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Transactional eHealth Literacy: Developing and Testing a Multi-Dimensional Instrument.

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This study introduces a new tool to measure four types of eHealth literacy: functional, communicative, critical, and translational. This instrument is vital for understanding how people interact with digital health tools.

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Area of Science:

  • Health Informatics
  • Digital Health
  • Patient Engagement

Background:

  • Existing measures of eHealth literacy often overlook the social aspects of digital health interactions.
  • The Transactional Model of eHealth Literacy (TMeHL) provides a theoretical framework for understanding these social affordances.
  • There is a need for a psychometrically sound instrument to assess multi-dimensional eHealth literacy.

Purpose of the Study:

  • To describe the psychometric testing of a new multi-dimensional instrument designed to measure functional, communicative, critical, and translational eHealth literacies.
  • To validate the instrument based on the Transactional Model of eHealth Literacy (TMeHL).
  • To provide researchers and healthcare providers with a reliable tool for assessing eHealth literacy.

Main Methods:

  • A 3-phase rating scale construction process involving eHealth experts and end-users.
  • Expert review and end-user think-aloud interviews for item refinement.
  • Field testing with 283 patients, followed by factor analyses, Rasch procedures, and correlational analyses for validity and reliability.

Main Results:

  • The instrument reliably measures four distinct factors: functional (4 items), communicative (5 items), critical (5 items), and translational (4 items) eHealth literacies.
  • Reliability coefficients (ω) ranged from .92 to .96, indicating high internal consistency.
  • Correlations between factors (r = .44–.64) provided evidence for external validity.

Conclusions:

  • The developed instrument is a theory-driven tool for measuring key dimensions of eHealth literacy.
  • It addresses the social affordances of the eHealth experience, offering a more comprehensive assessment.
  • Researchers and providers can utilize this validated instrument to evaluate and enhance patient engagement with digital health technologies.