Preliminary validity testing of the eHealth Literacy Questionnaire (eHLQ): A Confirmatory Factor Analysis (CFA) in Norwegian hospitalized patients
Hermansen, Åsmund; Andersen, Marit Helen; Borge, Christine Råheim; Dahl, Kari Gire; Larsen, Marie Hamilton; Lønning, Kjersti; Meyer, Käthe Birgitte; Vidnes, Tone Karine; Wahl, Astrid Klopstad
Peer reviewed, Journal article
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Date
2023Metadata
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Abstract
Aims To perform the first psychometric analysis of the Norwegian version of the eHLQ using confirmative factor
analysis (CFA) procedures in a population of patients admitted to hospital using a cross-sectional design. The eHLQ
consists of 35 items capturing the 7-dimensional eHealth Literacy Framework (eHLF) which describes users’ attributes,
user’s interaction with technologies and user’s experience with digital health systems.
Methods The 7 independent scales of the eHLQ was translated from Danish and culturally adapted into the Norwe-
gian language following a standardised protocol. Assessment of construct validity of the eHLQ was undertaken using
data from a cross-sectional survey of 260 patients hospitalized at a Norwegian University Hospital in the Oslo area dur-
ing a two-week period in June 2021. The analysis included using correlation analysis (Pearsons R), internal consistency
(Cronbach’s alpha) and confirmatory factor analysis (CFA).
Results All factor loadings were high to acceptable (i.e. > 0.6), except for five items which had somewhat lower
loadings. Regarding internal consistency, alpha ranged from 0.73 to 0.90. For optimal CFA fit for the different scale
models, correlated residuals were required for five of the seven scales. Overall our analysis shows an intermediate fit
of the orginal construct. Scale intercorrelations were all below 0.8, indicating an overall acceptable discriminant valid-
ity between the 7 dimensions.
Conclusions The results from the CFA analysis indicate that for almost all 7 eHLQ scales, an acceptable model fit
was achieved. The 260 hospitalized patients included in this study represented a variety of diagnoses, recruited
from a geographically limited area. Further studies on psychometric properties of the Norwegian version of eHLQ
in larger samples, diverse settings and by using more comprehensive approaches are warranted.