TY - JOUR
T1 - Psychometric validation and cultural adaptation of the simplified Chinese eHealth literacy scale
T2 - Cross-sectional study
AU - Xu, Richard Huan
AU - Zhou, Lingming
AU - Lu, Sabrina Yujun
AU - Wong, Eliza Laiyi
AU - Chang, Jinghui
AU - Wang, Dong
N1 - Publisher Copyright:
© 2020 Journal of Medical Internet Research. All rights reserved.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - Background: The rapid proliferation of web-based information on health and health care has profoundly changed individuals' health-seeking behaviors, with individuals choosing the internet as their first source of information on their health conditions before seeking professional advice. However, barriers to the evaluation of people's eHealth literacy present some difficulties for decision makers with respect to encouraging and empowering patients to use web-based resources. Objective: This study aims to examine the psychometric properties of a simplified Chinese version of the eHealth Literacy Scale (SC-eHEALS). Methods: Data used for analysis were obtained from a cross-sectional multicenter survey. Confirmatory factor analysis (CFA) was used to examine the structure of the SC-eHEALS. Correlations between the SC-eHEALS and ICEpop capability measure for adults (ICECAP-A) items and overall health status were estimated to assess the convergent validity. Internal consistency reliability was confirmed using Cronbach alpha (α), McDonald omega (ω), and split-half reliability (λ). A general partial credit model was used to perform the item response theory (IRT) analysis. Item difficulty, discrimination, and fit were reported. Item-category characteristic curves (ICCs) and item and test information curves were used to graphically assess the validity and reliability based on the IRT analysis. Differential item functioning (DIF) was used to check for possible item bias on gender and age. Results: A total of 574 respondents from 5 cities in China completed the SC-eHEALS. CFA confirmed that the one-factor model was acceptable. The internal consistency reliability was good, with α=0.96, ω=0.92, and λ=0.96. The item-total correlation coefficients ranged between 0.86 and 0.91. Items 8 and 4 showed the lowest and highest mean scores, respectively. The correlation coefficients between the SC-eHEALS and ICECAP-A items and overall health status were significant, but the strength was mild. The discrimination of SC-eHEALS items ranged between 2.63 and 5.42. ICCs indicated that the order of categories' thresholds for all items was as expected. In total, 70% of the information provided by SC-eHEALS was below the average level of the latent trait. DIF was found for item 6 on age. Conclusions: The SC-eHEALS has been demonstrated to have good psychometric properties and can therefore be used to evaluate people's eHealth literacy in China.
AB - Background: The rapid proliferation of web-based information on health and health care has profoundly changed individuals' health-seeking behaviors, with individuals choosing the internet as their first source of information on their health conditions before seeking professional advice. However, barriers to the evaluation of people's eHealth literacy present some difficulties for decision makers with respect to encouraging and empowering patients to use web-based resources. Objective: This study aims to examine the psychometric properties of a simplified Chinese version of the eHealth Literacy Scale (SC-eHEALS). Methods: Data used for analysis were obtained from a cross-sectional multicenter survey. Confirmatory factor analysis (CFA) was used to examine the structure of the SC-eHEALS. Correlations between the SC-eHEALS and ICEpop capability measure for adults (ICECAP-A) items and overall health status were estimated to assess the convergent validity. Internal consistency reliability was confirmed using Cronbach alpha (α), McDonald omega (ω), and split-half reliability (λ). A general partial credit model was used to perform the item response theory (IRT) analysis. Item difficulty, discrimination, and fit were reported. Item-category characteristic curves (ICCs) and item and test information curves were used to graphically assess the validity and reliability based on the IRT analysis. Differential item functioning (DIF) was used to check for possible item bias on gender and age. Results: A total of 574 respondents from 5 cities in China completed the SC-eHEALS. CFA confirmed that the one-factor model was acceptable. The internal consistency reliability was good, with α=0.96, ω=0.92, and λ=0.96. The item-total correlation coefficients ranged between 0.86 and 0.91. Items 8 and 4 showed the lowest and highest mean scores, respectively. The correlation coefficients between the SC-eHEALS and ICECAP-A items and overall health status were significant, but the strength was mild. The discrimination of SC-eHEALS items ranged between 2.63 and 5.42. ICCs indicated that the order of categories' thresholds for all items was as expected. In total, 70% of the information provided by SC-eHEALS was below the average level of the latent trait. DIF was found for item 6 on age. Conclusions: The SC-eHEALS has been demonstrated to have good psychometric properties and can therefore be used to evaluate people's eHealth literacy in China.
KW - China
KW - Classical test theory
KW - EHEALS
KW - Electronic health literacy
KW - Item response theory
KW - Psychometric property
UR - http://www.scopus.com/inward/record.url?scp=85097315058&partnerID=8YFLogxK
U2 - 10.2196/18613
DO - 10.2196/18613
M3 - Journal article
C2 - 33284123
AN - SCOPUS:85097315058
SN - 1439-4456
VL - 22
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
IS - 12
M1 - e18613
ER -