Norman Cameron D, Skinner Harvey A
Department of Public Health Sciences, University of Toronto, 155 College Street, Room 586, Toronto, ON M5T 3M7, Canada.
J Med Internet Res. 2006 Nov 14;8(4):e27. doi: 10.2196/jmir.8.4.e27.
Electronic health resources are helpful only when people are able to use them, yet there remain few tools available to assess consumers' capacity for engaging in eHealth. Over 40% of US and Canadian adults have low basic literacy levels, suggesting that eHealth resources are likely to be inaccessible to large segments of the population. Using information technology for health requires eHealth literacy-the ability to read, use computers, search for information, understand health information, and put it into context. The eHealth Literacy Scale (eHEALS) was designed (1) to assess consumers' perceived skills at using information technology for health and (2) to aid in determining the fit between eHealth programs and consumers.
The eHEALS is an 8-item measure of eHealth literacy developed to measure consumers' combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. The objective of the study was to psychometrically evaluate the properties of the eHEALS within a population context. A youth population was chosen as the focus for the initial development primarily because they have high levels of eHealth use and familiarity with information technology tools.
Data were collected at baseline, post-intervention, and 3- and 6-month follow-up using control group data as part of a single session, randomized intervention trial evaluating Web-based eHealth programs. Scale reliability was tested using item analysis for internal consistency (coefficient alpha) and test-retest reliability estimates. Principal components factor analysis was used to determine the theoretical fit of the measures with the data.
A total of 664 participants (370 boys; 294 girls) aged 13 to 21 (mean = 14.95; SD = 1.24) completed the eHEALS at four time points over 6 months. Item analysis was performed on the 8-item scale at baseline, producing a tight fitting scale with alpha = .88. Item-scale correlations ranged from r = .51 to .76. Test-retest reliability showed modest stability over time from baseline to 6-month follow-up (r = .68 to .40). Principal components analysis produced a single factor solution (56% of variance). Factor loadings ranged from .60 to .84 among the 8 items.
The eHEALS reliably and consistently captures the eHealth literacy concept in repeated administrations, showing promise as tool for assessing consumer comfort and skill in using information technology for health. Within a clinical environment, the eHEALS has the potential to serve as a means of identifying those who may or may not benefit from referrals to an eHealth intervention or resource. Further research needs to examine the applicability of the eHEALS to other populations and settings while exploring the relationship between eHealth literacy and health care outcomes.
只有当人们能够使用电子健康资源时，这些资源才会有所帮助，但目前可用于评估消费者参与电子健康能力的工具仍然很少。超过40%的美国和加拿大成年人基本识字水平较低，这表明很大一部分人口可能无法获取电子健康资源。利用信息技术促进健康需要具备电子健康素养，即阅读、使用计算机、搜索信息、理解健康信息并将其应用于实际情况的能力。电子健康素养量表（eHEALS）旨在：（1）评估消费者在利用信息技术促进健康方面的感知技能；（2）帮助确定电子健康项目与消费者之间的匹配度。
eHEALS是一项包含8个条目的电子健康素养测量工具，旨在测量消费者在查找、评估和应用电子健康信息解决健康问题方面的综合知识、舒适度和感知技能。本研究的目的是在人群背景下对eHEALS的属性进行心理测量学评估。选择青少年人群作为初始开发的重点，主要是因为他们电子健康使用水平高且熟悉信息技术工具。
在基线、干预后、3个月和6个月随访时收集数据，将对照组数据作为单次随机干预试验的一部分，该试验评估基于网络的电子健康项目。使用项目分析来测试量表的信度，包括内部一致性（α系数）和重测信度估计。主成分因子分析用于确定测量指标与数据的理论拟合度。
共有664名年龄在13至21岁（平均 = 14.95；标准差 = 1.24）的参与者（370名男孩；294名女孩）在6个月内的四个时间点完成了eHEALS。在基线时对8个条目的量表进行项目分析，得到一个拟合紧密的量表，α = 0.88。项目与量表的相关性范围为r = 0.51至0.76。从基线到6个月随访，重测信度随时间显示出适度的稳定性（r = 0.68至0.40）。主成分分析产生了一个单因素解决方案（方差的56%）。8个条目的因子载荷范围为0.60至0.84。
eHEALS在重复施测中可靠且一致地捕捉了电子健康素养概念，有望成为评估消费者在利用信息技术促进健康方面的舒适度和技能的工具。在临床环境中，eHEALS有可能作为一种手段，识别那些可能从转介到电子健康干预或资源中受益或不受益的人。进一步的研究需要检验eHEALS在其他人群和环境中的适用性，同时探索电子健康素养与医疗保健结果之间的关系。
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