Piloting an Educational Approach to Assess eHealth Literacy and Evidence-Based Medicine in Integrative Health: A Feasibility and Validation Study (Preprint)

A core competency of integrative health (IH) education is applying evidence to clinical practice. Low rates of online health literacy put consumers at higher risk of misinformation. Practitioners may serve to reduce this risk. Integrative Health (IH) crosses multiple healthcare disciplines and is therefore well-suited to improve the health information ecosystem. IH practitioners must demonstrate evidence-based medicine (EBM) skills and electronic health information literacy (eHL) to make a positive impact. The Fresno Test of Evidence-Based Medicine (FEBM) is a validated, performance-based assessment used in medical education. However, the scenarios included in this assessment do not reflect IH practices. This study used a multi-phase pilot observational design to assess feasibility of incorporating eHL and EBM assessments into graduate coursework while adapting and validating the FEBM for an IH audience (FEBM-IH). Re-validation of the FEBM-IH began with a discipline-focused adaptation, which was reviewed by an expert panel. The FEBM-IH was then administered to IH students and faculty. Independently scored assessments determined inter-rater reliability, internal consistency, item discrimination, and item difficulty. Outcome completion rates suggest the FEBM-IH and eHL assessment tools are feasible (>64% completion) to include in online courses, with 68.9% (102/148) eligible participants joining and 76.5% (78/102) completing all questions in all measures. The FEBM-IH demonstrated excellent assessor agreement (kappa = 0.97, p < 0.001), high internal consistency (α=0.799), and acceptable item discrimination (0.26-0.68). Self-perceived eHL scores showed a 3-point increase in median score by course’s end, suggesting improvements in eHL. Tools were feasible to integrate; FEBM-IH maintains acceptable validity; and further exploration of the relationship between EBM and eHL is warranted. NA- Not a Clinical Trial