JMIR Publications

ABSTRACT

Background:

The integration and fusion of digital technology in elderly health and eldercare has enhanced the intelligence level of health and eldercare products and services while altering how seniors acquire and disseminate health information. Assessing the digital health literacy (DHL) of the older people is crucial for formulating targeted interventions.

Objective:

This study developed a DHL assessment questionnaire for older adults. It evaluated the scientific validity and feasibility of the questionnaire among community-dwelling older adults in China to provide a scientific tool for assessing the level of DHL among older adults.

Methods:

The literature review, focus group discussion method, and Delphi method were used for questionnaire item pool construction and item screening. The questionnaire items were analyzed by item analysis for comprehensive judgment, and the questionnaire validity was analyzed by construct validity (exploratory factor analysis, confirmatory Factor Analysis, convergent and discriminant Validity), content validity, and criterion-related Validity. Questionnaire reliability was analyzed through Cronbach's alpha coefficient, split-half reliability, and test-retest reliability.

Results:

Item Analysis showed that in the extreme group comparisons, all items showed statistically significant differences between the high and low score groups (P<0.01). The correlation coefficient analysis showed that the correlation coefficients between the items and the total score ranged from 0.497 to 0.920 (P<0.01). A total of six common factors were extracted after multiple exploratory factor analysis with a cumulative variance contribution rate of 73.745%. Confirmatory factor analysis showed a good fit of the questionnaire (χ2/df=2. 803，RMSEA= 0.071，CFI= 0.907，GFI= 0.773，IFI= 0.908，TLI= 0.901，NFI= 0.863). The factor loadings of the 39 items corresponding to the 6 dimensions ranged from 0.538 to 0.931. The average variance extracted (AVE) for each dimension ranged from 0.608 to 0.768, demonstrating excellent convergent validity of the questionnaire. All dimensions of the questionnaire were significantly correlated with each other, with correlation coefficients ranging from 0.363 to 0.804 (P < 0.001), demonstrating ideal discriminant validity. The I-CVI of this questionnaire ranged from 0.81 to 1.000, and S-CVI/Ave = 0.92. Questionnaire for the older adults were positively correlated with the total score and the dimension scores of the eHEALS (P<0.01). The total questionnaire’s Cronbach’s α coefficient is 0.976, and each dimension’s Cronbach’s α coefficients ranged from 0.819 to 0.952.

Conclusions:

In our study, a questionnaire dedicated to assessing DHL in older adults was developed, with a scientific and rational development process and good psychometric properties of the questionnaire. Our questionnaire can be used to identify the current status of DHL in older adults and provide a scientific and feasible evaluation tool for assessing the current status of DHL in older adults in the future and providing personalized interventions. Clinical Trial: The study was approved by the Ethics Committee of Renji Hospital, affiliated with Shanghai Jiao Tong University School of Medicine (RA-2021-465).