Alexander Van Deursen, University of Twente, Enschede, Netherlands Rosalie Van Der Vaart*, University of Twente, Enschede, Netherlands Constance Drosseart, University of Twente, Enschede, Netherlands Jan Van Dijk, University of Twente, Enschede, Netherlands Erik Taal, University of Twente, Enschede, Netherlands Mart Van De Laar, University of Twente, Enschede, Netherlands Track: Research Presentation Topic: Usability and human factors on the web Presentation Type: Poster presentation Submission Type: Single Presentation Building: MECC Room: Trajectum Last modified: 2010-07-08

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Background: With the increased diffusion of the internet among households, large amounts of health information have become widely available to the public. Although it is assumed that this improves patient empowerment, it has also been argued that not everyone can benefit from the internet equally, for not everyone has enough skills to use the internet. This might result in a reinforcement of already existing differences in health knowledge and access to care. Insight in the differences in people’s ability to use information technology, also called e-health literacy, could enhance tailoring of health information to narrow existing differences.

Objective: Norman and Skinner (2006) developed the eHealth Literacy Scale (eHEALS), which proved a reliable and easy to use 8-item self-report scale, to measure these skills. However, up until now, this instrument is only available in English and there are no data on its validity. The aim of the present studies was to assess the reliability and the validity of the eHEALS among a Dutch population.

Methods: The items were translated into Dutch according to WHO guidelines. In study 1, the scale was examined on a sample of rheumatic patients (n = 189). Internal consistency was determined with Cronbach-alpha coefficients and factor analysis. Criterion validity was determined by studying correlations with current internet usage and with age and education. In study 2 the scale was studied among a stratified population sample (n = 89). The predictive value of the instrument was assessed by comparing self-administered scores on the eHEALS with an actual performance test. This test consisted of 9 assignments, measuring various different internet skills (including operational, formal, informational and strategic skills). The scores on the eHEALS were related to the total number of successfully completed tasks and to the total time needed to complete the tasks.

Results: The internal consistency of the scale was alpha = .93 in study 1 and alpha = .92 in study 2. In both studies all items loaded on one single factor. The mean sum score of the scale was 28.0 (SD 5.9) in the study among patients and 27.6 (SD 5.9) in the study among the population sample. In both studies a significant, though weak, correlation was found between the eHEALS and quantity of internet use, respectively (.19, p < .01) and (.18, p < .05). Correlations with age and education were not significant. The correlation between the eHEALS and actual performance amounted .23 (p < .05) for successfully completed tasks, and -.30 (p < .05) for time needed to complete the tasks.

Conclusions: Results show that the eHEALS is unidimensional and that the internal consistency of the scale is high, which makes the reliability adequate. However, findings suggest that the validity of the eHEALS is rather questionable, since expected relationships with age and education were not found and because the relation with actual performance was low. This would suggest that the eHEALS does not provide a valid picture of the actual skills people possess. More research is needed in order to propose a comparable self-report instrument with high correlations with people’s actual e-health literacy skills.