Construct Validity of the eHealth Literacy Scale (eHEALS) Among Two Adult Populations: A Rasch Analysis

Abstract

BackgroundThe Internet has become a ubiquitous venue for information seeking, especially for health information. Public health practitioners have noticed the promise and potential of the Internet, however, little is known about individuals' skills of their eHealth literacy. The eHealth Literacy Scale, eHEALS, was designed to measure perceptions of individuals' eHealth literacy skills.ObjectiveThe objective of the study was to examine the psychometric validity and reliability of the eHEALS with two adult populations using the Rasch Model.MethodsA college-aged sample and an Internet-based sample (Amazon's MTurk) were recruited to complete the eHEALS, demographic questions, and a health literacy scale. Using WINSTEPS and SPSS, unidimensionality, item fit, rating scale, item hierarchy, person ability-item match, and reliability were analyzed, compared, and contrasted against each sample and to other samples found in the literature.ResultsAn exploratory factor analysis supported unidimensionality in both samples. More than 90% of respondents from both samples fit the model. No items were outright misfitting. Both samples separated into three distinct groups.ConclusionsBased on the results, the eHEALS is a reliable and consistent measurement tool for a college sample and an Internet-based sample. As these individuals are most likely to use the Internet as a health resource, it is necessary to learn and know their skills versus perceiving that they can critically and successfully navigate the Internet. Further analyses are necessary to ensure that the eHEALS can serve as a standard eHealth literacy measure for public health.

A Psychometric Analysis of the Italian Version of the eHealth Literacy Scale Using Item Response and Classical Test Theory Methods

“…Even though some recent studies have already applied IRT to the original eHEALS [23,46], our study was the first to apply these techniques to investigate the structure of a translation of the scale. Also, in contrast with other validations which were conducted in students or in patients’ samples, we used a general population sample.…”

“…A recent psychometric analysis of the original version of eHEALS used PCA to test unidimensionality although it presented a rather comprehensive parametric IRT exploration of item properties [23]. Yet, scale dimensionality can be appropriately tested within the IRT framework together with several other item properties.…”

“…In addition to CTT and FA, we applied MSA to examine dimensionality and model fit, and employed parametric IRT methods to reproduce and extend prior explorations of eHEALS item properties [23,26]. …”

ComprehENotes, an Instrument to Assess Patient Reading Comprehension of Electronic Health Record Notes: Development and Validation

“…IRT [27,46] is one of the most widely used approaches for item evaluation and test construction [29,30,47]. For example, the Patient Reported Outcomes Measurement Information System funded by the National Institutes of Health has used IRT to characterize item banks and to support computerized adaptive testing [28].…”

Electronic Health Literacy Across the Lifespan: Measurement Invariance Study (Preprint)

“…The eHEALS is a brief, 8-item rating scale grounded in self-efficacy, or the confidence in one's capability to engage in a behavior to result in a desired outcome [32]. Despite its initial development with high school adolescents, evidence has been established for the validity of eHEALS scores across diverse populations, including college-aged students [33], the general adult population [33], patients with chronic disease [34], and older adults recruited to surveys conducted online [35] and through the telephone [36]. These studies provide evidence for using eHEALS in diverse populations, but they do not provide empirical evidence for valid age-group comparisons.…”