Digital Health Readiness Questionnaire (DHRQ)

Abstract

The Digital Health Readiness Questionnaire (DHRQ) (Scherrenberg et al., 2023) was developed to assess patients’ digital readiness in routine clinical settings. The DHRQ’s development was based on existing questionnaires (Karnoe et al., 2018; Kayer et al., 2018) and a definition of readiness for digital health interventions provided by two medical doctors experienced in digital health research. The questionnaire consists of 20 items, written simultaneously in Dutch and English, which cover digital skills, digital technology usage, digital health literacy, and digital learnability. It also includes digital literacy adapted for various digital health technologies such as smartphone apps, wearables, and internet-based interventions. Both face and content validity have been demonstrated. The DHRQ yields two scores: a general DHRQ score and a score for participant learnability. Data for its development were collected from adult cardiology patients in Belgium. Confirmatory factor analysis indicated a reasonably good model fit, and Cronbach’s alpha analysis showed scores greater than 0.7 in all DHRQ domains, indicating good sensitivity. The authors recommend future research for external validation of the DHRQ.

Keywords
Digital Access; Digital Health; