As oncology care increasingly relies on digital resources, electronic health literacy (e-HL) has attracted growing attention as a potentially modifiable communication competency in cancer survivorship. However, evidence on its relationship with health-related quality of life (HRQoL) in gynecologic oncology remains limited. This study examines the association between perceived e-HL and HRQoL in women surgically staged for endometrial cancer (EC). In doing so, it extends an established body of evidence to an understudied clinical population. A cross-sectional study was conducted with 399 women at a tertiary referral center in Istanbul, Turkey. Perceived e-HL was assessed using the eHealth Literacy Scale (eHEALS), and HRQoL was measured using the EQ-5D-5 L index and EQ-VAS. Limited perceived e-HL was prevalent, affecting 44.6% (n = 178) of participants. After adjustment, higher perceived e-HL was independently associated with better HRQoL (p < .001). Inadequate perceived e-HL was associated with higher odds of reporting problems in anxiety/depression (OR 1.75; p = .010), self-care (OR 1.97; p = .004), and usual activities (OR 1.92; p = .005), but was not associated with mobility or pain. In conclusion, limited perceived e-HL was independently associated with greater psychological distress and functional difficulty in EC survivors. Because the design is cross-sectional and the proposed mediating processes were not measured, these findings should be interpreted as associations rather than causal or mechanistic relationships.
"The Real Cost" Youth Cigarette Prevention Campaign launched in 2014 when broadcast television (TV) was the main media channel. However, over the last two decades, the media landscape has changed dramatically, and now digital media is the primary way teens consume media. As it is critical that "The Real Cost" appear in places where teens spend their time, the campaign adapted its media and implementation strategies to continue effectively reaching its intended audience. Additionally, the campaign is exploring new measurement methodologies to understand the full impact of digital media campaigns. Although "The Real Cost" has shown success preventing teens from initiating tobacco use with cigarettes and e-cigarettes, the evolving digital media landscape poses challenges for public education media campaigns trying to reach teen audiences who can now curate their own personal content streams to view whatever they want, whenever and wherever they want to watch. This commentary discusses these key challenges, including evolving data privacy policies and practice, existing data gaps, and practical implementation and measurement considerations, as well as a description of solutions that the U.S. Food and Drug Administration's Center for Tobacco Products are pursuing to address these challenges.
