The Effect of European Health Literacy-Based e-Pulse Education and e-Pulse Instructional Materials on Health Literacy Levels in Adults Aged 45-64: A Randomized Controlled Trial.

Abstract

e-Pulse is an electronic personal health record system known as e-Nabız in Turkey. This study compares the effect of European Health Literacy-based e-Pulse education and e-Pulse instructional materials on the health literacy levels of adults aged 45-64 with inadequate and problematic-limited health literacy levels. This single-blind, randomized controlled trial was conducted from June 2023 to September 2023. It included 140 participants, assigned to either the intervention group (n = 70) or the active control group (n = 70). The intervention group received HLS-EU-based e-Pulse education, which consisted of two 45-min sessions over 6 weeks, along with the e-Pulse user guide and introduction video. The active control group only received the e-Pulse user guide and introduction video, and each participant was individually briefed on the e-Pulse system content for 5-10 min. Results were measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and the eHealth Literacy Scale (eHEALS) at baseline and the sixth week. Both the intervention and active control groups showed an increase in health literacy and eHealth literacy scores, but the mean change was greater in the intervention group. A statistically significant difference was found in the effects of HLS-EU-based e-Pulse education and e-Pulse instructional materials on both health literacy (F (1, 137) = 25.215; p < 0.001) and eHealth literacy (F (1, 137) = 36.134; p < 0.001). HLS-EU-based e-Pulse education significantly improved health literacy (d = 0.8492; p < 0.001) and eHealth literacy (d = 1.0175; p < 0.001) compared to e-Pulse instructional materials. The intervention group demonstrated significantly higher rates of sufficient (32.9%) and excellent (12.9%) health literacy. Notably, a medium correlation (r = 0.602; p < 0.001) was observed between health literacy and eHealth literacy. Trial Registration: ClinicalTrials.gov (ID: NCT05831254) https://clinicaltrials.gov/study/NCT05831254.