Measuring Electronic Health Literacy: Development, Validation, and Test of Measurement Invariance of the 3-factor eHealth literacy inventory (3F-EHLI) (Preprint)

2021 ◽  
Author(s):  
Matthias Marsall ◽  
Gerrit Engelmann ◽  
Eva-Maria Skoda ◽  
Martin Teufel ◽  
Alexander Bäuerle
Keyword(s):  
Health Literacy ◽  
Measurement Invariance ◽  
Educational Level ◽  
Information Seeking ◽  
Criterion Validity ◽  
Information Evaluation ◽  
Ehealth Literacy ◽  
Health Related ◽  
Positive Correlations ◽  
Development And Validation

BACKGROUND The World Wide Web has become an essential source of health information. Especially the COVID-19 pandemic has shown that the amount and the quality of information provided can lead to an information overload. Therefore, people do need certain skills to search, identify and evaluate information from the internet. In the context of health information, these competences are described as eHealth literacy, which could be confirmed as predictor of various health-related outcomes. Existing instruments assessing eHealth literacy reveal limitation of methodological standards of test development and validation. Furthermore, existing scales do not cover the entire cognitive processes, which are proposed within the construct of eHealth literacy. OBJECTIVE The objective of this study is the development and validation of an extended eHealth literacy scale to provide an economic and empirically confirmed measurement of eHealth literacy in German language. METHODS For development, items from 2 international, validated instruments were merged to cover a wide bandwidth of the construct of eHealth literacy. Translation into German followed scientific guidelines and recommendations ensuring content validity. A convenience sample of N=470 German-speaking people was collected from October to November 2020. Validation was carried out by confirmatory factor analysis. Correlations were performed to examine for convergent, discriminant, and criterion validity. Additionally, analyses of measurement invariance of gender, age, and educational level were conducted. RESULTS Analyses revealed a 3-factorial model of eHealth literacy. By item-reduction, the 3 factors information seeking, information identification, and information evaluation were measured with 11 items reaching good model fits (CFI: 0.959 ; TLI: 0.945; RMSEA: 0 .068; SRMR: 0.045). Convergent validity was confirmed by positive correlations of information seeking, information identification, and information evaluation with health literacy (r=0.43, P<.001; r= 0.53, P<.001; r= 0.55, P<.001, respectively). No significant correlations with impulsivity (r=-0.06, P=.16; r=-0.08, P=.08; r=-0.08, P=.10, respectively) confirmed discriminant validity. Criterion validity was supported by positive correlations of information identification and information evaluation with mental health (r=0.29, P<.001; r= 0.21, P<.001, respectively). Analyses with further variables confirmed convergent, discriminant and criterion validity. Strict measurement invariance of gender (CFI: 0.941; TLI: 0.941 ; RMSEA: 0.073; SRMR: 0.059), age (CFI: 0.943; TLI: 0.943 ; RMSEA: 0.070; SRMR: 0 .053), and educational level (CFI: 0.956; TLI: 0.959 ; RMSEA: 0.059; SRMR: 0.060) was confirmed. CONCLUSIONS Following scientific suggestions for translation and performing analyses confirming 3-factorial structure, we developed the 3-factor eHealth literacy inventory (3F-EHLI) as an economic and valid assessment of eHealth literacy. By verifying measurement invariance of gender, age, and educational level, the 3F-EHLI is an applicable measurement independently of these main sociodemographic variables. The 3F-EHLI represents a valid and economic instrument international further development of the measurement of the important health-related construct of eHealth literacy.

scholarly journals Health Literacy in Web-Based Health Information Environments: Systematic Review of Concepts, Definitions, and Operationalization for Measurement (Preprint)

2018 ◽  
Author(s):  
Anna-Maija Huhta ◽  
Noora Hirvonen ◽  
Maija-Leena Huotari
Keyword(s):  
Health Literacy ◽  
Health Information ◽  
Quantitative Research ◽  
Conceptual Development ◽  
Web Based ◽  
Quantitative Research Methods ◽  
Ehealth Literacy ◽  
Domain Specific ◽  
Health Related ◽  
Specific Concept

