Validating the eHealth Literacy Scale in Rural Adolescents

Area of Science:

• Health Informatics
• Adolescent Health
• Educational Psychology

Background:

• The 3-factor eHealth Literacy Scale (eHEALS) model has demonstrated validity across diverse age groups.
• Evaluating eHEALS in rural adolescent populations is a crucial next step for understanding their digital health literacy.
• Previous research supports the eHEALS model's properties in millennials, adults, and older adults.

Purpose of the Study:

• To assess the reproducibility of the 3-factor eHealth Literacy Assessment Scale (eHEALS) model in a rural adolescent sample.
• To evaluate the 3-factor eHEALS model proposed by Paige and associates using seventh-grade students.
• To determine if the eHEALS model is a suitable instrument for measuring eHealth literacy in young, rural populations.

Main Methods:

• A cross-sectional study involving 137 seventh-grade students from 3 school districts in Appalachian Kentucky.
• Confirmatory factor analysis (CFA) was employed to evaluate the 3-factor eHEALS model.
• The 1-sample bootstrap algorithm was used to estimate associations between eHEALS scores and health/technology variables.

Main Results:

• Confirmatory factor analysis confirmed high and significant loadings for the 3 eHEALS factors: information awareness, information seeking, and information engagement (all ≥0.63).
• The model demonstrated good fit indices (RMSEA = 0.07, SRMR = 0.03, CFI = 0.99), comparable to previous findings.
• Higher technology access correlated with increased information seeking (r = 0.31) and engagement (r = 0.23); no significant differences were found based on rurality or gender.

Conclusions:

• The 3-factor eHealth Literacy Assessment Scale (eHEALS) is a reliable and valid instrument for assessing eHealth literacy in rural seventh graders.
• Findings support the use of eHEALS in diverse adolescent populations, including those in rural settings.
• The study validates the eHEALS model's applicability for understanding how rural adolescents engage with digital health information.