Psychometric Properties of Digital Divide Measurement Instruments in Health Contexts: Systematic Review

Background: The digital divide constitutes a growing form of social inequality, influencing access to, use of, and benefit from digital health technologies. Accurate assessment of this phenomenon requires psychometrically sound measurement instruments, especially in health care contexts. Objective: This systematic review aimed to identify and evaluate the psychometric properties of instruments developed to measure the digital divide, with a particular focus on their application in health-related settings. Methods: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 and COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) guidelines. Literature searches were performed in PubMed, Scopus, Dialnet, and Web of Science for studies published between 2015 and 2025. Inclusion criteria required studies to report a psychometric evaluation of instruments measuring the digital divide. Results: Four studies met the inclusion criteria (ranging from 875 to 1337 participants). The identified scales primarily measured digital skills and capital. All studies reported adequate internal consistency, with Cronbach α coefficients ranging from 0.70 to 0.94. Structural validity was confirmed through factor analysis in all studies. However, data on temporal stability and responsiveness were absent. Conclusions: Existing instruments show potential for assessing digital inequality in health, but further psychometric validation and cultural adaptation are required. Nursing professionals are encouraged to lead efforts in developing and validating context-sensitive instruments to promote digital health equity.