Miyawaki Rina, Kato Mio, Kawamura Yoko, Ishikawa Hirono, Oka Koichiro
School of Arts and Letters, Meiji University.
Center for Emergency Preparedness & Response, National Institute of Infectious Diseases.
Nihon Koshu Eisei Zasshi. 2024 Jan 26;71(1):3-14. doi: 10.11236/jph.23-021. Epub 2023 Sep 5.
Objectives The Internet has made it possible to search for, obtain, transmit, and share information. Accordingly, the ability to use health information and skills related to interactivity taken from the Internet have become important in the medical and health fields. However, there is no scale to evaluate these abilities. Therefore, this study was conducted to assess the validity and reliability of the Digital Health Literacy Instrument (DHLI) and examine the association of digital health literacy (DHL) with the characteristics of the study participants.Methods The Japanese version of the DHLI was developed using the basic guidelines for scale translation. The participants included 2,000 Japanese adults (men: 50.0%, mean age: 40.7±12.0 years) who responded to an Internet-based cross-sectional survey. The Japanese version of the DHLI, attributes, sources of health information, contents of health information taken from the Internet, and eHealth Literacy Scale (eHEALS) scores were obtained using a questionnaire. Confirmatory factor analysis and correlation with eHEALS scores were used to assess construct and criterion validities. Cronbach's alpha and correlation coefficients were computed for internal consistency and test-retest reliability. Differences in DHLI scores for each attribute and variables related to health information were examined using the analysis of variance and t-test.Results Confirmatory factor analysis revealed a goodness-of-fit index of .946, a comparative fit index of .969, and a root mean square error of approximation of .054, confirming that the Japanese version has the same seven-factor structure as the original version does. A significant positive correlation was found between DHLI and eHEALS scores (r=.40, P<.001). Cronbach's alpha was .92, and test-retest reliability was r=.88 (P<.001). DHLI scores were mainly associated with household income, health status, frequency of information searches on the Internet, and devices used. The subscale scores found difficulties in evaluating reliability, determining relevance, and adding self-generated content. Differences in DHL were observed among some sources and contents of health information on the Internet.Conclusion The Japanese version of the DHLI was a sufficiently reliable and valid instrument for assessing DHL among Japanese adults. Our results suggest that low DHL may lead to health information disparities. Therefore, it is necessary to consider support strategies for individuals who need to improve their DHL and for skills that need to be strengthened.
目的 互联网使搜索、获取、传输和共享信息成为可能。因此，使用从互联网获取的健康信息及互动相关技能的能力在医疗卫生领域变得至关重要。然而，尚无评估这些能力的量表。因此，本研究旨在评估数字健康素养工具（DHLI）的有效性和可靠性，并探讨数字健康素养（DHL）与研究参与者特征之间的关联。
方法 使用量表翻译的基本指南开发了DHLI的日语版本。参与者包括2000名日本成年人（男性：50.0%，平均年龄：40.7±12.0岁），他们参与了一项基于互联网的横断面调查。通过问卷获取DHLI的日语版本、属性、健康信息来源、从互联网获取的健康信息内容以及电子健康素养量表（eHEALS）得分。采用验证性因子分析以及与eHEALS得分的相关性来评估结构效度和效标效度。计算Cronbach's α系数和相关系数以评估内部一致性和重测信度。使用方差分析和t检验检查每个属性的DHLI得分以及与健康信息相关变量的差异。
结果 验证性因子分析显示拟合优度指数为0.946，比较拟合指数为0.969，近似均方根误差为0.054，证实日语版本与原始版本具有相同的七因素结构。发现DHLI与eHEALS得分之间存在显著正相关（r = 0.40，P < 0.001）。Cronbach's α系数为0.92，重测信度为r = 0.88（P < 0.001）。DHLI得分主要与家庭收入、健康状况、互联网信息搜索频率和使用的设备相关。分量表得分在评估可靠性、确定相关性和添加自我生成内容方面存在困难。在互联网上一些健康信息的来源和内容中观察到DHL的差异。
结论 DHLI的日语版本是评估日本成年人DHL的一种足够可靠和有效的工具。我们的结果表明，低DHL可能导致健康信息差异。因此，有必要考虑针对需要提高其DHL的个人以及需要加强的技能的支持策略。
