Collaborative Learning is an Effective Method for Improving the E-health Literacy of Older Adults in the Community. A Review of: Xie, B. (2011). Older adults, e-health literacy, and collaborative learning: An experimental study. Journal of the American Society for Information Science and Technology, 62(5), 933-946. doi: 10.1002/asi.21507

Objective – To determine whether collaborative learning strategies in an informal class setting can improve electronic health literacy skills of older adults. Design – Pre- and post-test instruments used to measure effects of an educational intervention. Setting – Small group classes offered at two branches of a large, publicly funded, urban public library in Maryland. Subjects – A total of 111 adults aged 52 to 91, mean age 70.4 (SD 8.0), completed the study. The majority of participants were from minority populations (66% African American, 3% Latino, 3% Asian). Thirty three percent of participants reported an annual household income below $20,000. Eight percent were non-native English speakers. The majority of participants had low-level or no computer/Internet experience prior to the study. Methods – Collaborative learning strategies were used in small group hands-on computer classes to deliver a standardized curriculum (Helping Older Adults Search for Health Information Online: A Toolkit for Trainers from the National Institute on Aging). Strategies employed were: explicit statement of group/participatory nature of class, periodic peer shared reflection times during class, active encouragement of discussion between peers, hands-on work with partners, group discussion of real-life questions from participants, and structured shared reflection time at the close of each session. Participants were recruited through local advertisements. No incentive other than the free classes was offered. Groups met for two hours, twice a week for four weeks. Assessment was via pre and post-tests. General computing knowledge/skills were measured using objective tests of abilities. Questions from several established scales were adapted for additional assessment. E-health literacy was measured using questions of perceived skill and comfort in finding health information online; perceived usefulness of the Internet for help making health decisions; and perceived importance of the Internet for obtaining health information. Subjects were also asked to report on changes to their health behaviour/decision- making post intervention, and learning effort expended during the study. Additional questions measured psychological adjustment to later life, attitudes toward computers, attitude toward the aging experience, and attitude toward the collaborative learning method and the class. Main Results – A dependent t-test analysis indicated strong significant gains post-test in computing/Internet knowledge and skills, and in e-health literacy efficacy (perceived skills/comfort with using t