Reliability and Validity of the Korean Version of the Digital Health Literacy Instrument

Area of Science:

• Health Informatics
• Psychometrics
• Public Health

Background:

• Digital transformation necessitates enhanced digital health literacy (DHL) for navigating online health resources.
• Existing international Digital Health Literacy Instruments (DHLI) lack a validated Korean version for all adult age groups.

Purpose of the Study:

• To develop and validate a Korean version of the Digital Health Literacy Instrument (K-DHLI).
• To assess the reliability and validity of the K-DHLI for broad application among Korean adults.

Main Methods:

• Translation, cultural adaptation, and expert review of the DHLI following WHO guidelines.
• A nationwide web survey of 524 adults (19-69 years) and a follow-up survey of 134 participants for test-retest reliability.
• Confirmatory factor analysis (CFA) to establish construct validity, alongside assessments of internal consistency, convergent, discriminant, and hypothesis-testing validity.

Main Results:

• The K-DHLI demonstrated excellent psychometric properties with high internal consistency (α = 0.91) and acceptable test-retest reliability (ICC = 0.70).
• A 7-factor model showed superior fit (CFI = 0.966, RMSEA = 0.047) compared to a 5-factor model.
• Convergent, discriminant, and hypothesis-testing validity were confirmed through correlations with age, health status, and eHealth literacy.

Conclusions:

• The K-DHLI is a reliable and valid instrument for assessing digital health literacy in the Korean population.
• The 7-factor structure is optimal, supporting the K-DHLI's applicability across diverse adult groups in Korea.
• The K-DHLI can be utilized in national surveys, clinical screening, and research to identify individuals with limited DHL, thereby reducing health disparities.