Development and Validation of the Media Health Literacy Scale (Preprint)

Abstract

Advancements in information technology (IT) have transformed the way of accessing and conveying health-related information (HRI). While the technical advancement offers more options for people to choose their preferred information sources, injudicious dissemination of incorrect or unverified HRI by online media poses a threat to society. The concepts of media health literacy and e-health literacy have emerged for assessing one’s ability to understand and use HRI from media sources. However, tools to evaluate the level of media health literacy comprehensively or following a solid validation process are scarce.

This study aimed to develop a validated tool to evaluate the level of media health literacy in adults.

A two-step tool development process, including item development and validation processes, was carried out. At first, tool development studies were identified by systematic review of the literature. Conceptual framework was established from the review by constructing an affinity diagram, and an item pool was generated. Face validation was conducted to assess whether the items measured media health literacy properly. Content validation was conducted to assess the overall relationship between domains by calculating the content validity index (CVI). Construct validation processes, including exploratory and confirmatory factor analyses, were completed with 1000 adults. Internal consistency of the Media Health Literacy Scale (MHLS) was assessed by Cronbach’s alpha. Concurrent validation was conducted to validate the MHLS’s performance by comparing it with a established tool—the Korean version of the eHealth Literacy scale (K-eHEALS).

A total of 13 studies were identified and utilized to develop the conceptual framework. For the MHLS, an item pool of 65 items, including 3 domains (Access, Critical Evaluation, and Communication) and 9 subdomains, was created. Through face and content validation processes, the MHLS was refined to comprise 3 domains, 6 subdomains, and 29 items. Five subdomains were identified through exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) demonstrated a good model fit. Following EFA and CFA, Cronbach’s alpha scores of 0.915 and 0.927, respectively, were obtained, indicating that the tool had good reliability. Concurrent validity was also established; a positive correlation was found between the MHLS and K-eHEALS, indicating that the MHLS can assess the target concept similar to the K-eHEALS (Pearson correlation coefficient = 0.791, p < 0.01).

The MHLS was developed and validated in a step-by-step process to assess individuals’ ability to access, critically evaluate, and communicate HRI through media platforms. This validated tool can serve in identifying deficiencies in specific MHLS areas and subsequently providing targeted education.