e-Health literacy scale: Turkish validity and reliability study for adults over 45 e-Sağlık okuryazarlığı ölçeği: 45 yaş üstü yetişkinlerde Türkçe geçerlik ve güvenirlik çalışması


Turk Hijyen ve Deneysel Biyoloji Dergisi, vol.79, no.4, pp.674-689, 2022 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 79 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.5505/turkhijyen.2022.75608
  • Journal Name: Turk Hijyen ve Deneysel Biyoloji Dergisi
  • Journal Indexes: Scopus, Academic Search Premier, CAB Abstracts, Veterinary Science Database, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.674-689
  • Keywords: E-health, E-health literacy, Validity and reliability
  • Süleyman Demirel University Affiliated: Yes


Objective: Today, the increasing sharing of health information in electronic media has affected individuals’ access to health-related information and decision-making processes in varying rates depending on the level of e-health literacy. This study was carried out to adapt Norman and Skinner’s “e-Health Literacy Scale” (e-Health Literacy) into Turkish and to evaluate its validity and reliability. Methods: In this methodological study, the final Turkish version of the scale, which was obtained by evaluating the linguistic equivalence study and content validity, was applied to 400 people over the age of 45. Data were analyzed with SPSS (22.0). Confirmatory factor analysis was performed by using the AMOS (24.0) program. Content validity was evaluated by using Davis technique and determining Content Validity Indices. Psychometric and reliability analyzes of the Turkish version of the scale were performed. The concordance of expert opinions was tested with Kendall’s Test. Factor analysis was performed to evaluate the construct validity. Kaiser-Meyer-Olkin test (KMO) and Bartlett Sphericity Test were used to evaluate the suitability for factor analysis. The models determined by exploratory factor analysis were examined with confirmatory factor analysis and the final model was created by using model fit indices. The difference between the lowest and highest scoring groups was analyzed using the t test in independent groups. In order to evaluate the criterion validity, the correlation with the Technology Use in the Elderly Scale was evaluated using the Pearson correlation test. Results: In the analyzes, it was determined that the scale showed a single factor structure consisting of eight items, as in the original, and the items provided 84.15% of the total variance. In the internal consistency analysis of the scale, it was determined that the Cronbach’s alpha value was 0.97 and it had a high reliability. In the evaluation of criterion validity, it was observed that the adapted scale showed a moderate correlation with the Attitudes towards Technology Scale of the Elderly (r=0.497; p<0.001). For each item of the scale, it was determined that there was a significant difference between the groups with the lowest and highest scores (p<0.001 for all comparisons), therefore, the items of the scale were distinctive and valid for the feature that was intended to be measured. It was observed that there was no floor and ceiling effect in the scale. Conclusion: The Turkish version of the e-Health Literacy Scale can be used validly and reliably to determine e-health literacy levels in adults over the age of 45.