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The purpose of this study is to evaluate the effectiveness of two different educational models in improving the use of the "My Health Bank" App (a Personal Health Record system in Taiwan) among adults aged 50 and older. As Taiwan's population ages, digital health management has become essential, yet older adults often face a "digital divide." Participants will be randomly assigned to either a "Intensive Guided Learning group" (receiving one-on-one human instruction) or a "Flexible Self-study group" (using self-learning materials co-created with Generative AI). The study aims to compare the outcomes of these two groups in terms of enhancing digital health literacy, self-efficacy, and actual App usage behavior to identify more effective and scalable digital health education strategies.
This study is conducted over a period of 18 months (from March 1, 2026, to August 31, 2027) and is divided into three strategic phases:
Phase 1 (Months 1-6): Focuses on the development of AI-collaborative educational materials, expert validity review, and a questionnaire pre-test (n=15). A Pilot Randomized Controlled Trial (Pilot RCT, n=60) will be executed to verify the feasibility and readability of the intervention materials.
Phase 2 (Months 7-15): The formal enrollment and intervention phase. A full-scale Randomized Controlled Trial (Full-scale RCT, n=160) will be conducted using a single-blind, two-arm design. Participants will be randomly assigned to either the "Intensive Guided Learning group" or the "Flexible Self-study group," with longitudinal data collection and tracking at three time points.
Phase 3 (Months 16-18): Data processing, advanced statistical analysis (including SEM to verify empowerment mechanisms), and final manuscript preparation.
The study aims to provide empirical evidence for scalable digital health education strategies to reduce the "digital divide" among adults over 50.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intensive Guided Learning Group | Experimental | Participants receive AI-collaborative educational materials with intensive guidance from instructors. |
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| Flexible Self-study Group | Active Comparator | Participants receive the same AI-collaborative educational materials as the experimental group but engage in self-paced learning without intensive instructor-led guidance. This group serves to evaluate the baseline effectiveness of the digital materials when used independently. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AI-Collaborative eHealth Education | Behavioral | This behavioral intervention consists of a structured eHealth literacy curriculum using AI-collaborative educational materials. The program focuses on teaching participants how to utilize the "My Health Bank" platform for personal health management. The intervention is delivered in two formats depending on group assignment: The experimental group receives intensive instructor-led guidance and hands-on practice. The control group engages in flexible self-study using the same AI-generated materials. The curriculum aims to enhance digital health literacy, self-efficacy, and active engagement (measured by frequency of use) with digital health tools among older adults. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in eHealth Literacy Scale (eHEALS) Score | The eHealth Literacy Scale (eHEALS) is used to measure participants' combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. The scale contains 8 items, each scored on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 8 to 40, with higher scores indicating higher perceived eHealth literacy. | Baseline (T0), 1-week post-intervention (T1), and 4-weeks post-intervention (T2) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in General Self-Efficacy Scale (GSES) Score | This scale is used to assess participants' self-efficacy in managing their health and using digital tools. It consists of 5 items, with each item scored on a 10-point scale ranging from 1 (not confident at all) to 10 (completely confident). The total score ranges from 5 to 50. A higher score indicates a stronger sense of self-efficacy in health management and digital tool proficiency. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yu-Wen Chen, PhD Student | Contact | +886-922-419-022 | viven0824@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Kun-Yi Lin, MD, PhD | Department of Orthopaedics, Tri-Service General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Anle District Health Center and Affiliated Community Centers | Recruiting | Keelung | Anle District | 204 | Taiwan |
To protect participant privacy and maintain data confidentiality according to the approved IRB protocol.
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This study is conducted in sequential phases. Following a pre-test (n=15) for tool validation and a Pilot Randomized Controlled Trial (n=60) to evaluate feasibility, the Full-scale RCT (n=160) employs a single-blind, two-arm parallel design. Participants in the full-scale trial are randomly assigned to either the "Intensive Guided Learning Group" or the "Flexible Self-study Group." Data collection occurs at three time points: baseline (T0), 1-week post-intervention (T1), and 4-weeks post-intervention (T2). To ensure data independence, participants from the pre-test and pilot stages will be excluded from the final full-scale RCT analysis.
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This is a single-blind study where the outcomes assessors are kept masked to the group assignments during data collection and statistical analysis to minimize bias.
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| Baseline (T0), 1-week post-intervention (T1), and 4-weeks post-intervention (T2) |
| Post-Intervention Digital Health Management Behavior | This measures the frequency and proficiency of participants' actual use of digital health tools, specifically the "My Health Bank" platform. Depending on the questionnaire used (e.g., a self-reported health behavior frequency scale), each item is typically scored on a Likert scale. Total scores reflect the active engagement level in digital health self-management. Higher scores indicate more frequent and positive health-promoting behaviors. | 4-weeks post-intervention (T2) |
| Tri-Service General Hospital, Department of Orthopaedics | Recruiting | Taipei | Neihu District | 114 | Taiwan |
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