Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden.
JMIR Mhealth Uhealth. 2020 Feb 24;8(2):e16316. doi: 10.2196/16316.
To enhance the efficacy of information and communication, health care has increasingly turned to digitalization. Electronic health (eHealth) is an important factor that influences the use and receipt of benefits from Web-based health resources. Consequently, the concept of eHealth literacy has emerged, and in 2006 Norman and Skinner developed an 8-item self-report instrument to measure these skills: the eHealth Literacy Scale (eHEALS). However, the eHEALS has not been tested for reliability and validity in the general Swedish population and no threshold values have been established.
The aim of this study was to translate and adapt eHEALS into a Swedish version; evaluate convergent validity and psychometric properties; and determine threshold levels for inadequate, problematic, and sufficient eHealth literacy.
Prospective psychometric evaluation study included 323 participants equally distributed between sexes with a mean age of 49 years recruited from 12 different arenas.
There were some difficulties translating the English concept health resources. This resulted in this concept being translated as health information (ie, Hälsoinformation in Swedish). The eHEALS total score was 29.3 (SD 6.2), Cronbach alpha .94, Spearman-Brown coefficient .96, and response rate 94.6%. All a priori hypotheses were confirmed, supporting convergent validity. The test-retest reliability indicated an almost perfect agreement, .86 (P<.001). An exploratory factor analysis found one component explaining 64% of the total variance. No floor or ceiling effect was noted. Thresholds levels were set at 8 to 20 = inadequate, 21 to 26 = problematic, and 27 to 40 = sufficient, and there were no significant differences in distribution of the three levels between the Swedish version of eHEALS and the HLS-EU-Q16.
The Swedish version of eHEALS was assessed as being unidimensional with high internal consistency of the instrument, making the reliability adequate. Adapted threshold levels for inadequate, problematic, and sufficient levels of eHealth literacy seem to be relevant. However, there are some linguistic issues relating to the concept of health resources.
为了增强信息和通信的效果，医疗保健越来越倾向于数字化。电子健康（eHealth）是影响基于网络的健康资源使用和收益的一个重要因素。因此，出现了 eHealth 素养的概念，2006 年，Norman 和 Skinner 开发了一个 8 项自评工具来衡量这些技能：电子健康素养量表（eHEALS）。然而，eHEALS 尚未在瑞典普通人群中进行可靠性和有效性测试，也没有确定阈值。
本研究旨在将 eHEALS 翻译成瑞典语版本；评估收敛效度和心理测量特性；并确定 eHealth 素养不足、有问题和充足的阈值水平。
前瞻性心理测量评估研究纳入了 323 名参与者，他们在性别上平均分配，年龄 49 岁，来自 12 个不同的领域。
翻译英语概念 health resources 有些困难。因此，这个概念被翻译成 Hälsoinformation（瑞典语中的健康信息）。eHEALS 总分为 29.3（SD 6.2），Cronbach α值为.94，Spearman-Brown 系数为.96，响应率为 94.6%。所有先验假设均得到证实，支持收敛效度。测试-重测信度表明存在几乎完美的一致性，.86（P<.001）。探索性因子分析发现一个成分解释了 64%的总方差。未发现地板或天花板效应。设定的阈值水平为 8 到 20 = 不足，21 到 26 = 有问题，27 到 40 = 充足，并且在瑞典版 eHEALS 和 HLS-EU-Q16 之间，三个水平的分布没有显著差异。
评估瑞典版 eHEALS 为单维，工具内部一致性高，可靠性充足。适应 eHealth 素养不足、有问题和充足水平的适应阈值似乎是相关的。然而，在健康资源概念方面存在一些语言问题。