BACKGROUND Health literacy research seems to lack a consensus on what aspects to include into literacy in the context of health and on how to operationalize these concepts for measurement purposes. In addition to health literacy, several other concepts, such as electronic health (eHealth) literacy and mental health literacy, have been developed across disciplines. This study examines how these different concepts are used when studying health-related competencies in Web contexts. OBJECTIVE This study systematically reviews health literacy concepts and definitions and their operationalization in studies focused on Web-based health information environments. METHODS A systematic literature search was conducted in April 2016 in 6 electronic databases with a limitation to articles in English published between January 2011 and April 2016. Altogether, 1289 unique records were identified and screened according to the predefined inclusion criteria: (1) original, peer-reviewed research articles written in English; (2) the topic of the article concerned literacy in the context of health; (3) informants of the study were lay people, not health professionals or students of the field; and (4) the focus of the study was placed on an Web-based information environment. In total, 180 full texts were screened, of which 68 were included in the review. The studies were analyzed with an emphasis on the used health literacy concepts and measures. RESULTS On the basis of the included studies, several concepts are in use when studying health-related literacy in Web environments, eHealth literacy and health literacy being the most common ones. The reviewed studies represent a variety of disciplines, but mostly medical sciences. Typically, quantitative research methods are used. On the basis of the definitions for health literacy, 3 thematic categories were identified: general and skill-based, multidimensional, and domain-specific health literacy. Most studies adopted a domain-specific concept, followed by the ones that used a general and skill-based concept. Multidimensional concepts occurred least frequently. The general health literacy concepts were usually operationalized with reading comprehension measures, the domain-specific concepts with self-efficacy measures, and multidimensional concepts with several types of measures. However, inconsistencies in operationalization were identified. CONCLUSIONS The results show that in studies conducted in Web-based information environments, several different health literacy concepts are in use, and there is no clear consensus on the definitions for these concepts. Future studies should place emphasis on the conceptual development of health literacy in Web contexts to gain better results on operationalization for measurement. Researchers are encouraged to provide clear operational definitions for the concepts they use to ensure transparency in reporting.

scholarly journals Digital health literacy and online information seeking in times of COVID-19. A cross-sectional survey among university students in Germany (Preprint)

2020 ◽  
Author(s):  
Kevin Dadaczynski ◽  
Orkan Okan ◽  
Melanie Messer ◽  
Angela Y. M. Leung ◽  
Rafaela Rosário ◽  
...  
Keyword(s):  
Social Media ◽  
Health Literacy ◽  
University Students ◽  
Information Seeking ◽  
Digital Health ◽  
Online Information ◽  
Cross Sectional ◽  
Related Information ◽  
Health Related ◽  
Online Information Seeking

BACKGROUND Digital communication technologies play an important role in governments’ and public health authorities’ health communication strategies during the COVID-19 pandemic. The internet and social media have become important sources of health-related information on the coronavirus and on protective behaviours. In addition, the COVID-19 infodemic spreads faster than the coronavirus itself, which interferes with governmental health-related communication efforts. This puts national public health containment strategies in jeopardy. Therefore, digital health literacy is a key competence to navigate coronavirus-related information and service environments. OBJECTIVE This study aimed to investigate university students’ digital health literacy and online information seeking behaviours during the early stages of the coronavirus pandemic in Germany. METHODS A cross-sectional study among N=14,916 university students aged ≥18 from 130 universities across all sixteen federal states of Germany was conducted using an online survey. Along with sociodemographic characteristics (sex, age, subjective social status) measures included five subscales from the Digital Health Literacy Instrument (DHLI), which was adapted to the specific coronavirus context. Online information seeking behaviour was investigated by examining the online sources used by university students and the topics that students search for in connection with the coronavirus. Data were analysed using univariate and bivariate analyses. RESULTS Across digital health literacy dimensions, the greatest difficulties could be found for assessing the reliability of health-related information (42.3%) and the ability to determine whether the information was written with commercial interest (38.9%). Moreover, respondents also indicated that they most frequently have problems finding the information they are looking for (30.4%). When stratified according to sociodemographic characteristics, significant differences were found with female university students reporting a lower DHLI for the dimensions of ‘information searching’ and of ‘evaluating reliability’. Search engines, news portals and public bodies’ websites were most often used by the respondents as sources to search for information on COVID-19 and related issues. Female students were found to use social media and health portals more frequently, while male students used Wikipedia and other online encyclopaedias as well as YouTube more often. The use of social media was associated with a low ability to critically evaluate information, while opposite differences were observed for the use of public websites. CONCLUSIONS Although digital health literacy is, in summary, well developed in university students, a significant proportion of students still face difficulties with certain abilities to deal with information. There is need to strengthen the digital health literacy capacities of university students using tailored interventions. Improving the quality of health-related information on the internet is also key. CLINICALTRIAL

