ArticleJournal of medical Internet research2026
Validation of the Updated Digital Health Literacy Instrument and Development of a Short Form: Online Survey Study of the General Population.
Article in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The digital health literacy instrument (DHLI) was developed in 2017 to measure individuals' ability to access, understand, evaluate, and apply online health information. Since that time, digital health has shifted from desktop-based internet use to mobile devices, and there has been a rapidly expanding range of health apps. Additionally, heightened privacy and data security requirements have increased the complexity of user competencies needed to engage with digital health tools. These developments underscore the need to update the original DHLI. Objective: This study aimed to create an updated version of the DHLI (DHLI 2.0) that reflects current digital health practices and to examine its reliability and validity by exploring associations with user characteristics. Additionally, we aimed to develop a short-form version to facilitate broader use in research and practice. Methods: The instrument was iteratively updated and pilot-tested to retain the original theoretical framework while reflecting current digital health practices, devices, and emerging challenges such as mobile use and data security. Several items were reworded and a new 2-item subscale on digital safety was added. The full DHLI 2.0 comprises 24 items across 8 skill domains. A 16-item short form was developed by iteratively removing 1 or 2 items per subscale based on the "α if item deleted" criterion, while retaining the same subscale structure as the full form. Data to validate the new version of the instrument were collected in June 2024 through an online survey among members of a representative citizen panel in Friesland, a province in the Netherlands (N=2728). Sociodemographics, internet and health-related internet use, general health literacy (measured with the Single Item Literacy Screener), self-reported health, and health care use were assessed. Internal consistency was evaluated using Cronbach α, and construct validity was assessed via Spearman ρ correlations with related constructs. Results: Internal consistency was high for both the full (α=0.94) and short-form (α=0.90) scales. Most subscales showed satisfactory to excellent reliability (α=0.71-0.93), while "Securing privacy" and "Using security measures" demonstrated moderate reliability (α=0.65-0.66). The DHLI 2.0 total scores were approximately normally distributed (skewness -0.5; kurtosis 0.4). As expected, digital health literacy was negatively correlated with age (ρ=-0.39, P<.001) and positively correlated with education (ρ=0.22, P<.001), income (ρ=0.27, P<.001), time spent online (ρ=0.32, P<.001), and general health literacy (ρ=-0.42, P<.001). Conclusions: The DHLI 2.0 provides an updated, reliable, and valid measure of digital health literacy covering 8 key domains, including data security. The 16-item short form offers a concise alternative suitable for research and possibly practical applications in health and eHealth contexts.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.