# Measuring electronic health literacy in the context of diabetes care: psychometric evaluation of a Persian version of the condition-specific eHealth literacy scale for diabetes

## TL;DR

This study evaluates a Persian version of a diabetes-specific eHealth literacy scale to assess how well patients can use online health information for managing diabetes.

## Contribution

The paper introduces and validates a Persian version of the Condition-specific eHealth Literacy Scale for Diabetes (Persian CeHLS-D) for use in Iran.

## Key findings

- The Persian CeHLS-D showed good psychometric properties with a two-factor model supported by factor analysis.
- The scale demonstrated strong internal consistency and convergent validity with related health literacy measures.
- Known-groups validity was confirmed using groups with different internet-use frequencies and attitudes toward online healthcare.

## Abstract

The rise of the internet and social media has led to increased interest among diabetes patients in using technology for information gathering and disease management. However, adequate eHealth literacy is crucial for protecting patients from unreliable diabetes-related information online.

To examine the psychometric characteristics and explore the preliminary validity of the Persian version of the Condition-specific eHealth Literacy Scale for Diabetes (Persian CeHLS-D) to assess eHealth literacy in the context of diabetes care.

After adapting, translating, examining content validity, and pilot testing the questionnaire, it was administered to 300 patients with type 2 diabetes mellitus (T2DM). Construct validity was assessed through confirmatory factor analysis, convergent and known-groups validity. The internal consistency (Cronbach’s alpha), composite reliability and maximum reliability, and test-retest correlation were assessed.

Factor analysis supported the hypothesized two-factor model with 10 items, and the standardized factor loadings ranged from 0.44 to 0.86 (P-values < 0.001). Cronbach’s alpha and test-retest correlation were good for each factor. Convergent validity was confirmed by significant correlations of Persian CeHLS-D with diabetes health literacy, perceived usefulness and importance of using the internet for health information, internet anxiety, and perceived physical and mental health. Know-groups validity determined using groups with different internet-use frequencies, and different attitudes towards providing online healthcare services, were satisfied.

This study demonstrated the Persian CeHLS-D as a reliable and valid measure of eHealth literacy among patients with T2DM in Iran. Its satisfactory psychometric properties support its use in research and clinical settings to assess eHealth literacy and inform interventions.

The online version contains supplementary material available at 10.1186/s12911-024-02594-0.