Lars Kayser|Astrid Karnoe|Dorthe Furstrand|Roy Batterham|Karl Bang Christensen|Gerald R. Elsworth|Richard H. Osborne
A Multidimensional Tool Based on the eHealth Literacy Framework: Development and Initial Validity Testing of the eHealth Literacy Questionnaire (eHLQ)
University of Copenhagen|University of Copenhagen|Danish Multiple Sclerosis Center|University of Copenhagen|Danish Cancer Society|Deakin University|Thammasat University|University of Copenhagen|Deakin University|University of Copenhagen|Deakin University
background people able access understand benefit increasing digitalization health services critical services provided way meets users needs resources competence objectivethe objective study develop questionnaire captures 7dimensional ehealth literacy framework ehlfmethods draft items created parallel english danishthe items generated 450 statements collected conceptual development ehlfin 57 items 7 9 items per scale generated adjusted cognitive testingitems tested 475 people recruited settings scale intended used community health care settings including people range chronic conditionsmeasurement properties assessed using approaches item response theory irt classical test theory ctt confirmatory factor analysis cfa reliability using composite scale reliability csr potential bias due age sex evaluated using differential item functioning difresults cfa confirmed presence 7 priori dimensions ehlffollowing item analysis 35item 7scale questionnaire constructed covering 1 using technology process health information 5 items csr84 2 understanding health concepts language 5 items csr75 3 ability actively engage digital services 5 items csr86 4 feel safe control 5 items csr87 5 motivated engage digital services 5 items csr84 6 access digital services work 6 items csr77 7 digital services suit individual needs 4 items csr85a 7factor cfa model using smallvariance priors crossloadings residual correlations satisfactory fit posterior productive p value 2795 ci difference observed replicated chisquare values 637 1338the cfa showed items loaded strongly respective factorsthe irt analysis showed items found disordered thresholdsfor scales discriminant validity acceptable however 2 pairs dimensions highly correlated dimensions 1 5 r95 dimensions 6 7 r96all dimensions retained strong content differentiation potential causal relationships dimensionsthere evidence dif conclusionsthe ehealth literacy questionnaire ehlq multidimensional tool based welldefined priori ehlf framework robust propertiesit satisfactory evidence construct validity reliable measurement across broad range