背景:尽管全球越来越关注健康素养和青少年的数字健康信息寻求,据报道,没有使用Rasch模型对测量青少年数字健康素养(DHL)的一维仪器进行验证.此外,根据青少年的DHL能力,他们在卫生系统中的导航能力(NAV-HL)的证据仍然很少。因此,我们的研究旨在评估DHL仪器的心理测量特性(HLS19-DIGI量表),以调查16-25岁青少年和青少年的DHL及其与健康系统导航能力的关联.
方法:在2020年4月至10月期间,使用计算机辅助电话访谈对890名挪威青少年进行了基于人群的横断面调查。Rasch建模,独立样本t检验,卡方检验,并采用二元回归模型对数据进行分析。
结果:HLS19-DIGI尺度足够一维,而没有观察到不同的项目功能或无序的反应类别。然而,显示出相对较差的目标,表明目标人群的简单项目过多。然而,观察到青少年DHL熟练程度低的比例很高(54%),以及DHL与卫生系统的导航能力呈正相关。
结论:HLS19-DIGI量表被认为是测量青少年DHL的足够一维和有效的仪器,这对卫生当局来说可能是一个有用的工具,公共卫生工作者,和卫生服务提供者。虽然DHL影响青少年驾驭卫生系统的能力,未来的研究应该衡量和检查他们利用数字医疗服务的能力,分开。
BACKGROUND: Despite increasing global attention to health literacy and adolescents\' digital health information seeking, no unidimensional instruments measuring digital health literacy (DHL) in adolescents have reportedly been validated using Rasch modeling. Moreover, the evidence of adolescents\' abilities to navigate the health system (NAV-HL) in light of their DHL proficiency is still scarce. Therefore, our study aims to evaluate the psychometric properties of a DHL instrument (HLS19-DIGI scale) in order to investigate DHL in adolescents and young adults aged 16-25 and associations with abilities to navigate the health system.
METHODS: A population-based cross-sectional survey among 890 Norwegian adolescents was conducted during April-October 2020 using computer-assisted telephone interviewing. Rasch modeling, independent samples t-test, chi-square test, and binary regression models were used to analyze the data.
RESULTS: The HLS19-DIGI scale was sufficiently unidimensional, whereas no differential item functioning or disordered response categories were observed. However, relatively poor targeting was revealed indicating too many easy items for the target population. Yet, a high proportion (54%) of low DHL proficiency in adolescents was observed, as well as DHL was positively associated with the abilities to navigate the health system.
CONCLUSIONS: The HLS19-DIGI scale is considered a sufficiently unidimensional and valid instrument for measuring DHL in adolescents, which may be a useful tool for health authorities, public health workers, and health service providers. While DHL affects adolescents\' abilities to navigate the health system, future research should measure and examine their ability to utilize digital health services, separately.