Development and Validation of the Digital Addiction Scale for Teenagers (DAST)

2021 ◽  
pp. 073428292110563
Author(s):  
Riin Seema ◽  
Mati Heidmets ◽  
Kenn Konstabel ◽  
Ene Varik-Maasik
Keyword(s):  
School Engagement ◽  
Learning Difficulties ◽  
Negative Relationship ◽  
Psychoeducational Assessment ◽  
Main Study ◽  
Digital Devices ◽  
Health Related ◽  
Digital Addiction ◽  
Positive Correlations ◽  
Development And Validation

We present the development and validation of the Digital Addiction Scale for Teenagers (DAST), describing the pilot study ( N = 40 students) and main study ( N = 4493) with Estonian students aged 11–19, in spring 2020. Our aim was to create a scale suitable for psychoeducational assessment of teenagers’ behaviour and feelings towards digital devices. We used the mixed research framework . Half of the study sample was collected before the coronavirus crisis (Sample I: 1972 students) and the rest during a distance-learning period (Sample II: 2521 students). We found that factor structure in both subsamples were similar. The DAST shows a negative relationship with emotional school engagement and life satisfaction and positive correlations with school burnout, learning difficulties and screen time. We discuss potential uses of the scale for assessing health-related digital competences.

Promoting eHealth Literacy in Older Adults: Key Informant Perspectives

2013 ◽  
Vol 74 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Elizabeth Manafò ◽  
Sharon Wong
Keyword(s):  
Older Adults ◽  
Health Literacy ◽  
Health Care Professionals ◽  
Information Seeking ◽  
Adult Population ◽  
Relevant Literature ◽  
Well Being ◽  
Ehealth Literacy ◽  
Key Informant ◽  
Literacy Tool

Health literacy has the potential to improve an individual’s capacity to access, understand, evaluate, and communicate basic health information and services in order to make appropriate health decisions. We developed a research agenda to help older adults become aware of health literacy and its function in promoting their nutritional health and well-being. A key activity is the development, implementation, and evaluation of an eHealth literacy tool, eSEARCH, targeted at older adults to help improve their eHealth literacy skills. Before consultations were held with this subpopulation to assess their eHealth literacy needs and abilities, key informant interviews were conducted with eight experts in the field of health literacy, the older adult population, and/or online communications. Some experts were identified from the relevant literature; others were identified by informants who had already been interviewed. Informants were asked nine questions about the perceived importance of health literacy in Canada, key considerations in developing an eHealth literacy tool, and supporting resources for advancement of the eHealth literacy tool. Informants agreed that health literacy is a key concept and stressed that key considerations for development of the eSEARCH tool are identifying the target population’s needs, focusing on health promotion, and increasing confidence in information-seeking behaviours. Identified challenges are ensuring accessibility, applicability to older adults, and adoption of the tool by dietetic and other health care professionals.

scholarly journals Development and validation of the Digital Addiction Scale for Teenagers (DAST)

