Assessment of the psychometric properties of the eHealth Literacy Scale for Brazilian adolescents
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by Mariane Carolina Faria Barbosa, Ana Luiza Peres Baldiotti, Júlia Lara Resende, Matheus de França Perazzo, Ramon Targino Firmino, Ana Flávia Granville-Garcia, Saul Martins Paiva, Fernanda de Morais Ferreira
With the increase in digitalization of adolescents and health services, the population must demonstrate digital health literacy skills to be able to navigate online health information, as well as identify, evaluate, and apply relevant information. The present study aimed to investigate the psychometric properties of the adapted version of the eHealth Literacy Scale (eHEALS-BrA) for Brazilian adolescents. This study was conducted between September 2022 and May 2023, involving a total of 260 adolescents aged 13 to 19, with a mean age of 15.64 years (SD = 1.84), all of whom were enrolled in public schools in Brazil. Structural validity was evaluated by confirmatory factor analysis (CFA). The reliability of the instrument was assessed using Cronbach’s alpha (α) and McDonald’s omega (ω), and test-retest reliability. Questionnaires about sociodemographic aspects, health-related characteristics, and internet use were administered and used as discriminant validation measures. Convergent Validity was determined by correction with the domains of the World Health Organization Quality of Life-Bref (WHOQOL-Bref) instrument. For test-retest reliability, 67 participants completed the eHEALS-BrA a fortnight later. The average eHEALS-BrA score was 28.05 points (SD = 5.05). CFA revealed that the model with the best fit had a single factor (χ2 = 49.884 [df = 20, p = 0.0002], CFI = 0.934, TLI = 0.908, RMSEA = 0.076(CI:0.05–0.10), and SRMR = 0.045). The instrument demonstrated good reliability, with satisfactory internal consistency (α and ω = 0.71) and stability (ICC = 0.82, 95% CI:0.70–0.89). The eHEALS-BrA was correlated with the physical, psychological, and environmental domains of the WHOQOL-Bref (p = 0.001) (convergent validity). Higher scores were found among male adolescents, individuals who practiced physical activity, those with better self-rated health, those who considered the internet useful for searching for health information (discriminant validity), and those with better self-rated skills related to using the internet (convergent validity) (p < 0.05). The eHEALS-BrA demonstrated adequate psychometric properties for measuring digital health literacy in Brazilian adolescents.