ArticleJournal of medical Internet research2022
Measuring Electronic Health Literacy: Development, Validation, and Test of Measurement Invariance of a Revised German Version of the eHealth Literacy Scale.
Article in Journal of medical Internet research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
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Who cites it
47 citing papers in PubMed.
- How Many Instruments Do We Need? Strengths, Weaknesses, and Potentials for Further Developments of Digital Health Literacy Measurement Instruments: Narrative Overview of Reviews and Content Analysis.Interactive journal of medical research · 2026Review
- Measuring eHealth Literacy in the European Economic Area, Switzerland, and the United Kingdom: Scoping Review.Journal of medical Internet research · 2026Article
- Digital Health Literacy, Technology Acceptance, and Competence Among Older Adults Aged ≥65 Years: Cross-Sectional Study Investigating Differences Between Women and Men.Journal of medical Internet research · 2026Article
- Understanding digital health literacy in later life: the role of sociodemographic and health-related factors - a cross-sectional study.BMC geriatrics · 2026Article
- Explainable Machine Learning for Assessing Digital Health Literacy in Older Adults: Validation and Development of a Two-Stage Model Integrating Performance-Based and Self-Assessed Indicators.JMIR medical informatics · 2026Article
- Acceptance of Men Living With HIV Toward Treatment-Supportive Mobile Apps Using the Unified Theory of Acceptance and Use of Technology: Cross-Sectional Study.JMIR formative research · 2026Article
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- [Relevance of eHealth Literacy (eHL) for Health Services Research and Practice - Part I].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2026Article
- The role of perceived competence in remote cochlear implant aftercare: a mixed-methods study.Frontiers in digital health · 2026Article
- Usability Evaluation of Digital Health Applications for Older People With Depressive Disorders: Prospective Observational Study in a Mixed Methods Design.JMIR human factors · 2025Observational
- Drivers and barriers of acceptance of eHealth interventions in postpartum mental health care: a cross-sectional study.BMC public health · 2025Article
- Patient acceptance of video consultations in cardiology.European heart journal. Digital health · 2025Article
- Piloting Digital Navigators to Promote Acceptance and Engagement With Digital Mental Health Apps in German Outpatient Care: Protocol for a Multicenter, Single-Group, Observational, Mixed Methods Interventional Study (DigiNavi).JMIR research protocols · 2025Article
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- Acceptance, Drivers, and Barriers to Use of mHealth Apps to Improve Quality of Life in Female Patients Affected by Hypothyroidism: Cross-Sectional Study.JMIR formative research · 2025Article
- eHealth Literacy and Participation in Remote Blood Pressure Monitoring Among Patients With Hypertension: Cross-Sectional Study.Journal of medical Internet research · 2025Article
- Acceptance and perceived usefulness of digital health services in the management of chronic urticaria: a survey of patients and physicians.BMC health services research · 2025Article
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- Digital Health Literacy and Attitudes Toward eHealth Technologies Among Patients With Cardiovascular Disease and Their Implications for Secondary Prevention: Survey Study.JMIR formative research · 2025Article
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5 authors.
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Abstract
backgroundThe World Wide Web has become an essential source of health information. Nevertheless, the amount and quality of information provided may lead to information overload. Therefore, people need certain skills to search for, identify, and evaluate information from the internet. In the context of health information, these competencies are summarized as the construct of eHealth literacy. Previous research has highlighted the relevance of eHealth literacy in terms of health-related outcomes. However, the existing instrument assessing eHealth literacy in the German language reveals methodological limitations regarding test development and validation. The development and validation of a revised scale for this important construct is highly relevant.
objectiveThe objective of this study was the development and validation of a revised German eHealth literacy scale. In particular, this study aimed to focus on high methodological and psychometric standards to provide a valid and reliable instrument for measuring eHealth literacy in the German language.
methodsTwo internationally validated instruments were merged to cover a wide scope of the construct of eHealth literacy and create a revised eHealth literacy scale. Translation into the German language followed scientific guidelines and recommendations to ensure content validity. Data from German-speaking people (n=470) were collected in a convenience sample from October to November 2020. Validation was performed by factor analyses. Further, correlations were performed to examine convergent, discriminant, and criterion validity. Additionally, analyses of measurement invariance of gender, age, and educational level were conducted.
resultsAnalyses revealed a 2-factorial model of eHealth literacy. By item-reduction, the 2 factors information seeking and information appraisal were measured with 8 items reaching acceptable-to-good model fits (comparative fit index [CFI]: 0.942, Tucker Lewis index [TLI]: 0.915, root mean square error of approximation [RMSEA]: 0.127, and standardized root mean square residual [SRMR]: 0.055). Convergent validity was comprehensively confirmed by significant correlations of information seeking and information appraisal with health literacy, internet confidence, and internet anxiety. Discriminant and criterion validity were examined by correlation analyses with various scales and could partly be confirmed. Scalar level of measurement invariance for gender (CFI: 0.932, TLI: 0.923, RMSEA: 0.122, and SRMR: 0.068) and educational level (CFI: 0.937, TLI: 0.934, RMSEA: 0.112, and SRMR: 0.063) were confirmed. Measurement invariance of age was rejected.
conclusionsFollowing scientific guidelines for translation and test validation, we developed a revised German eHealth Literacy Scale (GR-eHEALS). Our factor analyses confirmed an acceptable-to-good model fit. Construct validation in terms of convergent, discriminant, and criterion validity could mainly be confirmed. Our findings provide evidence for measurement invariance of the instrument regarding gender and educational level. The newly revised GR-eHEALS questionnaire represents a valid instrument to measure the important health-related construct eHealth literacy.
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