2021 ◽  
Author(s):  
Riin Seema ◽  
Mati Heidmets ◽  
Kenn Konstabel ◽  
Ene Varik-Maasik
Keyword(s):  
School Engagement ◽  
Learning Difficulties ◽  
Psychoeducational Assessment ◽  
Main Study ◽  
Digital Devices ◽  
Health Related ◽  
Digital Addiction ◽  
School Burnout ◽  
Positive Correlations ◽  
Development And Validation

<p>We present development and validation of the Digital Addiction Scale for Teenagers (DAST), describing the pilot study (N = 40 students) and main study (N = 4493) with Estonian students aged 11–19, in spring 2020. Our aim was to create a scale suitable for psychoeducational assessment of teenagers’ behaviour and feelings towards digital devices. We used the mixed research framework (Onwuegbuzie, Bustamante, & Nelson, 2010). Half of the study sample was collected before the coronavirus crisis (Sample 1: 1972 students) and the rest of it during a distance learning period (Sample 2: 2521 students). We found that factor structure in both subsamples were similar. The DAST shows a negative relation with emotional school engagement and life satisfaction and positive correlations with school burnout, learning difficulties and screen time. We discuss potential uses of the scale for assessing health related digital competences. </p>

eHealth and adolescents in Serbia: psychometric properties of eHeals questionnaire and contributing factors to better online health literacy

2018 ◽  
Vol 34 (4) ◽  
pp. 770-778 ◽  
Author(s):  
Tatjana Gazibara ◽  
Jelena Cakic ◽  
Milica Cakic ◽  
Tatjana Pekmezovic ◽  
Anita Grgurevic
Keyword(s):  
Health Literacy ◽  
Psychometric Properties ◽  
Health Resources ◽  
Contributing Factors ◽  
Ehealth Literacy ◽  
Related Information ◽  
Health Related ◽  
Valid Instrument ◽  
Serbian Version ◽  
Parental Marital Status

Abstract Internet is important resource of health-related information and health services. Factors associated with higher level of online health (eHealth) literacy among adolescence have been understudied. The aim of this study was to assess psychometric properties of the eHealth Literacy Scale (eHEALS) in Serbian language and to evaluate eHealth literacy among adolescents in Serbia. The study was carried out in four high schools in Belgrade, Serbia in the period December 2016 to January 2017. A total of 702 students comprised the study sample. The eHEALS was translated according to internationally accepted methodology and its psychometric properties were analyzed. The Cronbach’s alpha coefficient for the entire eHEALS was 0.849. On exploratory factor analysis we obtained two-factorial structure. Our adolescents reported low confidence in knowing what health resources are available online. High confidence was observed for knowing how to use and how to find health information online. There was no difference in eHEALS score between genders or between school years. After adjustment for gender, type of school program, parental marital status, fathers’ education level and household income, being female was associated with higher eHealth literacy (B = 1.12, 95% confidence interval 0.07–2.18; p = 0.036). Serbian version of the eHEALS is a valid instrument in assessment of online health literacy and can be further used in evaluation of eHealth literacy in other population groups in Serbian language. It is advised that some classes in school are dedicated to appraisal and use of online health websites. This could be achieved through peer-education.

The Impact of Medical or Health-Related Internet Searches on Patient Compliance

2022 ◽  
pp. 72-97
Author(s):  
Sara Wilcox ◽  
Olha Huzo ◽  
Annu Minhas ◽  
Nicole Walters ◽  
Joel Ehis Adada ◽  
...  
Keyword(s):  
Patient Compliance ◽  
Medical Information ◽  
Ehealth Literacy ◽  
Physician Trust ◽  
Internet Information ◽  
Health Related ◽  
Internet Searches ◽  
Positive Correlations ◽  
Physician Recommendations ◽  
The Impact

