Intervention outcomes.

Health information on the Internet has a ubiquitous influence on health consumers’ behaviour. Searching and evaluating online health information poses a real challenge for many health consumers. To our knowledge, our systematic review paper is the first to explore the interventions targeting lay people to improve their e-health literacy skills. Our paper aims to explore interventions to improve laypeople ability to identify trustworthy online health information. The search was conducted on Ovid Medline, Embase, Cochrane database, Academic Search Complete, and APA psych info. Publications were selected by screening title, abstract, and full text, then manual review of reference lists of selected publications. Data was extracted from eligible studies on an excel sheet about the types of interventions, the outcomes of the interventions and whether they are effective, and the barriers and facilitators for using the interventions by consumers. A mixed-methods appraisal tool was used to appraise evidence from quantitative, qualitative, and mixed-methods studies. Whittemore and Knafl’s integrative review approach was used as a guidance for narrative synthesis. The total number of included studies is twelve. Media literacy interventions are the most common type of interventions. Few studies measured the effect of the interventions on patient health outcomes. All the procedural and navigation/ evaluation skills-building interventions are significantly effective. Computer/internet illiteracy and the absence of guidance/facilitators are significant barriers to web-based intervention use. Few interventions are distinguished by its implementation in a context tailored to consumers, using a human-centred design approach, and delivery through multiple health stakeholders’ partnership. There is potential for further research to understand how to improve consumers health information use focusing on collaborative learning, using human-centred approaches, and addressing the social determinants of health.

互联网健康信息对健康消费者的行为具有广泛渗透的影响。搜索与评估在线健康信息，对诸多健康消费者而言都是一项切实挑战。据我们所知，本系统综述是首个探索针对普通民众以提升其电子健康素养（e-health literacy）技能的干预措施的研究。本综述旨在探索可提升普通民众识别可信在线健康信息能力的干预措施。检索范围涵盖Ovid Medline、Embase、Cochrane数据库、Academic Search Complete以及APA psych info。文献筛选流程为先对标题、摘要及全文进行筛查，随后对纳入文献的参考文献列表进行人工复核。研究人员从符合纳入标准的研究中提取数据，并录入Excel表格，采集内容涵盖干预措施类型、干预效果与有效性、消费者使用该类干预措施的阻碍因素与促进因素。采用混合研究质量评价工具对定量、定性及混合方法研究的证据进行质量评价。以惠特莫尔（Whittemore）与纳夫尔（Knafl）提出的整合性综述方法作为叙述性合成的指导框架。最终纳入的研究共计12项。媒介素养干预是最常见的干预类型。仅有少量研究评估了干预措施对患者健康结局的影响。所有针对操作技能、网络导航与信息评估技能的干预措施均具有显著效果。计算机/互联网素养缺失以及缺乏指导与促进因素，是制约消费者使用基于网络的干预措施的显著阻碍。仅有少数干预措施具备以下特征：针对消费者需求定制实施场景、采用以人为中心的设计方法、并通过多健康利益相关方合作开展干预交付。未来研究可聚焦于协作学习、以人为中心的方法以及解决健康的社会决定因素，探索如何改善消费者对健康信息的使用行为，具备广阔的研究空间。