Development and psychometric evaluation of a new brief scale to measure eHealth literacy in people with type 2 diabetes

Abstract

Background The internet has become a major source of health information, and obtaining appropriate information requires various abilities and skills, labeled as electronic health literacy (eHealth literacy). The existing instruments for measuring eHealth literacy are outdated because they were developed during the Web 1.0 era, or not sufficiently sensitive for people with a specific condition or disease because they were designed to assess eHealth literacy over a broad range for a general population. Approximately one in ten adults worldwide live with diabetes. Health professionals have a responsibility to identify patients with low eHealth literacy to prevent them from obtaining misleading internet diabetes information. Aims The aims were to develop a condition-specific eHealth literacy scale for diabetes and to evaluate its psychometric properties among people with type 2 diabetes. Methods An instrument development design was used. This study recruited 453 people diagnosed with type 2 diabetes at the outpatient clinics of hospitals in 2021. Psychometric properties (internal consistency, measurement invariance, and content, structural, convergent, and known-groups validities) were analyzed. Results An expert panel assessed content validity. Exploratory factor analysis, exploratory graph analysis, and confirmatory factor analysis (CFA) for structural validity yielded a two-factor solution (CFI = 0.977, SRMR = 0.029, RMSEA = 0.077). Cronbach’s alpha and omega values were excellent for each factor (0.87–0.94). Multigroup CFA yielded configural and metric measurement invariance across the gender, age, and glycemic control status groups. Convergent validity with a comparator instrument to measure health literacy was supported by a moderate correlation, and known-groups validity determined using groups with different internet-use frequencies was satisfied with a high effect size. Conclusion A new condition-specific eHealth literacy scale for people with type 2 diabetes was developed, comprising 10 items. The scale exhibited good psychometric properties; however, test–retest reliability must be determined for the stability of the scale and cross-cultural validity is required among different languages. The brief scale has the merits of being feasible to use in busy clinical practice and being less burdensome to respondents. The scale can be applied in clinical trials of internet-based diabetes interventions for assessing the eHealth literacy of respondents.

The Development and Psychometric Testing of the Scale of Cultural Sensitivity of Health Care Professionals in Japan

“…First, latent factors in an exploratory factor analysis of the HP and ST populations were extracted and then a CFA was performed to test a hypothetical model of the CS scale’s factor structure. In this study, we performed EFA and CFA on different samples by creating two subsamples, referring to a previous study ( Lee et al, 2022 ; Şimşek et al, 2023 ). Although previous studies performed EFA and CFA on the same sample for scale development, we believe that the use of two samples in this study was an appropriate way to increase the accuracy in confirming the hypothesized model with CFA ( Mokkink et al, 2018 ).…”

Relationship Between Electronic Health Literacy and Self-Management in People With Type 2 Diabetes Using a Structural Equation Modeling Approach

“…This study used a cross-sectional design based on structural equation modeling (SEM) using secondary data from a field survey for the development of an instrument for people with Type 2 diabetes who were recruited from outpatient clinics from August to December 2021 (E.-H. Lee et al, 2022). The data collection process and participant information are presented in detail elsewhere (E.-H. Lee et al, 2022). Women comprised 35.3% of the 453 participants.…”

“…Electronic health literacy eHealth literacy was assessed using the Condition-Specific eHealth Literacy Scale for Diabetes (CeHLS-D) that was developed recently to reflect the social nature of Web 2.0 (E.-H. Lee et al, 2022). This scale comprises 10 items scored on a…”

Professionals Evaluating Clients’ Suitability for Digital Health and Social Care: Scoping Review of Assessment Instruments

“…The reference lists of the included studies were screened for potential additional publications. The search strategy for databases is presented in Table S1 in Multimedia Appendix 1 [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”

“…From the point of view of the practical usefulness of the instruments for professionals' work, many of the studies emphasized the instrument's screening features [27,28,33,36,39,40,43], such as being convenient and brief (eHEALS, CeHLS-D, and DHLS), not burdensome for clients, and easy for professionals to use and complete in a busy clinical setting (CeHLS-D and DHTL-AQ). A total of 19 aspects regarding the practical usefulness of the instruments were described in the studies.…”