Journal List > Korean J Adult Nurs > v.30(5) > 1106002

Chang, Yang, Ryu, Kim, and Yoon: Cross-cultural Adaptation and Validation of the eHealth Literacy Scale in Korea



The purpose of this study was to cross-culturally adapt the eHealth Literacy Scale into Korean (KeHEALS) and evaluate its reliability and validity.


The cross-cultural adaptation of the KeHEALS was conducted according to the World Health Organization's guideline. To evaluate the reliability and validity, the data of 397 participants (210 young adults and 187 older adults) were collected from 2017 November to 2018 February. An online survey was conducted with young adults, while a face-to-face survey was conducted with older adults in two senior welfare centers. The reliability of the KeHEALS was examined using the internal consistency and test-retest reliability tests. Regarding the validity, the content validity index was calculated for content validity, and exploratory and confirmatory factor analyses and the hypothesized test were conducted for assessing construct validity of the KeHEALS.


The Cronbach's α coefficient was .89 and the intraclass correlation coefficient for the 2-week test-retest reliability was .80. The content validity index of the KeHEALS was 1.0. From the exploratory factor analysis, eight items were retained in one factor, which accounted for 58.1% of the total variance. This factor structure was confirmed by the confirmatory factor analysis. The total score of the KeHEALS was significantly correlated with the attitudes toward internet health information.


The findings of this study provide evidence for the adequate psychometric properties of the KeHEALS. The KeHEALS will be useful to evaluate the eHealth literacy among Koreans.

Figures and Tables

Table 1

Personal and Internet-related Characteristics (N=397)


CAM=complementary alternative medicine; KeHEALS=Korean version of the eHealth Literacy Scale; Multiple responses.

Table 2

The Results of the Exploratory Factor analysis (EFA) and Confirmatory Factor Analysis (CFA)


B=unstandardized coefficient, SE=standard error, β=standardized coefficient, AVE=average variance extrated; CR=construct reliability; GFI=goodness of fit index; NFI=normed fit index; CFI=comparative fit index; TLI=Turker-Lewis index; RMSEA=root mean square error of approximation.

Table 3

Results of the Item Analysis, Internal Consistency, and the Test-retest Reliability of the KeHEALS


The possible range of each item was from 1 to 5 whereas that of total score was from 8 to 40; The total score was calculated by summing 8 items ranged from item 3 to item 10; ICC=intraclass correlation; CI=confidence interval.


This research was supported by both the 2017 SNU invitation program for distinguished scholar of Seoul National University and the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (Grant No. NRF2017R1C1B5017768).


CONFLICTS OF INTEREST The authors declared no conflict of interest.


Appendix 1

Korean version of the eHealth Literacy Scale



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Sun Ju Chang

Eunjin Yang

Hyunju Ryu

Hee Jung Kim

Ju Young Yoon

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