Shin Sangyoon, Kim Seungyeon, Song Youngshin, Jeong Hyesun, Yu Yun Mi, Lee Euni
Research Institute of Pharmaceutical Sciences, Natural Products Research Institute, College of Pharmacy, Seoul National University, Seoul, Republic of Korea.
College of Pharmacy, Dankook University, Cheonan si, Chungnam, Republic of Korea.
J Med Internet Res. 2025 May 5;27:e62884. doi: 10.2196/62884.
Advancements in IT have transformed methods for accessing and conveying health-related information. While technical advancements offer more options for people to choose their preferred information sources, injudicious dissemination of incorrect or unverified health-related information by internet-based media poses a threat to society. The concepts of media health literacy (MeHlit) and eHealth literacy have emerged for assessing one's ability to understand and use health-related information from media sources. However, tools to evaluate the level of MeHlit within the domain of communication or follow a solid validation process are scarce.
This study aimed to develop a validated tool to evaluate the level of MeHlit in adults in South Korea.
A 2-step tool development process, including item development and validation processes, was carried out. At first, tool development studies were identified by a systematic review of the literature. A conceptual framework was established from the review by constructing an affinity diagram, and an item pool was generated. Face validation was conducted to assess whether the items measured MeHlit properly. Content validation was conducted to assess the overall relationship between domains by calculating the content validity index. Construct validation processes, including exploratory and confirmatory factor analyses, were completed with 1000 adults. Internal consistency of the Media Health Literacy Scale (MHLS) was assessed with Cronbach α. Concurrent validation was conducted to validate the MHLS's performance by comparing it with an established tool, the Korean version of the eHealth Literacy scale (K-eHEALS).
A total of 13 published studies from the systematic review was used to develop the conceptual framework and an item pool of 65 items was created, including 3 domains (access, critical evaluation, and communication) and 9 subdomains. Through face and content validation processes, the MHLS was refined to comprise 3 domains, 6 subdomains, and 29 items. A total of 1000 participants were recruited for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Five subdomains were identified through EFA, and CFA demonstrated a good model fit (chi-square [Cmin χ/df] under 2.659, root mean square error of approximation=0.058 [90% CI 0.053-0.062], comparative fit index=0.927, and standard root mean residual under 0.067). Following the EFA and CFA, Cronbach α scores of 0.915 and 0.932, respectively, were obtained, indicating that the tool had good reliability. A positive correlation was found between the MHLS and K-eHEALS from the concurrent validity evaluation, indicating that the MHLS can assess the target concept similarly as the K-eHEALS (Pearson correlation coefficient=0.736, P<.001).
The MHLS was developed and validated in a step-by-step process to assess individuals' ability to access, critically evaluate, and communicate health-related information through media platforms. This validated tool can serve in identifying deficiencies in specific MHLS areas and subsequently providing targeted education.
信息技术的进步改变了获取和传递健康相关信息的方式。虽然技术进步为人们提供了更多选择来挑选他们偏爱的信息来源，但基于互联网的媒体对不正确或未经证实的健康相关信息的不当传播对社会构成了威胁。媒体健康素养（MeHlit）和电子健康素养的概念已经出现，用于评估一个人理解和使用来自媒体来源的健康相关信息的能力。然而，在传播领域评估MeHlit水平或遵循坚实验证过程的工具却很稀缺。
本研究旨在开发一种经过验证的工具，以评估韩国成年人的MeHlit水平。
进行了一个两步工具开发过程，包括项目开发和验证过程。首先，通过对文献的系统回顾来确定工具开发研究。通过构建亲和图从回顾中建立一个概念框架，并生成一个项目池。进行表面效度评估以确定这些项目是否恰当地测量了MeHlit。通过计算内容效度指数进行内容效度评估，以评估各领域之间的整体关系。对1000名成年人完成了包括探索性和验证性因素分析在内的结构效度过程。使用Cronbach α评估媒体健康素养量表（MHLS）的内部一致性。通过将MHLS与一个既定工具——韩国版电子健康素养量表（K-eHEALS）进行比较来进行同时效度验证，以验证MHLS的性能。
系统回顾中总共13项已发表的研究被用于开发概念框架，并创建了一个包含65个条目的项目池，包括3个领域（获取、批判性评估和传播）和9个子领域。通过表面效度和内容效度过程，MHLS被提炼为包括3个领域、6个子领域和29个条目。总共招募了1000名参与者进行探索性因素分析（EFA）和验证性因素分析（CFA）。通过EFA确定了5个子领域，CFA显示出良好的模型拟合（卡方[Cmin χ/df]低于2.659，近似均方根误差=0.058[90%CI 0.053 - 0.062]，比较拟合指数=0.927，标准根均残差低于0.067）。在EFA和CFA之后，分别获得了Cronbach α分数0.915和0.932，表明该工具具有良好的信度。同时效度评估中发现MHLS与K-eHEALS之间存在正相关，表明MHLS能够与K-eHEALS类似地评估目标概念（Pearson相关系数=0.736，P<0.001）。
MHLS是通过一个逐步的过程开发和验证的，以评估个人通过媒体平台获取、批判性评估和传播健康相关信息的能力。这个经过验证的工具可用于识别特定MHLS领域的不足，并随后提供有针对性的教育。
