A 3-Item Measure of Digital Health Care Literacy: Development and Validation Study

With increased reliance on digital health care, including telehealth, efficient and effective ways are needed to assess patients' comfort and confidence with using these services.

The goal of this study was to develop and validate a brief scale that assesses digital health care literacy.

We first developed an item pool using existing literature and expert review. We then administered the items to participants as part of a larger study. Participants were caregivers of children receiving care at a pediatric clinic who completed a survey either on the web or over the telephone. We randomized participants into development and confirmatory samples, stratifying by language so that exploratory factor analysis and confirmatory factor analysis could be performed with separate samples of participants. We assessed the scale's validity by examining its associations with participants' demographics, digital access, and prior digital health care use.

Participants (N=508) were, on average, aged 34.7 (SD 7.7) years, and 89.4% (454/508) were women. Of the 508 participants, 280 (55.1%) preferred English as their primary language, 157 (30.9%) preferred Spanish, and 71 (14%) preferred Arabic; 228 (45%) had a high school degree or less; and 230 (45.3%) had an annual household income of

Despite the potential for digital health care to improve quality of life and clinical outcomes, many individuals may not have the skills to engage with and benefit from it. Moreover, these individuals may be those who already experience worse outcomes. A screening tool such as the Digital Health Care Literacy Scale could be a useful resource to identify patients who require additional assistance to use digital health services and help ensure health equity.