A reliability and validity study of the electronic health literacy scale among stroke patients in China

Background Patients with stroke usually use smartphones to obtain online information to maintain their health. But their ability to identify, evaluate and apply this information is still unknown.Aim This study was designed to examine the reliability and validity of the electronic Health Literacy Scale among patients with stroke in China.Design This is a cross-sectional survey.Methods A demographic questionnaire, the electronic Health Literacy Scale (e-HLS) and the eHealth Literacy Scale (eHEALS) were administered to a sample of 648 patients with ischemic stroke recruited from December 2020 to March 2021 in a tertiary hospital.Results The Cronbach’α coefficient on the e-HLS-CHI was 0.907. Kappa consistency coefficient of test-retest reliability was 0.691 (p < .05). Three factors were extracted by Exploratory Factor Analysis (EFA), accounting for 90.84% of the total variance. Confirmatory Factory Analysis (CFA) revealed that three factors of e-HLS-CHI fit well (NFI = 0.979, RFI = 0.955, IFI = 0.987, TLI = 0.972, CFI = 0.987, RMSEA = 0.070, CMIN/DF = 2.586). Good simultaneous validity was suggested by the positive correlation of 0.94 (p < .001) between the e-HLS-CHI and eHEALS. When using eHEALS as the standard, the area under the ROC curve of e-HLS-CHI was 0.896 (95% CI: 0.831–0.960, p < .001). The sensitivity and specificity were 97.8% and 70.4% respectively.Conclusions The e-HLS can be used to evaluate electronic health literacy of patients with stroke in China after translation and cultural adaption.