Christina Cheng|Gerald R. Elsworth|Richard H. Osborne
Validity Evidence of the eHealth Literacy Questionnaire (eHLQ) Part 2: Mixed Methods Approach to Evaluate Test Content, Response Process, and Internal Structure in the Australian Community Health Setting
Deakin University|Swinburne University of Technology|Deakin University|Swinburne University of Technology|Deakin University|Swinburne University of Technology
digital technologies changed manage health ehealth literacy needed engage health technologies ehealth strategy would ineffective users ehealth literacy needs addressed robust measure ehealth literacy essential understanding needs basis ehealth literacy framework identified 7 dimensions ehealth literacy ehealth literacy questionnaire ehlq developed tool demonstrated robust psychometric properties danish setting validity testing ongoing accumulative processthis study aims evaluate validity evidence based test content response process internal structure ehlq australian community health settinga mixed methods approach used cognitive interviewing conducted examine evidence test content response process whereas crosssectional survey undertaken evidence internal structure data collected 3 diverse community health sites victoria australia psychometric testing included classical test theory item response theory approaches methods included bayesian structural equation modeling confirmatory factor analysis internal consistency testretest reliability bayesian multipleindicators multiplecauses model testing differential item functioningcognitive interviewing identified 1 confusing term clarified items easy read understood intended total 525 questionnaires included psychometric analysis scales homogenous composite scale reliability ranging 073 090 intraclass correlation coefficient testretest reliability 7 scales ranged 072 095 7factor bayesian structural equation modeling using small variance priors crossloadings residual covariances fitted data model interest produced satisfactory fit posterior productive p49 95 ci difference observed replicated chisquare values 10140 10883 priorposterior productive p92 items loaded relevant factor loadings ranging 036 094 significant crossloading found evidence differential item functioning administration format site area health setting however discriminant validity well established scales 1 3 5 6 7 item response theory analysis found items provided precise information different trait levels except 1 item items demonstrated different sensitivity different trait levels represented range difficulty levelsthe evidence suggests ehlq tool robust psychometric properties investigation discriminant validity recommended ready used identify ehealth literacy strengths challenges assist development digital health interventions ensure people limited digital access skills left behind