Title:
[Developing Japanese version of the eHealth Literacy Scale (eHEALS)].

Abstract:
With the rapid developing an internet society, ehealth literacy, defined as the ability to seek, find, understand, and appraise and apply the knowledge gained to addressing or solving a health problem, becomes important to promote and aid health care at the individual level. However, the eHealth Literacy Scale (eHEALS) was only a scale developed to assess the ehealth literacy. Thus, the present study was conducted to evaluated the validity and reliability of a Japanese version of the eHEALS (J-eHEALS), and examine the association of ehealth literacy with demographic attributes and characteristics on health information searching among Japanese adults.
Data were analyzed for 3,000 Japanese adults (males: 50.0%,mean age: 39.6 + 10.9 years) who responded to an Internet-based cross-sectional survey. The J-eHEALS, 6 demographic attributes, resources for obtaining health information (health resources), and contents of health information obtained from internet (ehealth contents) were obtained with a questionnaire. Confirmatory factor analysis and correlation with the communicative and critical health literacy scale were utilized to assess construct validity and criterion validity. Cronbach alpha and correlation coefficients were computed for internal consistency and test-retest reliability. Also, differences in J-eHEALS scores with each demographic attribute were examined with ANOVA and the independent t-test. Finally, chi-square tests were used to determine differences in the proportions of ehealth literacy groups (high or low) classified with a median split within health resources and ehealth contents.
Principal components analysis produced a single factor solution and confirmatory factor analysis for the 8-items model demonstrated high indices (GFI = .988, CFI = .993, RMSEA= .056). A significant positive correlation was found between the J-eHEALS and communicative and critical health literacy scores. Cronbach alpha was 0.93 (P < .01), and test-retest reliability was r = 0.63 (P < .01). The J-eHEALS scores were significantly higher in women, the 40-and 50-year age group, those with high income, and individuals with a high frequency of internet searching. Furthermore, the high ehealth literacy group used many health resources and obtained a greater variety of ehealth contents as compared with the low literacy group. The most frequent resource was the internet in the high group, and television/radio in the low group. However, these results could be subject to bias because of the non-representative nature of the Internet population.
The results indicate the J-eHEALS to be a highly validated and reliable scale. The present study suggests that enhancement of ehealth literacy will be important to utilize the increasing amount of health information on the internet effectively and appropriately.