JMIR Publications

ABSTRACT

Background:

The rapid evolution of digital health technologies, particularly within the Web 3.0 framework, has underscored eHealth literacy (eHL) as a critical competency for patients engaging with digital healthcare platforms. Patients in sustained hospital stays, often in vulnerable conditions, face unique challenges in utilizing eHealth tools effectively. However, existing eHL assessment tools are insufficient to address the intricate and dynamic demands of contemporary healthcare systems, especially for individuals under continuous hospital care.

Objective:

This study aimed to develop the Adult Inpatient eHealth Literacy Scale (AIPeHLS), a comprehensive, multidimensional tool grounded in the Lily Model, to evaluate eHL among adult inpatients within the context of digital healthcare innovations.

Methods:

The development of the AIPeHLS followed a systematic, multi-phase process. Initial item generation was informed by an extensive literature review and expert consultations using the Delphi method, resulting in a preliminary set of 53 items spanning six dimensions of the Lily Model. The scale was refined through a pilot survey among 100 individuals requiring inpatient care, followed by item analysis and exploratory factor analysis (EFA). Validation was achieved via a cross-sectional study with 532 participants, employing confirmatory factor analysis (CFA) to verify the scale structure, alongside evaluations of convergent, discriminant, criterion-related, and content validity. Reliability was assessed using Cronbach's α and split-half reliability.

Results:

The finalized AIPeHLS comprised 44 items across six dimensions: traditional literacy, information literacy, media literacy, health literacy, computer literacy, and scientific literacy, reflecting the skills necessary in the Web 3.0 context. Both EFA and CFA confirmed the six-factor structure, demonstrating excellent model fit indices (χ²/df = 2.226, RMSEA = 0.048, CFI = 0.957, NFI = 0.925, and IFI = 0.957). The scale exhibited robust content validity, convergent and discriminant validity, criterion-related validity, and high internal consistency, with a Cronbach's α of 0.965 and a split-half reliability of 0.791 for the entire scale.

Conclusions:

The 44-item AIPeHLS The AIPeHLS was found to be a reliable and valid instrument for assessing eHL in adult inpatients in the evolving Web 3.0 context. Its comprehensive framework and strong psychometric properties make it an effective tool for healthcare providers to understand patients' digital health competencies and tailor interventions accordingly. For researchers, our findings provided opportunities to explore the relationship between eHL and health outcomes, while offering valuable insights into the development of more effective eHealth interventions and policies.