Sudbury-Riley Lynn, FitzPatrick Mary, Schulz Peter J
Management School, University of Liverpool, Liverpool, United Kingdom.
Waikato Management School, University of Waikato, Hamilton, New Zealand.
J Med Internet Res. 2017 Feb 27;19(2):e53. doi: 10.2196/jmir.5998.
The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully.
The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months.
Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS.
We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008).
To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and random samples drawn from an increasingly important cohort. The results give increased confidence to researchers using the scale in a range of eHealth assessment applications from primary care to health promotions.
电子健康素养量表（eHEALS）是少数可用于评估电子健康素养的测量量表之一。或许由于此类测量方法相对较少，且电子健康素养的重要性日益凸显，eHEALS越来越多地被选入针对不同群体、文化和国家的一系列研究中。然而，尽管其越来越受欢迎，但人们对其理论基础提出了质疑，该量表的因子效度和多组测量特性尚未得到充分研究。
我们研究的目的是检验在美国、英国和新西兰过去6个月内使用互联网搜索健康信息的婴儿潮一代（出生于1946年至1964年之间）中eHEALS的因子效度和测量不变性。
通过在线问卷从3个相关国家的婴儿潮一代随机样本中收集数据。eHEALS的理论基础包括社会认知理论和自我效能理论。对eHEALS进行仔细审查并结合这些理论分析表明，一种三因素结构值得研究，而此前从未有人对此进行过探索。结构方程模型基于eHEALS的理论基础测试了一种三因素结构，并研究了eHEALS的跨国测量不变性。
我们使用来自3个国家的随机样本收集了问卷回复（N = 996）。结果表明，eHEALS包含一个三因素结构，其测量模型符合所有相关拟合指数（近似均方根误差，RMSEA = 0.041，比较拟合指数，CFI = 0.986）。此外，该量表显示出度量不变性（RMSEA = 0.040，CFI = 0.984，ΔCFI = 0.002），甚至标量不变性（RMSEA = 0.042，CFI = 0.978，ΔCFI = 0.008）。
据我们所知，这是第一项证明eHEALS多组因子等效性的研究，并且是基于来自3个不同国家的数据以及从一个日益重要的队列中抽取的随机样本进行的。研究结果使研究人员在从初级保健到健康促进等一系列电子健康评估应用中使用该量表时更有信心。
