Measuring Digital Health Literacy in Older Adults: Development and Validation Study

BackgroundNew health care services such as smart health care and digital therapeutics have greatly expanded. To effectively use these services, digital health literacy skills, involving the use of digital devices to explore and understand health information, are important. Ol...

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Main Authors: SungMin Kim, Choonghee Park, Sunghyeon Park, Dai-Jin Kim, Ye-Seul Bae, Jae-Heon Kang, Ji-Won Chun
Format: Article
Language:English
Published: JMIR Publications 2025-02-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e65492
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author SungMin Kim
Choonghee Park
Sunghyeon Park
Dai-Jin Kim
Ye-Seul Bae
Jae-Heon Kang
Ji-Won Chun
author_facet SungMin Kim
Choonghee Park
Sunghyeon Park
Dai-Jin Kim
Ye-Seul Bae
Jae-Heon Kang
Ji-Won Chun
author_sort SungMin Kim
collection DOAJ
description BackgroundNew health care services such as smart health care and digital therapeutics have greatly expanded. To effectively use these services, digital health literacy skills, involving the use of digital devices to explore and understand health information, are important. Older adults, requiring consistent health management highlight the need for enhanced digital health literacy skills. To address this issue, it is imperative to develop methods to assess older adults’ digital health literacy levels. ObjectiveThis study aimed to develop a tool to measure digital health literacy. To this end, it reviewed existing literature to identify the components of digital health literacy, drafted preliminary items, and developed a scale using a representative sample. MethodsWe conducted a primary survey targeting 600 adults aged 55-75 years and performed an exploratory factor analysis on 74 preliminary items. Items with low factor loadings were removed, and their contents were modified to enhance their validity. Then, we conducted a secondary survey with 400 participants to perform exploratory and confirmatory factor analyses. ResultsA digital health literacy scale consisting of 25 items was developed, comprising 4 subfactors: use of digital devices, understanding health information, use and decision regarding health information, and use intention. The model fit indices indicated excellent structural validity (Tucker-Lewis Index=0.924, comparative fit index=0.916, root-mean-square error of approximation=0.088, standardized root-mean-square residual=0.044). High convergent validity (average variance extracted>0.5) and reliability (composite reliability>0.7) were observed within each factor. Discriminant validity was also confirmed as the square root of the average variance extracted was greater than the correlation coefficients between the factors. This scale demonstrates high reliability and excellent structural validity. ConclusionsThis study is a significant first step toward enhancing digital health literacy among older adults by developing an appropriate tool for measuring digital health literacy. We expect this study to contribute to the future provision of tailored education and treatment based on individual literacy levels.
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spelling doaj-art-73c4258263a44742adf4432f0b1463ae2025-02-05T13:32:09ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-02-0127e6549210.2196/65492Measuring Digital Health Literacy in Older Adults: Development and Validation StudySungMin Kimhttps://orcid.org/0000-0002-0597-7414Choonghee Parkhttps://orcid.org/0009-0005-1782-4844Sunghyeon Parkhttps://orcid.org/0000-0002-2235-4358Dai-Jin Kimhttps://orcid.org/0000-0001-9408-5639Ye-Seul Baehttps://orcid.org/0000-0003-0763-5458Jae-Heon Kanghttps://orcid.org/0000-0002-5209-0824Ji-Won Chunhttps://orcid.org/0000-0002-0629-0358 BackgroundNew health care services such as smart health care and digital therapeutics have greatly expanded. To effectively use these services, digital health literacy skills, involving the use of digital devices to explore and understand health information, are important. Older adults, requiring consistent health management highlight the need for enhanced digital health literacy skills. To address this issue, it is imperative to develop methods to assess older adults’ digital health literacy levels. ObjectiveThis study aimed to develop a tool to measure digital health literacy. To this end, it reviewed existing literature to identify the components of digital health literacy, drafted preliminary items, and developed a scale using a representative sample. MethodsWe conducted a primary survey targeting 600 adults aged 55-75 years and performed an exploratory factor analysis on 74 preliminary items. Items with low factor loadings were removed, and their contents were modified to enhance their validity. Then, we conducted a secondary survey with 400 participants to perform exploratory and confirmatory factor analyses. ResultsA digital health literacy scale consisting of 25 items was developed, comprising 4 subfactors: use of digital devices, understanding health information, use and decision regarding health information, and use intention. The model fit indices indicated excellent structural validity (Tucker-Lewis Index=0.924, comparative fit index=0.916, root-mean-square error of approximation=0.088, standardized root-mean-square residual=0.044). High convergent validity (average variance extracted>0.5) and reliability (composite reliability>0.7) were observed within each factor. Discriminant validity was also confirmed as the square root of the average variance extracted was greater than the correlation coefficients between the factors. This scale demonstrates high reliability and excellent structural validity. ConclusionsThis study is a significant first step toward enhancing digital health literacy among older adults by developing an appropriate tool for measuring digital health literacy. We expect this study to contribute to the future provision of tailored education and treatment based on individual literacy levels.https://www.jmir.org/2025/1/e65492
spellingShingle SungMin Kim
Choonghee Park
Sunghyeon Park
Dai-Jin Kim
Ye-Seul Bae
Jae-Heon Kang
Ji-Won Chun
Measuring Digital Health Literacy in Older Adults: Development and Validation Study
Journal of Medical Internet Research
title Measuring Digital Health Literacy in Older Adults: Development and Validation Study
title_full Measuring Digital Health Literacy in Older Adults: Development and Validation Study
title_fullStr Measuring Digital Health Literacy in Older Adults: Development and Validation Study
title_full_unstemmed Measuring Digital Health Literacy in Older Adults: Development and Validation Study
title_short Measuring Digital Health Literacy in Older Adults: Development and Validation Study
title_sort measuring digital health literacy in older adults development and validation study
url https://www.jmir.org/2025/1/e65492
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