Development and initial validation of the digital health equity questionnaire for rural older adults

To develop a digital health equity questionnaire for rural elderly and test its reliability and validity.

The initial questionnaire items were based on the social ecological model. They were identified by systematically reviewing the literature and conducting semi-structured interviews. Delphi expert consultation was used to screen and revise the items, resulting in a pre-test questionnaire for digital health equity among rural older adults. A total of 206 rural older adults were selected to complete item analysis and exploratory factor analysis on the pre-test questionnaire. Another group of 227 rural older adults were selected to evaluate the reliability and validity of the formal questionnaire.

The developed Digital Health Equity Questionnaire for rural older adults includes five dimensions: individual level, interpersonal level, organizational level, community level, and policy level, with a total of 31 items. Exploratory factor analysis extracted 5 common factors, with a cumulative variance contribution of 75.120%. The results of the confirmatory factor analysis indicate that the overall fit of the constructed model is good: χ2/df = 2.19, TLI = 0.916, IFI = 0.903, CFI = 0.912, RMSEA = 0.064. The overall Cronbach's α coefficient of the questionnaire is 0.903, the split-half reliability is 0.879, and the test-retest reliability after a two-week interval is 0.857.

The Digital Health Equity Questionnaire for rural older adults has good reliability and validity and can be used as a standardized tool for the preliminary assessment of digital health equity among rural older adults.