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Cited by 2,680Health Literacy and Information AccessibilityTechnology Use by Older AdultsICT in Developing Communities

eHEALS: The eHealth Literacy Scale

Open access
Norman, Cameron D, Skinner, Harvey A·2006·Journal of Medical Internet Research
DOI 10.2196/jmir.8.4.e27PMC PMC1794004
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Abstract

BACKGROUND: Electronic health resources are helpful only when people are able to use them, yet there remain few tools available to assess consumers' capacity for engaging in eHealth. Over 40% of US and Canadian adults have low basic literacy levels, suggesting that eHealth resources are likely to be inaccessible to large segments of the population. Using information technology for health requires eHealth literacy-the ability to read, use computers, search for information, understand health information, and put it into context. The eHealth Literacy Scale (eHEALS) was designed (1) to assess consumers' perceived skills at using information technology for health and (2) to aid in determining the fit between eHealth programs and consumers. OBJECTIVES: The eHEALS is an 8-item measure of eHealth literacy developed to measure consumers' combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. The objective of the study was to psychometrically evaluate the properties of the eHEALS within a population context. A youth population was chosen as the focus for the initial development primarily because they have high levels of eHealth use and familiarity with information technology tools. METHODS: Data were collected at baseline, post-intervention, and 3- and 6-month follow-up using control group data as part of a single session, randomized intervention trial evaluating Web-based eHealth programs. Scale reliability was tested using item analysis for internal consistency (coefficient alpha) and test-retest reliability estimates. Principal components factor analysis was used to determine the theoretical fit of the measures with the data. RESULTS: A total of 664 participants (370 boys; 294 girls) aged 13 to 21 (mean = 14.95; SD = 1.24) completed the eHEALS at four time points over 6 months. Item analysis was performed on the 8-item scale at baseline, producing a tight fitting scale with alpha = .88. Item-scale correlations ranged from r = .51 to .76. Test-retest reliability showed modest stability over time from baseline to 6-month follow-up (r = .68 to .40). Principal components analysis produced a single factor solution (56% of variance). Factor loadings ranged from .60 to .84 among the 8 items. CONCLUSIONS: The eHEALS reliably and consistently captures the eHealth literacy concept in repeated administrations, showing promise as tool for assessing consumer comfort and skill in using information technology for health. Within a clinical environment, the eHEALS has the potential to serve as a means of identifying those who may or may not benefit from referrals to an eHealth intervention or resource. Further research needs to examine the applicability of the eHEALS to other populations and settings while exploring the relationship between eHealth literacy and health care outcomes.

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  1. [8]Institute of Medicine Health literacy: a prescription to end confusion 2004 2006 Nov 11 Washington, DC The National Academies Press http://www.iom.edu/?id=19750 25009856
  2. [18]Eysenbach G Jadad AR Consumer health informatics in the Internet age. In: Edwards A, Elwyn G, editors. Evidence-based patient choice: inevitable or impossible 2001 Oxford, UK Oxford University Press 289 307

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Authors
Norman, C. D., & Skinner, H. A.
Affiliations
  • University of Toronto (CA)
  • York University (CA)
Corresponding author
Norman, Cameron D
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2006-11-14
Volume
8
Issue
4
Pages
e27
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.8.4.e27
PMC
PMC1794004
OpenAlex
W1967390644
Cited by
2,680
References
16
Citations by year
2026: 443 · 2025: 402 · 2024: 329 · 2023: 293 · 2022: 273 · 2021: 209 · 2020: 178 · 2019: 123 · 2018: 97 · 2017: 79 · 2016: 57 · 2015: 58 · 2014: 37 · 2013: 19 · 2012: 29
FWCI
12.87
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • TSpace (University of Toronto) (submittedVersion, cc-by)
Funders
  • Health Canada
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Social Sciences › Demography › Technology Use by Older Adults
  • Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords
digital health literacy, eHealth Literacy Scale, scale development, psychometric properties, youth, adolescents, health information seeking, perceived skills, test-retest reliability, internal consistency, factor structure, low-literacy populations, health information application
MeSH terms
Adolescent, Adult, Canada, Computer Literacy, Consumer Behavior, Factor Analysis, Statistical, Female, Health Education, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Male, Pilot Projects, Psychometrics, Surveys and Questionnaires, Reproducibility of Results, Adolescent Health Services, Information Dissemination

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