Psychometric comparisons of measures of eHealth literacy using a sample of Korean older adults

Abstract

Aims: This study aimed to compare the psychometric properties of two measures of eHealth literacy, namely, the Korean versions of the Digital Health Literacy Instrument (K-DHLI) and eHealth Literacy Scale (K-eHEALS), among older adults in South Korea. Background:Given the usefulness of eHealth information, measures of eHealth literacy have been developed. It is necessary to examine the validity of such tools among older adults who are likely to experience difficulties in using eHealth resources.Methods: A validation study was conducted using the secondary data of 180 older adults in South Korea. Two weeks after they had responded to the K-DHLI and K-eHEALS, 89 of them completed the assessments a second time so that the assessments' test-retest reliability could be examined. Using the collected data, their reliability (i.e. internal consistency, test-retest reliability) and validity (i.e. construct validity and criterion validity) were examined.Results: Both tools demonstrated satisfactory internal consistency (α ≥ 0.90, itemtotal correlation coefficients = .39-.76) as well as good test-retest reliability with intraclass correlation coefficients .77 and .84, respectively. The 21 items of the K-DHLI loaded onto five factors, which accounted for 71% of the variance. The 10 items of the K-eHEALS loaded onto a single factor, which explained 58% of the total variance. The scores of both tools were strongly correlated (r = .63) and positively related to attitudes towards internet health information and subjective health status (r = .23-.50). Conclusions:The findings suggest that the K-DHLI and K-eHEALS are reliable and valid tools that can be used to assess the utilisation of eHealth resources by older adults. Implications for Practice:The findings can help healthcare providers choose a suitable measure of eHealth literacy when working with older adults.

eHealth Literacy Instruments: Systematic Review of Measurement Properties

“…The characteristics of the included eHealth literacy instruments and studies are presented in Multimedia Appendix 2 [ 24 - 64 ]. The eHEALS, which consists of 8 items scored on a 5-point Likert scale, was originally developed in English [ 24 ], and its psychometrics have been studied in diverse languages: Amharic [ 50 ], Mandarin Chinese [ 26 ], Simplified Chinese [ 34 , 36 , 41 ], Dutch [ 25 ], English [ 27 - 30 , 47 , 53 , 54 , 57 , 58 ], German [ 39 , 44 ], Greek [ 48 ], Hebrew [ 45 ], Hungarian [ 37 ], Indonesian [ 43 ], Italian [ 31 , 33 ], Korean [ 32 , 42 , 55 ], Persian [ 38 , 46 ], Polish [ 35 ], Portuguese [ 52 ], Norwegian [ 49 , 56 ], Serbian [ 51 ], and Swedish [ 40 ]. The eHEALS has been used to evaluate diverse populations, including not only youths, adults, and older adults, but also healthy people, patients, caregivers, and health professionals in school, community, and clinic settings.…”

“…In addition, this instrument has 3 items that are not obligatory to answer when respondents do not have experience posting messages on social media (ie, they can leave the items blank). The DHLI was further assessed in the Korean language for older adults in welfare centers [ 42 ]. The eHLA is the longest instrument, comprising 42 items scored on a 4-point Likert scale and using multiple choices, and was developed in both Danish and English [ 62 ].…”

“…There was sufficient low-quality evidence for reliability and insufficient high-quality evidence for convergent validity. The five-factor structure of the DHLI (ID 52) [ 42 ] also demonstrated sufficient low-quality evidence for structural validity. The eHLQ from 2 studies reported in a single article (IDs 54, 55) [ 63 ] had insufficient high-quality evidence for structural validity, sufficient high-quality evidence for internal consistency, and indeterminate low-quality evidence for measurement invariance.…”

Validating the Digital Health Literacy Instrument in Relation to COVID-19 Information (COVID-DHL-K) among South Korean Undergraduates

“…The new tool DHLI can include interactivities on the web, so-called “e-Health 2.0 Skills” [ 15 ]. The Korean version of the eHealth Literacy Scale (K-eHEALS) was validated among young adults [ 16 ] and among older adults [ 17 , 18 ]. Among older people, the validated K-DHLI, composed of 21 items with five factors, was recently introduced [ 18 ].…”

“…The Korean version of the eHealth Literacy Scale (K-eHEALS) was validated among young adults [ 16 ] and among older adults [ 17 , 18 ]. Among older people, the validated K-DHLI, composed of 21 items with five factors, was recently introduced [ 18 ]. Previous studies reported an association between digital health literacy and doctor–patient communication [ 19 ], as well as preventive health behaviors [ 20 , 21 ].…”