title: Psychosocial Health, e-Health Literacy, and Perceptions of e-Health as Predictors and Moderators of e-Health Use Among Caregivers of Children with Special Healthcare Needs.
abstract: OBJECTIVE
  In this study, we explored the relationships between the psychosocial health of caregivers of children with special healthcare needs and their e-health use. Additionally, the analysis examined moderating effects of a caregiver's perceptions of e-health and his or her e-health literacy on the associations among four domains of psychosocial health and e-health use.
  
  
  METHODS
  To date, 313 caregivers of children, 12-18 years of age, with special healthcare needs have been recruited. Covariate-adjusted multivariable regressions determined associations between psychosocial health domains of caregivers and e-health use. E-health literacy and perceptions of e-health were further tested as moderators of the relationship between psychosocial health and e-health use.
  
  
  RESULTS
  Among the caregiver population, 31% had problems with social functioning, 36.1% with communication, 43.3% with family relationships, and 46.3% with worrying for their child. After adjusting for demographic variables, e-health use was associated with poorer levels of social functioning, communication, worry, and family relationship. E-health use was also associated with e-health literacy. Perceptions of e-health significantly moderated the relationships among social functioning, communication, and e-health, with the relationship being significantly stronger in caregivers with more positive perceptions of e-health.
  
  
  CONCLUSIONS
  Caregivers of children with special healthcare needs have notable levels of psychosocial challenges and those challenges are associated with their e-health resource seeking. Although e-health interventions, including ones that focus on child health education and caregiver support, may be the future of healthcare, a concerted effort is needed to educate caregivers about the benefits of e-health.
authors: 1 Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio.
authors: Madhurima
authors: M
authors: Sarkar
authors: 2 Division of General Pediatrics, Stanford University , Stanford, California.
authors: Lee M
authors: LM
authors: Sanders
authors: 1 Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio.|3 Department of Pediatrics, The Ohio State University , Columbus, Ohio.
authors: Kelly J
authors: KJ
authors: Kelleher
authors: 1 Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio.|3 Department of Pediatrics, The Ohio State University , Columbus, Ohio.
authors: Deena J
authors: DJ
authors: Chisolm
keywords: caregivers; e-health use; pediatrics; psychosocial health; telehealth