title: Specific technological communication skills and functional health literacy have no influence on self-reported benefits from enrollment in the TeleCare North trial.
abstract: OBJECTIVE
  The Danish TeleCare North trial has developed a telehealth system, Telekit, which is used for self-management by patients diagnosed with chronic obstructive pulmonary disease (COPD). Self-management is the engagement in one's own illness and health by monitoring and managing one's symptoms and signs of illness. The study examines the association between COPD patients' use of Telekit and their functional health literacy and the association between their use of Telekit and their specific technological communication skills.
  
  
  METHODS
  A consecutive sample of participants (n=60) from the TeleCare North trial were recruited. Face-to-face interviews were conducted with each participant to collect demographic data. Functional health literacy was measured with the Danish TOFHLA test. Participants completed a non-standardised questionnaire about their health status, their use of the Telekit system, and their specific technological communication skills. Binary logistic regressions were performed to examine how functional health literacy and specific technological communication skills influenced the use of Telekit by giving users an enhanced sense of freedom, security, control, and a greater awareness of COPD symptoms.
  
  
  RESULTS
  Participants (27 women, 33 men) had a mean age of 70 (SD: 8.37) years. Functional health literacy levels were classified as inadequate in 14 (23%) participants, as marginal in 12 (20%), and as adequate in 34 (57%). Participants self-reported a feeling of increased security (72%), greater freedom (27%), more control (62%), and greater awareness of symptoms (50%) when using Telekit. The use of Telekit was not significantly associated with levels of functional health literacy or with the number of specific technological communication skills (p>0.05) based on the binary logistic regressions.
  
  
  CONCLUSIONS
  The enhanced sense of security, freedom, control, and the greater awareness of COPD symptoms achieved by using Telekit were unassociated both with the patients' score of functional health literacy and with their specific technological communication skills. On the basis of our results it seems that the specific technological communication skills and functional health literacy are not a prerequisite for the use of the Telekit system.
authors.affiliation: Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark. Electronic address: phl@hst.aau.dk.
authors.forename: Pernille Heyckendorff
authors.initials: PH
authors.lastname: Lilholt
authors.affiliation: Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark.
authors.forename: Lisa Korsbakke Emtekær
authors.initials: LK
authors.lastname: Hæsum
authors.affiliation: Danish Centre for Healthcare Improvements, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University, Denmark.
authors.forename: Lars Holger
authors.initials: LH
authors.lastname: Ehlers
authors.affiliation: Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark; Department of Computer Science, Faculty of Science, University of Tromsø, Norway.
authors.forename: Ole K
authors.initials: OK
authors.lastname: Hejlesen
mesh_terms: D000368:Aged; D003718:Denmark; D005260:Female; D057220:Health Literacy; D006801:Humans; D008297:Male; D010358:Patient Participation; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012648:Self Care / Q000379:methods* / Q000706:statistics & numerical data; D057566:Self Report; D017216:Telemedicine / Q000379:methods* / Q000706:statistics & numerical data
keywords: Chronic obstructive pulmonary disease; Logistic models; Patient education; Self-care; Telehealth; Usability