Reliability and Validity of the Japanese Version of the eHealth Literacy Scale in Community-Dwelling Older Adults: A Cross-Sectional Study

The Japanese version of the eHealth Literacy Scale (J-eHEALS) measure has primarily been applied to younger populations; however, the psychometric properties of the J-eHEALS in older adults have not been investigated. Therefore, in this cross-sectional study, we aimed to evaluate the psychometric properties of the J-eHEALS in community-dwelling older adults. A total of 553 adults aged ≥ 65 years (mean age, 73.5 years) attending routine health checkups in a single Japanese municipality completed the J-eHEALS and the Japanese version of the 12-item Health Literacy Scale (J-HLS-Q12). We examined internal consistency, item characteristics, factorial validity using exploratory and confirmatory factor analyses, measurement invariance by sex, and convergent and criterion-related validity with general health literacy. The J-eHEALS scores indicated moderate to slightly low perceived eHealth literacy in this population. The scale demonstrated excellent internal consistency (Cronbach's α = 0.94), a stable unidimensional factor structure with acceptable model fit across sexes, and moderate positive associations with general health literacy. Overall, these findings support the J-eHEALS as a reliable and valid instrument for assessing perceived eHealth literacy in older Japanese adults and its suitability for use in research and practice.