Atanasova Sara, Petric Gregor
Centre for Methodology and Informatics, Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia.
J Med Internet Res. 2019 Nov 20;21(11):e14392. doi: 10.2196/14392.
The role of online health communities (OHCs) in patient empowerment is growing and has been increasingly studied in recent years. Research has focused primarily on individualistic conception of patients' empowerment, with much less attention paid to the role of OHCs in the development of patients' collective empowerment. Although OHCs have immense potential for empowerment that goes beyond the individual, the concept and scale of collective empowerment in OHCs have not yet been developed or validated.
This study aimed to develop an instrument for measuring collective empowerment in online health communities (CE-OHC) and to test its quality by investigating its factorial structure, reliability, construct validity, and predictive validity.
The CE-OHC scale was developed according to a strict methodology for developing valid and reliable scales. An initial set of 20 items was first tested in the pilot study conducted in 2016 using a sample of 280 registered users of Slovenia's largest OHC. A refined version with 11 items was tested in the main study conducted in 2018 on a random sample of 30,000 registered users of the same OHC. The final sample comprised 784 users. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to investigate the factorial structure, discriminant validity, and convergent validity of the scale. Cronbach alpha coefficient was used to determine the CE-OHC scale's internal consistency. To establish the predictive validity, ordinary least squares regression was performed to test the role of CE-OHC in users' civic participation.
The EFA resulted in a two-factor solution, and the two factors-knowledge of resources and resource mobilization for collective action-together explain 63.8% of the variance. The second-order CFA demonstrated a good fit to the data (root mean square error of approximation=0.07) and the scale had a good internal consistency (alpha=.86). Although evidence of the scale's convergent validity was partially provided, discriminant validity of the scale remained unconfirmed. Overall, CE-OHC was confirmed to be a predictor of users' civic participation, but the influence was somewhat weak and inconsistent across two subscales.
The proposed CE-OHC scale is a reliable and relatively valid instrument and serves as a good baseline to advance the measurement of collective empowerment in OHC contexts. This is the first scale developed for this purpose, and future research should focus on the development of a clear nomological network of the collective empowerment construct in relation to the OHC settings.
在线健康社区（OHC）在患者赋权方面的作用日益凸显，近年来受到了越来越多的研究。研究主要集中在患者赋权的个人主义概念上，而对OHC在患者集体赋权发展中的作用关注较少。尽管OHC具有超越个体的巨大赋权潜力，但OHC中集体赋权的概念和规模尚未得到发展或验证。
本研究旨在开发一种用于测量在线健康社区集体赋权（CE - OHC）的工具，并通过研究其因子结构、信度、结构效度和预测效度来检验其质量。
CE - OHC量表是根据开发有效可靠量表的严格方法制定的。最初的20个项目首先在2016年对斯洛文尼亚最大的OHC的280名注册用户进行的试点研究中进行测试。2018年，在对同一OHC的30000名注册用户的随机样本进行的主要研究中，对一个包含11个项目的精炼版本进行了测试。最终样本包括784名用户。探索性因子分析（EFA）和验证性因子分析（CFA）用于研究量表的因子结构、区分效度和聚合效度。Cronbach alpha系数用于确定CE - OHC量表的内部一致性。为了建立预测效度，进行了普通最小二乘法回归，以测试CE - OHC在用户公民参与中的作用。
EFA得出了一个双因子解决方案，这两个因子——资源知识和集体行动的资源动员——共同解释了63.8%的方差。二阶CFA表明该量表与数据拟合良好（近似均方根误差 = 0.07），且量表具有良好的内部一致性（α = 0.86）。尽管部分提供了量表聚合效度的证据，但量表的区分效度仍未得到证实。总体而言，CE - OHC被证实是用户公民参与的一个预测指标，但影响在两个子量表上有些微弱且不一致。
所提出的CE - OHC量表是一种可靠且相对有效的工具，是推进OHC背景下集体赋权测量的良好基线。这是为此目的开发的第一个量表，未来的研究应侧重于开发与OHC环境相关的集体赋权结构的清晰的理论网络。
