Development of the Multidimensional Readiness and Enablement Index for Health Technology (READHY) Tool to Measure Individuals’ Health Technology Readiness: Initial Testing in a Cancer Rehabilitation Setting

Abstract

Background The increasing digitization of health care services with enhanced access to fast internet connections, along with wide use of smartphones, offers the opportunity to get health advice or treatment remotely. For service providers, it is important to consider how consumers can take full advantage of available services and how this can create an enabling environment. However, it is important to consider the digital context and the attributes of current and future users, such as their readiness (ie, knowledge, skills, and attitudes, including trust and motivation). Objective The objective of this study was to evaluate how the eHealth Literacy Questionnaire (eHLQ) combined with selected dimensions from the Health Education Impact Questionnaire (heiQ) and the Health Literacy Questionnaire (HLQ) can be used together as an instrument to characterize an individual’s level of health technology readiness and explore how the generated data can be used to create health technology readiness profiles of potential users of health technologies and digital health services. Methods We administered the instrument and sociodemographic questions to a population of 305 patients with a recent cancer diagnosis referred to rehabilitation in a setting that plans to introduce various technologies to assist the individuals. We evaluated properties of the Readiness and Enablement Index for Health Technology (READHY) instrument using confirmatory factor analysis, convergent and discriminant validity analysis, and exploratory factor analysis. To identify different health technology readiness profiles in the population, we further analyzed the data using hierarchical and k-means cluster analysis. Results The confirmatory factor analysis found a suitable fit for the 13 factors with only 1 cross-loading of 1 item between 2 dimensions. The convergent and discriminant validity analysis revealed many factor correlations, suggesting that, in this population, a more parsimonious model might be achieved. Exploratory factor analysis pointed to 5 to 6 constructs based on aggregates of the existing dimensions. The results were not satisfactory, so we performed an 8-factor confirmatory factor analysis, resulting in a good fit with only 1 item cross-loading between 2 dimensions. Cluster analysis showed that data from the READHY instrument can be clustered to create meaningful health technology readiness profiles of users. Conclusions The 13 dimensions from heiQ, HLQ, and eHLQ can be used in combination to describe a user’s health technology readiness level and degree of enablement. Further studies in other populations are needed to understand whether the associations between dimensions are consistent and the number of dimensions can be reduced.

Health literacy, digital literacy and eHealth literacy in Danish nursing students at entry and graduate level: a cross sectional study

“…The scales eHLA and eHLQ used to measure DL and eHL have only been applied in relatively few studies [24,42] and not in relation to nursing students. It may be argued that the reliability and validity in our context has not yet been fully established.…”

Cancer Survivors’ Receptiveness to Digital Technology–Supported Physical Rehabilitation and the Implications for Design: Qualitative Study

“…We previously reported how cancer survivors referred to rehabilitation can be stratified into four distinct profiles according to their health technology readiness using the Readiness and Enablement Index for Health Technology (READHY) [ 29 ], an instrument based on the eHealth Literacy Framework [ 30 ] and the eHealth Literacy Questionnaire [ 31 ], supplemented by the social dimensions of the Health Literacy Questionnaire [ 32 ] and by the self-management dimensions of the Health Education Impact Questionnaire [ 33 ]. The dimensions relating to electronic health (eHealth) literacy described user knowledge and skills, the intersection between users and technologies, and users’ experience of systems.…”

“…The dimensions relating to self-management add knowledge about the individuals’ ability to handle their condition and emotional response. The social dimensions add knowledge about the individuals’ social context (ie, support from family and friends or health professionals) [ 29 ]. The four identified READHY profiles ( Figure 1 ) differ regarding their receptiveness to physical activity rehabilitation supplemented by digital technology.…”

Integrated personalized diabetes management goes Europe: A multi-disciplinary approach to innovating type 2 diabetes care in Europe

“…Such broader investigations will be required to evaluate the viability of the digital, smartphone-based patient assessment tool during and beyond the iPDM-GO project phase, preferably in different cultural scenarios. Complimentary approaches to assess potential users' health technology readiness and enablement may also help identify the patient segments that will benefit most from a given healthcare intervention like the one developed in iPDM-GO [35].…”