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Evaluation of the Psychometric Properties of the Digital Health Literacy Instrument (DHLI-BrA) for Use in Brazilian Adolescents

Author

Listed:
  • Mariane Carolina Faria Barbosa

    (Department of Pediatric Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte 31270-901, MG, Brazil)

  • Ana Luiza Peres Baldiotti

    (Department of Pediatric Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte 31270-901, MG, Brazil)

  • Ramon Targino Firmino

    (Department of Dentistry, Federal University of Campina Grande (UFCG), Patos 58708-110, PB, Brazil)

  • Saul Martins Paiva

    (Department of Pediatric Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte 31270-901, MG, Brazil)

  • Ana Flávia Granville-Garcia

    (Postgraduate Program in Dentistry, State University of Paraíba (UEPB), Campina Grande 58429-500, PB, Brazil)

  • Fernanda de Morais Ferreira

    (Department of Pediatric Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte 31270-901, MG, Brazil)

Abstract

This study evaluated the psychometric properties of the Portuguese version of Digital Health Literacy Instrument for Brazilian Adolescents (DHLI-BrA). Two hundred and sixty Brazilian adolescents answered the DHLI-BrA and the Brazilian version of quality-of-life and health literacy instruments: WHOQOL-Bref, eHEALS-BrA, NVS-BR, and REALMD-20. Then, they answered a questionnaire on sociodemographics, health, Internet access, and digital health aspects. The data collection was conducted between September and December of 2022.The statistical test assessed internal consistency, stability, discriminant and convergent validities, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Item response theory (IRT) analysis using 2PL was applied to performance-based DHLI-BrA. The DHLI-BrA self-reported questions demonstrated almost perfect internal consistency (α and ω = 0.83) and good stability (ICC = 0.906; 95% CI: 0.75–0.95). In EFA and CFA, the best-adjusted model was composed of six factors (χ 2 = 229.173 (df = 174, p = 0.003), CFI = 0.944, TLI = 0.933, RMSEA = 0.035, and RMSR = 0.047). The performance-based DHLI-BrA demonstrated moderate internal consistency (α = 0.57 and KR20 = 0.56) and good stability (ICC = 0.86, 95% CI: 0.76–0.92). In EFA and CFA, the best-adjusted model was composed of a single factor (χ 2 = 17.901 (df = 14, p = 0.2113), CFI = 0.952, TLI = 0.927, RMSEA = 0.033, and RMSR = 0.038). IRT analyses revealed item discrimination ranging from −0.71 to 1.83 and difficulty from −1.53 to 1.02. Convergent validity of the self-reported DHLI-BrA was obtained by its correlation with the eHEALS-BrA (r = 0.45) and REALMD-20 (r = 0.19), besides the performance-based DHLI-BrA with its correlation with the NVS (r = 0.47) and REALMD-20 (r = 0.44). The DHLI-BrA demonstrated adequate psychometric properties to measure the self-reported, performance-based digital health literacy of Brazilian typically developing adolescents.

Suggested Citation

  • Mariane Carolina Faria Barbosa & Ana Luiza Peres Baldiotti & Ramon Targino Firmino & Saul Martins Paiva & Ana Flávia Granville-Garcia & Fernanda de Morais Ferreira, 2024. "Evaluation of the Psychometric Properties of the Digital Health Literacy Instrument (DHLI-BrA) for Use in Brazilian Adolescents," IJERPH, MDPI, vol. 21(11), pages 1-14, October.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:11:p:1458-:d:1511872
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    References listed on IDEAS

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    1. Luyao Xie & Phoenix K. H. Mo, 2023. "Comparison of eHealth Literacy Scale (eHEALS) and Digital Health Literacy Instrument (DHLI) in Assessing Electronic Health Literacy in Chinese Older Adults: A Mixed-Methods Approach," IJERPH, MDPI, vol. 20(4), pages 1-13, February.
    2. G. Kuder & M. Richardson, 1937. "The theory of the estimation of test reliability," Psychometrika, Springer;The Psychometric Society, vol. 2(3), pages 151-160, September.
    3. Chalmers, R. Philip, 2012. "mirt: A Multidimensional Item Response Theory Package for the R Environment," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 48(i06).
    4. María F. Rivadeneira & María J. Miranda-Velasco & Hiram V. Arroyo & José D. Caicedo-Gallardo & Carmen Salvador-Pinos, 2022. "Digital Health Literacy Related to COVID-19: Validation and Implementation of a Questionnaire in Hispanic University Students," IJERPH, MDPI, vol. 19(7), pages 1-14, March.
    5. Heeran Chun & Eun-Ja Park & Seul Ki Choi & Hyeran Yoon & Orkan Okan & Kevin Dadaczynski, 2022. "Validating the Digital Health Literacy Instrument in Relation to COVID-19 Information (COVID-DHL-K) among South Korean Undergraduates," IJERPH, MDPI, vol. 19(6), pages 1-9, March.
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