Construct Validity of the eHealth Literacy Scale (eHEALS) Among Two Adult Populations: A Rasch Analysis

Jennifer Nguyen, Michael Moorhouse, Barbara Curbow, Juliette Christie, Kim Walsh-Childers, Sabrina Islam, Jennifer Nguyen, Michael Moorhouse, Barbara Curbow, Juliette Christie, Kim Walsh-Childers, Sabrina Islam

Abstract

Background: The Internet has become a ubiquitous venue for information seeking, especially for health information. Public health practitioners have noticed the promise and potential of the Internet, however, little is known about individuals' skills of their eHealth literacy. The eHealth Literacy Scale, eHEALS, was designed to measure perceptions of individuals' eHealth literacy skills.

Objective: The objective of the study was to examine the psychometric validity and reliability of the eHEALS with two adult populations using the Rasch Model.

Methods: A college-aged sample and an Internet-based sample (Amazon's MTurk) were recruited to complete the eHEALS, demographic questions, and a health literacy scale. Using WINSTEPS and SPSS, unidimensionality, item fit, rating scale, item hierarchy, person ability-item match, and reliability were analyzed, compared, and contrasted against each sample and to other samples found in the literature.

Results: An exploratory factor analysis supported unidimensionality in both samples. More than 90% of respondents from both samples fit the model. No items were outright misfitting. Both samples separated into three distinct groups.

Conclusions: Based on the results, the eHEALS is a reliable and consistent measurement tool for a college sample and an Internet-based sample. As these individuals are most likely to use the Internet as a health resource, it is necessary to learn and know their skills versus perceiving that they can critically and successfully navigate the Internet. Further analyses are necessary to ensure that the eHEALS can serve as a standard eHealth literacy measure for public health.

Keywords: eHEALS; eHealth; internet; measurement; public health; rasch.

Figures

Figure 1
Figure 1
Person ability item-difficulty match of the college sample. Persons are on the left of the line, whereas the item difficulty map is to the right of the line. Each “O” represents 1-2 individuals, whereas each “X” represents 3 persons.
Figure 2
Figure 2
Person ability of the MTurk sample is on the left side, whereas item difficulty is on the right side. Each “O” represents 1-2 individuals, whereas each “X” represents 3 persons.
Figure 3
Figure 3
The person and item map after the rating scale was collapsed. Person ability is on the left side, whereas item difficulty is on the right side. Each “O” represents 1-2 individuals and each “X” is equal to 3 persons.

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