JMIR Publications

ABSTRACT

Background:

eHealth literacy describes the ability to locate, comprehend, evaluate, and apply online health information to a health problem. In studies of eHealth literacy, researchers have primarily assessed participant’s perceived eHealth literacy using a short self-report instrument, for which ample research has shown has little to no association with actual performed eHealth-related skills. Performance-based measures of eHealth literacy may be more effective at assessing actual eHealth skills, yet such measures appear to be scarcer in the literature.

Objective:

The primary purpose of this study was to identify tools that currently exist to measure eHealth literacy based on objective performance. A secondary purpose of this study was to characterize the prevalence of performance-based measurement of eHealth literacy in the literature, as compared to subjective measurement.

Methods:

We conducted a systematic scoping review of the literature in three stages: Conducting the search, screening articles, and extracting data into a summary table. The summary table includes terminology for eHealth literacy, description of participants, instrument design, health topics used, and a brief note on evidence of validity for each performance-based measurement tool. A total of 1444 unique articles retrieved from six relevant databases (MEDLINE, PsycINFO, CINAHL, LISA, LISTA, ERIC) were considered for inclusion, 313 of which included a measure of eHealth literacy.

Results:

We identified 33 articles that reported on 29 unique performance-based eHealth literacy measurement tools. The types of tools ranged from having participants answer health-related questions using the internet, to having participants engage in simulated internet tasks, to having participants evaluate website quality, to quizzing participants on their knowledge of health and the online health information-seeking process. We additionally identified 280 articles that measured eHealth literacy using only a self-rating tool, representing 89.5% of our sample of the literature.

Conclusions:

This study is the first research synthesis looking specifically at performance-based measures of eHealth literacy, and may direct researchers towards existing performance-based measurement tools to be applied in future projects. We discuss some of the key benefits and drawbacks of different approaches to performance-based measurement of eHealth literacy. Researchers with an interest in gauging participants’ actual eHealth literacy (as opposed to perceived eHealth literacy) should make efforts to incorporate tools such as those identified in this systematic scoping review.