Fiona Chew*, Syracuse University, Syracuse, United States Zhuqing Cheng, Syracuse University, Syracuse, United States William D Grant, Upstate Medical University, Syracuse, United States Carlos Enrique Caicedo, Syracuse University, Syracuse, United States Track: Research Presentation Topic: Public (e-)health, population health technologies, surveillance Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2014-10-13

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Background
Previous research reported that 12% of US adults have proficient health literacy and 14% have below basic health literacy. Low health literacy is associated with poorer health outcomes, lower compliance with health therapies, more frequent visits to emergency rooms and hospitalizations and a higher risk of mortality. Recent data indicated that 6 out of 10 US adults look for health information online, more than from any other media or interpersonal sources including physicians. The increased use of online searches for health and medical information has the potential to promote health and health care. However, access to health information does not mean that health information seekers fully benefit from their online searches or that they have the capacity to use information technology to obtain, process, understand and act on basic health information and services needed to make appropriate health decisions, in other words, possess e-health literacy. This set of skills can potentially enhance health decision making and health care.

Objective
We propose to develop and assess a new measure of e-health literacy profiling its prevalence in a sample of US adults.

Methods
We developed a new scale of e-health literacy based on six components proposed in eHEALS, a 2006 unidimensional e-literacy measure developed and tested on adolescent subjects and whose validity has been questioned. Our scale comprised validated literacy component measures and included the following: NVS or the Newest Vital Sign health and basic literacy measure; science literacy from US science and engineering indicators; and media, computer and information literacy measures drawn from the communication, computer and information studies disciplines. These measures were aggregated as a composite e-health literacy scale. We identified and transformed the attained threshold levels of each of the literacy component measures as binary variables and summed them. Data came from 510 US adults quota sampled to represent the US population who were surveyed online in June 2014. We used factor analysis to assess the e-health literacy construct and also ran correlations between this measure and health status, age and education.

Results
Our construct had a three-factor solution accounting for 70% of the variance. The factors comprised 1) health/basic and science literacies (information appraisal), 2) information and computer literacies (information seeking) and 3) media literacy (critical skills). Low construct reliability reflected multidimensionality which was consistent with the separate literacy components. The new measure correlated positively and significantly with health status, demonstrating predictive validity. It correlated negatively with age and positively with education. Results were consistent with previous research on health literacy. Overall, nearly 8% of the sample had e-health literacy.

Conclusion
The new e-health literacy shows promise and validity as it is derived from validated literacy component measures drawn from various disciplines. The three-factor solution partially reinforced other e-health literacy research which identified information appraisal and information seeking dimensions. This is the first time that e-health literacy prevalence among US adults has been reported and the scale may be used to assess interventions in online health information seeking strategies.