Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Int J Environ Res Public Health. 2023 Feb 13;20(4):3293. doi: 10.3390/ijerph20043293.
This study compared the reliability, construct validity, and respondents' preference of the Chinese version of 8-item eHEALS (C-eHEALS) and 21-item DHLI (C-DHLI) in assessing older adults' electronic health (eHealth) literacy using a mixed-methods approach. A web-based, cross-sectional survey was conducted among 277 Chinese older adults from September to October 2021, and 15 respondents were subsequently interviewed to understand their preference of scale to use in practice. Results showed that the internal consistency and test-retest reliability of both scales were satisfactory. For the construct validity, the C-DHLI score showed stronger positive correlations with having Internet use for health information and higher educational attainments, occupational skill levels, self-rated Internet skills, and health literacy than the C-eHEALS score. In addition, younger age, higher household income, urban residence, and longer Internet use history were only positively correlated with C-DHLI score. Qualitative data suggested that most interviewees perceived the C-DHLI as more readable than C-eHEALS for its clear structure, specific description, short sentence length, and less semantic complexity. Findings revealed that both scales are reliable tools to measure eHealth literacy among Chinese older adults, and the C-DHLI seemed to be a more valid and favored instrument for the general Chinese older population based on the quantitative and qualitative results.
本研究采用混合方法比较了中文电子健康素养量表（C-eHEALS）和 21 项数字健康素养量表（C-DHLI）评估老年人电子健康素养的可靠性、结构效度和受访者偏好。2021 年 9 月至 10 月期间，通过网络对 277 名中国老年人进行了横断面调查，随后对 15 名受访者进行了访谈，以了解他们在实践中对使用哪种量表的偏好。结果表明，两种量表的内部一致性和重测信度均令人满意。对于结构效度，C-DHLI 评分与使用互联网获取健康信息、较高的教育程度、职业技能水平、自我评估的互联网技能和健康素养呈更强的正相关，而 C-eHEALS 评分则较弱。此外，年龄较小、家庭收入较高、居住在城市和互联网使用时间较长与 C-DHLI 评分呈正相关。定性数据表明，大多数受访者认为 C-DHLI 比 C-eHEALS 更易读，因为其结构清晰、描述具体、句子长度较短且语义复杂性较低。研究结果表明，这两种量表都是评估中国老年人电子健康素养的可靠工具，基于定量和定性结果，C-DHLI 似乎是一般中国老年人群更有效的首选工具。
