eHEALS: The eHealth Literacy Scale

By Cameron D. Norman, H. Skinner. Journal of Medical Internet Research, 2006

2,295 citations recorded by the source corpus.

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 α = .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.

Subfields: Applied Psychology, General Health Professions

View Paper: https://www.semanticscholar.org/paper/7d801f6f873cd69d98065a5891821d28ee6593a4

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Citations in the corpus

The Digital Divide Among Low-Income Homebound Older Adults: Internet Use Patterns, eHealth Literacy, and Attitudes Toward Computer/Internet Use (2013, background): “eHealth literacy is “the ability to seek, find, understand and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem” and is composed of basic literacy, health literacy, scientific literacy, media literacy, and computer literacy [33]”
Measurement of Digital Literacy Among Older Adults: Systematic Review (2020, background): “84 (range among items) [55] 8 5-point Likert questions Self-administered O O X O O eHealth Literacy Scale (eHEALS)”
eHealth Literacy: Extending the Digital Divide to the Realm of Health Information (2012, methodology): “To further address this divide, Norman and Skinner developed an eHealth literacy scale (eHEALS) to measure eHealth literacy [27], using a sample of Canadian adolescents.”
Predictors of eHealth Usage: Insights on The Digital Divide From the Health Information National Trends Survey 2012 (2014, background): “Research is emerging that advocates matching eHealth technology to the eHealth literacy (defined as “the ability to seek, find, understand, and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem”) of the intended user [50-52].”
Public Health and Online Misinformation: Challenges and Recommendations. (2019, background): “it comes to persuasion and the correction of misinformation, perceived trustworthiness is more information has long been a growing topic of concern.”
Development of the Digital Health Literacy Instrument: Measuring a Broad Spectrum of Health 1.0 and Health 2.0 Skills (2017, methodology): “Studies on its validation have shown that it measures 1 overall concept [17,18], or 2 separate concepts: seeking and appraising online information [19,20].”
Inequities in Health Care Services Caused by the Adoption of Digital Health Technologies: Scoping Review (2021, background): “…find, understand, and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem” [70]), including a lack of awareness of digital health services, literacy, and skills, as well as the understanding of the operation mode and…”
eHealth Literacy and Web 2.0 Health Information Seeking Behaviors Among Baby Boomers and Older Adults (2015, positive): “The eHEALS determines consumers’combined knowledge, confidence, and perceived skills finding, evaluating, and applying electronic health information to health problems [54].”
Digital literacy as a new determinant of health: A scoping review (2023, methodology): “eHealth Literacy Scale [eHEALS] [43] [1] traditional literacy; [2] computer literacy; [3] information literacy; [4] health literacy; [5] media literacy; [6] science literacy Self-rated, Likert scale Chinese, English, Japanese, Korean, Vietnamese [14–16– 18,28,35,52,55– 61,65,66,70–74]”