Accepted for/Published in: JMIR Human Factors
Date Submitted: Jan 1, 2026
Date Accepted: Jun 23, 2026
Development and Psychometric Validation of the Japanese Health Information Technology Usability Evaluation Scale (Health-ITUES) for STI-Related Chatbots
ABSTRACT
Background:
The rapid expansion of mobile technology has accelerated the integration of health applications and conversational artificial intelligence into clinical and public health practices. To ensure these tools are effective and sustainable, usability evaluations and early user engagement during development are essential The Health Information Technology Usability Evaluation Scale (Health-ITUES) is a validated flexible usability assessment instrument that is available in multiple languages and applicable across diverse contexts. However, a Japanese version of this scale has yet to be developed.
Objective:
This study aimed to translate the Health-ITUES into Japanese, evaluate its validity, and contribute to the usability assessment of mobile health (mHealth tools), which are expected to expand across diverse contexts.
Methods:
We developed a Japanese version of the Health-ITUES using a chatbot under development as a consultation tool for young women regarding sexually transmitted infections (STIs). First, the original scale was customized to reflect the chatbot’s specific purpose and intended usage context. Following established translation guidelines, we conducted forward translation from English to Japanese, back-translation, expert review, and reconciliation. We then evaluated the reliability and validity of the Japanese version in 301 young women.
Results:
The Japanese version of Health-ITUES demonstrated high internal consistency (Cronbach’s α=0.85–0.98). Confirmatory factor analysis supported acceptable construct validity (RMSEA=0.10, CFI > 0.90). Additionally, the Health-ITUES scores showed strong correlations with satisfaction and usage intention for the tool (r=0.779 and 0.797, respectively).
Conclusions:
The Japanese version of the Health-ITUES demonstrated sufficient reliability and validity in a hypothetical STI concern scenario among young women. Given that the Health-ITUES has previously been validated in Human immunodeficiency virus (HIV) patients, dysmenorrhea management, and home healthcare, it is promising as a widely applicable usability assessment tool for mHealth technologies across health conditions.
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