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A Psychometric Analysis of the Italian Version of the eHealth Literacy Scale Using Item Response and Classical Test Theory Methods.

ABSTRACT: BACKGROUND:The eHealth Literacy Scale (eHEALS) is a tool to assess consumers' comfort and skills in using information technologies for health. Although evidence exists of reliability and construct validity of the scale, less agreement exists on structural validity. OBJECTIVE:The aim of this study was to validate the Italian version of the eHealth Literacy Scale (I-eHEALS) in a community sample with a focus on its structural validity, by applying psychometric techniques that account for item difficulty. METHODS:Two Web-based surveys were conducted among a total of 296 people living in the Italian-speaking region of Switzerland (Ticino). After examining the latent variables underlying the observed variables of the Italian scale via principal component analysis (PCA), fit indices for two alternative models were calculated using confirmatory factor analysis (CFA). The scale structure was examined via parametric and nonparametric item response theory (IRT) analyses accounting for differences between items regarding the proportion of answers indicating high ability. Convergent validity was assessed by correlations with theoretically related constructs. RESULTS:CFA showed a suboptimal model fit for both models. IRT analyses confirmed all items measure a single dimension as intended. Reliability and construct validity of the final scale were also confirmed. The contrasting results of factor analysis (FA) and IRT analyses highlight the importance of considering differences in item difficulty when examining health literacy scales. CONCLUSIONS:The findings support the reliability and validity of the translated scale and its use for assessing Italian-speaking consumers' eHealth literacy.

SUBMITTER: Diviani N

PROVIDER: S-EPMC5405289 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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A Psychometric Analysis of the Italian Version of the eHealth Literacy Scale Using Item Response and Classical Test Theory Methods.

Diviani Nicola N Dima Alexandra Lelia AL Schulz Peter Johannes PJ Schulz Peter Johannes PJ

Journal of medical Internet research 20170411 4

<h4>Background</h4>The eHealth Literacy Scale (eHEALS) is a tool to assess consumers' comfort and skills in using information technologies for health. Although evidence exists of reliability and construct validity of the scale, less agreement exists on structural validity.<h4>Objective</h4>The aim of this study was to validate the Italian version of the eHealth Literacy Scale (I-eHEALS) in a community sample with a focus on its structural validity, by applying psychometric techniques that accoun ...[more]

PMID: 28400356

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Project description:BackgroundEarly prelingual auditory development (EPLAD) is a fundamental and important process in the speech and language development of infants and toddlers. The Infant-Toddler Meaningful Auditory Integration Scale (ITMAIS) is a widely used measurement tool for EPLAD, however it has not yet undergone a comprehensive psychometric analysis. The aim of this research was to modify and verify the psychometric properties of ITMAIS using a combination of Item Response Theory (IRT) and Classical Test Theory (CTT).MethodsStage 1-1730 children were retrospectively recruited to enable the application of an IRT model, specifically the graded response model, to modify the ITMAIS. Stage 2-another 450 infants and toddlers with normal hearing or permanent hearing loss before auditory intervention were recruited to verify the psychometric properties of the modified ITMAIS (ITMAIS-m) using the CTT method.ResultsUsing the metric of the graded response model, by removing item 2 from the ITMAIS, ITMAIS-m demonstrated discrimination parameters ranging from 3.947 to 5.431, difficulty parameters from - 1.146 to 1.150, item information distributed between 4.798 and 9.259 and a test information score of 48.061. None of the items showed differential item functioning. ITMAIS-m was further verified in Stage 2, showing Cronbach's α of 0.919 and item-total correlations ranging from 0.693 to 0.851. There was good convergent validity of ITMAIS-m with other auditory outcome measure (r = 0.932) and pure tone average thresholds (r ranging from - 0.670 to - 0.909), as well as a high ability to discriminate between different hearing grades (Cohen d ranging from 0.41 to 5.83).ConclusionsThe ITMAIS-m is a reliable and valid tool for evaluating EPLAD in infants and toddlers, which can be efficiently and precisely applied in clinical practice. The combined use of IRT and CTT provides a powerful means to modify psychometrically robust scales aimed at childhood auditory outcome measurements.

Project description:BackgroundThe International Classification of Functioning, Disability and Health (ICF) proposes three main health outcomes, Impairment (I), Activity Limitation (A) and Participation Restriction (P), but good measures of these constructs are needed The aim of this study was to use both Classical Test Theory (CTT) and Item Response Theory (IRT) methods to carry out an item analysis to improve measurement of these three components in patients having joint replacement surgery mainly for osteoarthritis (OA).MethodsA geographical cohort of patients about to undergo lower limb joint replacement was invited to participate. Five hundred and twenty four patients completed ICF items that had been previously identified as measuring only a single ICF construct in patients with osteoarthritis. There were 13 I, 26 A and 20 P items. The SF-36 was used to explore the construct validity of the resultant I, A and P measures. The CTT and IRT analyses were run separately to identify items for inclusion or exclusion in the measurement of each construct. The results from both analyses were compared and contrasted.ResultsOverall, the item analysis resulted in the removal of 4 I items, 9 A items and 11 P items. CTT and IRT identified the same 14 items for removal, with CTT additionally excluding 3 items, and IRT a further 7 items. In a preliminary exploration of reliability and validity, the new measures appeared acceptable.ConclusionNew measures were developed that reflect the ICF components of Impairment, Activity Limitation and Participation Restriction for patients with advanced arthritis. The resulting Aberdeen IAP measures (Ab-IAP) comprising I (Ab-I, 9 items), A (Ab-A, 17 items), and P (Ab-P, 9 items) met the criteria of conventional psychometric (CTT) analyses and the additional criteria (information and discrimination) of IRT. The use of both methods was more informative than the use of only one of these methods. Thus combining CTT and IRT appears to be a valuable tool in the development of measures.

Dataset Information

A Psychometric Analysis of the Italian Version of the eHealth Literacy Scale Using Item Response and Classical Test Theory Methods.

Publications

A Psychometric Analysis of the Italian Version of the eHealth Literacy Scale Using Item Response and Classical Test Theory Methods.

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