3.2.3). Items had a response gradient from 0 (totally disagree) to 4 (totally agree) and assessed the three main skills required in DHL: finding (3 items), understanding (2 items) and appraisal (3 items) information on the Internet. The total score on these scales was divided by their corresponding number of items.
2.3. Analysis
2.3.1. Qualitative Measures
2.3.2. Quantitative Measures
3. Results
3.1. Focus Groups
3.2. Communities of Practice for the Development of MOOCs
3.2.1. Experience during the Co-Creation Process
3.2.2. Acceptability of the MOOCs
3.2.3. Self-Perceived DHL
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Participants | Total Pregnant and Lactating Women | Pregnant Women | Lactating Women |
---|---|---|---|
Country (n) | 17 | 8 | 9 |
Spain | 11 | 7 | 4 |
Italy | 6 | 1 | 5 |
Age range (years) | 26–41 | 28–39 | 26–41 |
Spain | 26–40 | 28–40 | 26–40 |
Italy | 38–41 | 39 | 38–41 |
Education (n) | |||
University Degree | 12 | 3 | 9 |
High School | 3 | - | 3 |
Vocational superior training | 2 | 2 | - |
Civil status (n) | |||
Married/Living with partner | 14 | 5 | 9 |
Single | 3 | - | 3 |
Employment Status (n) | |||
Employed | 13 | 6 | 7 |
Unemployed | 3 | 1 | 2 |
Retired | 1 | 1 | - |
Occupation (n) | |||
Office work | 6 | 1 | 5 |
Intellectual scientific work | 4 | 2 | 2 |
Technician | 4 | 3 | 1 |
Entrepreneur/executive | 1 | 1 | - |
Dealer/trader | 2 | 1 | 1 |
Themes | Subthemes | Example Quote |
---|---|---|
Experience/general opinion using the Internet for health and illness issues |
| “Before pregnancy, I had never thought about the Internet and health as connected. When I first got pregnant, I started using Internet for health-related issues because I was curious to understand what was happening to my body, since I do not know anything about medicine” “When doctors are not available or when the human touch is missing, Internet can compensate this lack of empathy by health personnel” “I have searched on the Internet (…) in other cases I say to myself that just in case I should go to the pediatrician” |
Needs and expectations of the use of the Internet as a source of information on health and illness issues |
| “Issues like ante-natal courses and preparation to delivery cannot be fully understood if read… You need sharing views with other peers, to listen to midwives’ indications, to make questions… maybe a webinar can help, but certainly websites are not enough” “If doctors talk too technical, I don’t understand. I think if the information is presented in videos or images, it is easier for me to understand it” |
Trust on the Internet as a source of information on health and illness issues |
| “I refused to look on the Internet about vaccines. I know the web is full of fake news about it and I simply didn’t want to assist or take part in that debate” “I tend to verify the source of information… I look for sites linked to health institutions, health professionals’ orders, research centers… I link to science-based sites” “I have always been a bit skeptical about looking for health information on the web, also listening to some friends that joined mothers’ forums where information is not filtered… They told me it just made them more confused and anxious” |
Perception of the use of the Internet as a source of information on health and illness issues by other people |
| “People who suffer from serious diseases and want to escape from reality, commonly look on the Internet to find a way out of their situation” “My pediatrician looks completely disconnected... I think she’s a very good doctor but, since she’s completely out of the world of Internet, instead of considering it a supportive tool she takes it as an enemy. If she was keener to suggest some online readings to mothers who bother her with minor babies’ health issues, maybe her workload could decrease…. but she does not even have an email” |
Questions | Totally Agree n (%) | Agree n (%) | Not Sure n (%) | Disagree n (%) | Totally Disagree n (%) | Mean 1 (sd) |
---|---|---|---|---|---|---|
1. The MOOC is easy to use/navigate and the information was clearly organized | 15 (22.1) | 37 (54.4) | 6 (8.8) | 6 (8.8) | 4 (5.9) | 2.78 (1.08) |
