Development and validation of an e-health literacy scale for pregnant women

Existing e-health literacy assessment tools fail to accurately assess the e-health literacy status of pregnant women. We aimed to develop an e-health literacy scale for pregnant women, and evaluate its psychometric properties.

The scale may provide a scientific tool for evaluating the e-health literacy of pregnant women and developing targeted intervention plans. The initial constructs and items of the scale were developed through a literature review, qualitative analysis, and Delphi expert consultation based on the e-health literacy interactive model. Item analysis used a sample (n=220) of pregnant women in China to develop the formal scale. Additional participants (n=230) completed a survey to assess the internal consistency and test-retest reliability, and the content, construct, convergence and discrimination validity, of the scale.

The e-health literacy scale for pregnant women consisted of 22 items, and four dimensions including e-health information acquisition ability, e-health information evaluation ability, e-health information interaction ability, and e-health information application ability. The Cronbach's alpha coefficient was 0.937, test-retest reliability was 0.772, and the content validity index was 0.962. The cumulative variance contribution rate of the four common factors was 64.159%, the Kendall harmony coefficients were 0.386 and 0.439 (P<0.001), and the confirmatory factor analysis model had acceptable goodness-of-fit indices [χ²/df =2.250, root mean squared error of approximation (RMSEA) =0.075]. The average variance extracted (AVE) of each dimension were all above 0.500, and the composite reliability (CR) were all >0.700.

The e-health literacy scale for pregnant women showed satisfactory psychometric properties and practice implications.