Development of a digital health competency scale for public health nurses

This study developed and psychometrically validated a new instrument - the Digital Health Competency Scale for Public Health Nurses (hereafter, DHCP) - to assess digital health competencies among public health nurses working in administrative agencies.

DHCP was developed based on a literature review and expert interviews with four public health nurses (PHNs) and three researchers. A cross-sectional national survey was conducted with 1810 PHNs from stratified, randomly selected municipalities across Japan. Exploratory factor analysis (EFA) was used to identify the initial structure of DHCP, followed by confirmatory factor analysis (CFA) to assess construct validity. Internal consistency was calculated using Cronbach's alpha and criterion-related validity was examined by correlating DHCP scores with the eHealth Literacy Scale (eHEALS).

In total, 521 valid responses were obtained. The EFA applied an initial version of the scale with 28 items. The analysis identified a 12-item scale with a three-factor structure (motivation for digitalization, ethical-social assessment, and technical skills). The CFA supported the three-factor structure for DHCP, demonstrating a good model fit (GFI = 0.949, AGFI = 0.922, CFI = 0.960, RMSEA = 0.067). The Cronbach's alpha for the scale was 0.869. The total DHCP score was positively correlated with eHEALS (r = 0.444, 95 % confidence interval 0.372-0.511, p < 0.001), supporting criterion-related validity.

DHCP is a novel instrument with good psychometric properties for assessing digital health competencies among PHNs. It has the potential to support digitalization efforts within municipal public health services.