2. The language on the MOOC was easy to understand | 18 (26.5) | 46 (67.6) | 3 (4.4) | 0 (0.0) | 1 (1.5) | 3.18 (0.64) |
3. The objectives of the course were made clear | 18 (26.5) | 49 (72.1) | 0 (0.0) | 0 (0.0) | 1 (1.5) | 3.22 (0.59) |
4. The course content was consistent with the course objectives | 20 (29.4) | 42 (61.8) | 2 (2.9) | 3 (4.4) | 1 (1.5) | 3.13 (0.79) |
5. The learning activities were useful to gain a clear understanding of the course content | 16 (23.5) | 42 (61.8) | 8 (11.8) | 1 (1.5) | 1 (1.5) | 3.04 (0.74) |
6. The quizzes did appropriately test the material presented in the course | 12 (17.6) | 43 (63.2) | 11 (16.2) | 1 (1.5) | 1 (1.5) | 2.94 (0.73) |
7. This course has met my expectations | 12 (17.6) | 49 (72.1) | 3 (4.4) | 3 (4.4) | 1 (1.5) | 3.00 (0.73) |
8. I would recommend this course to other people | 25 (36.8) | 27 (39.7) | 13 (19.1) | 1 (1.5) | 2 (2.9) | 3.06 (0.94) |
High or very high n (%) | Not sure n (%) | Low n (%) | Very low n (%) | Mean 1 (sd) | ||
9. Quality of the overall design and aesthetics of the contents and materials | 49 (72.1) | 16 (23.5) | 3 (4.4) | 0 (0.0) | 2.67 (0.56) | |
10. Quality/usefulness of the examples provided in the course | 23 (33.8) | 24 (35.3) | 19 (27.9) | 2 (2.9) | 2.00 (0.86) | |
Yes n (%) | Too short n (%) | Too long n (%) | ||||
11. Was the amount of time appropriate for the course content? | 53 (77.9) | 7 (10.3) | 8 (11.8) | |||
12. Open question: Please provide a short summary of the strengths and weaknesses of the course | ||||||
13. Open question: Please provide brief suggestions on how to improve the course | ||||||
14. Open question: What are the main points that you have learned through this course? |
Digital Health Literacy Items a | Baseline Sample (n = 113) | Post Sample (n = 98) | z (p) b |
---|---|---|---|
F1. I know how to find useful health resources on the Internet | 2.62 (0.94) | 3.14 (0.62) | −4.56 (<0.001) |
F2. I get nervous using the Internet to find information about my health (reversed) | 2.62 (1.04) | 2.82 (0.95) | −0.99 (0.320) |
F3. I know where to find useful health resources on the Internet | 2.54 (0.91) | 3.07 (0.65) | −4.69 (<0.001) |
Finding total | 2.59 (0.74) | 3.01 (0.58) | −4.68 (<0.001) |
U1. I know how to use the Internet to help me to understand what I am not sure about my health | 2.59 (0.92) | 3.03 (0.63) | −3.74 (<0.001) |
U2. I can understand the health information I get from the Internet well enough to know what to do | 2.53 (0.91) | 3.05 (0.72) | −4.70 (<0.001) |
Understanding total | 2.56 (0.78) | 3.04 (0.62) | −3.93 (<0.001) |
A1. I have the skills I need to evaluate the health resources I find on the Internet | 2.62 (0.84) | 2.96 (0.72) | −2.98 (0.003) |
A2. I can differentiate high-quality health resources from low-quality health resources on the Internet | 2.66 (0.81) | 3.11 (0.66) | −4.47 (<0.001) |
A3. I feel confident in using information from the Internet to make health decisions | 2.04 (0.96) | 2.81 (0.84) | −5.67 (<0.001) |
Appraising total | 2.44 (0.73) | 2.96 (0.64) | −5.68 (<0.001) |
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Álvarez-Pérez, Y.; Perestelo-Pérez, L.; Rivero-Santanta, A.; Torres-Castaño, A.; Toledo-Chávarri, A.; Duarte-Díaz, A.; Mahtani-Chugani, V.; Marrero-Díaz, M.D.; Montanari, A.; Tangerini, S.; et al. Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women. Int. J. Environ. Res. Public Health 2022, 19, 913. https://doi.org/10.3390/ijerph19020913
Álvarez-Pérez Y, Perestelo-Pérez L, Rivero-Santanta A, Torres-Castaño A, Toledo-Chávarri A, Duarte-Díaz A, Mahtani-Chugani V, Marrero-Díaz MD, Montanari A, Tangerini S, et al. Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women. International Journal of Environmental Research and Public Health. 2022; 19(2):913. https://doi.org/10.3390/ijerph19020913
Chicago/Turabian StyleÁlvarez-Pérez, Yolanda, Lilisbeth Perestelo-Pérez, Amado Rivero-Santanta, Alezandra Torres-Castaño, Ana Toledo-Chávarri, Andrea Duarte-Díaz, Vinita Mahtani-Chugani, María Dolores Marrero-Díaz, Alessia Montanari, Sabina Tangerini, and et al. 2022. "Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women" International Journal of Environmental Research and Public Health 19, no. 2: 913. https://doi.org/10.3390/ijerph19020913