Health-related Internet searches have been associated with cyberchondria and can impact how patients receive and react to medical advice. The purpose of this study was to analyze the relationships between patient compliance and the experiences of 191 Internet information seekers from >12 countries and 27 occupations, surveyed online between 2015 and 2016 using the ‘Dr. Net' questionnaire. After Internet search, 75% agreed with the diagnosis given by their doctor and 83% remained compliant with their doctor's orders. Statistical analysis using Kruskal-Wallis H test (“one-way ANOVA on ranks”) and Spearman correlation coefficient revealed strong positive correlations (p < 0.001) between compliance and each of the following: finding the search helpful (86%), being satisfied with Internet information (71%), becoming more cautious about health (60%), finding the information provided by their doctor comprehensible (71%), and agreement with physician. Recommendations are discussed for increasing ehealth literacy and patient-physician trust with improved online medical information.

scholarly journals Development and Psychometric Properties of a Questionnaire Assessing Self-Reported Generic Health Literacy in Adolescence

2020 ◽  
Vol 17 (8) ◽  
pp. 2860 ◽  
Author(s):  
Olga Maria Domanska ◽  
Torsten Michael Bollweg ◽  
Anne-Kathrin Loer ◽  
Christine Holmberg ◽  
Liane Schenk ◽  
...  
Keyword(s):  
Health Literacy ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Related Information ◽  
Significant Step ◽  
Health Related ◽  
Expert Assessments ◽  
Stage 1 ◽  
Two Stages ◽  
Development And Validation

Health literacy is a promising approach to promoting health and preventing disease among children and adolescents. Promoting health literacy in early stages of life could contribute to reducing health inequalities. However, it is difficult to identify concrete needs for action as there are few age-adjusted measures to assess generic health literacy in young people. Our aim was to develop a multidimensional measure of health literacy in German to assess generic health literacy among 14- to 17-year-old adolescents, namely, the “Measurement of Health Literacy Among Adolescents Questionnaire” (MOHLAA-Q). The development process included two stages. Stage 1 comprised the development and validation using a literature review, two rounds of cognitive interviews, two focus groups and two rounds of expert assessments by health literacy experts. Stage 2 included a standard pretest (n = 625) of the questionnaire draft to examine the psychometric properties, reliability and different validity aspects. The MOHLAA-Q consists of 29 items in four scales: (A) “Dealing with health-related information (HLS-EU-Q12-adolescents-DE)”; (B) “Communication and interaction skills”, (C) “Attitudes toward one’s own health and health information”, and (D) “Health-related knowledge”. The confirmatory factor analysis indicated a multidimensional structure of the MOHLAA-Q. The internal consistency coefficients (Cronbach’s α) of the scales varied from 0.54 to 0.77. The development of the MOHLAA-Q constitutes a significant step towards the comprehensive measurement of adolescents’ health literacy. However, further research is necessary to re-examine its structural validity and to improve the internal consistency of two scales.

scholarly journals The Relationship between E-Health Literacy and Health-Promoting Behaviors in Nursing Students: A Multiple Mediation Model

2021 ◽  
Vol 18 (11) ◽  
pp. 5804
Author(s):  
Sunghee Kim ◽  
Jihyun Oh
Keyword(s):  
Health Literacy ◽  
Nursing Students ◽  
Health Information ◽  
Information Seeking ◽  
Multiple Mediation ◽  
Health Promoting Behaviors ◽  
Healthy Behaviors ◽  
Wide Range ◽  
Health Related ◽  
Health Promoting

The availability of a wide range of online health-related information on the internet has made it an increasingly popular source of health information, particularly for people in their 20s. This study aimed to explore possible multistep and indirect pathways of association between e-health literacy and health-promoting behaviors through social media use for health information, online health information-seeking behaviors, and self-care agency among nursing students. The study included 558 nursing students from three different universities in South Korea. Data were collected using structured questionnaires from 2 August to 29 August, 2019. The results show that e-health literacy had a significant direct effect on health-promoting behaviors through the three mediators. Moreover, the overall model explained 46% of the total variance in health-promoting behaviors. Based on these findings, it is necessary to introduce interventions that improve e-health literacy and develop a strategy to promote healthy behaviors. It is also necessary to develop programs to improve e-health literacy competency in nursing students. Moreover, health interventions that improve health-promoting behaviors should be developed, and research to evaluate the effect of the interventions should be conducted.

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