eHealth Literacy Instruments: Systematic Review of Measurement Properties

Area of Science:

• Digital Health
• Health Informatics
• Psychometrics

Background:

• The internet is a primary source of health information, making eHealth literacy essential for digital healthcare.
• Health professionals must consider consumer eHealth literacy when using digital health technologies.

Purpose of the Study:

• To identify and evaluate the measurement properties of existing eHealth literacy instruments.
• To provide evidence for researchers and clinicians selecting appropriate instruments.

Main Methods:

• A systematic review and meta-analysis of self-reported eHealth literacy instruments.
• Application of the updated COSMIN methodology for evaluating measurement properties.

Main Results:

• Seven instruments were identified across 41 articles and 57 psychometric studies.
• No single instrument demonstrated evidence for all measurement properties.
• The eHealth Literacy Scale (eHEALS) is widely used but shows varied factor structures; the Transactional eHealth Literacy Instrument (TeHLI) has limited evidence for content validity but good structural validity.

Conclusions:

• The eHealth Literacy Scale (eHEALS) requires content updates to reflect current digital health advancements.
• The Transactional eHealth Literacy Instrument (TeHLI) needs improved content validity and further psychometric evaluation.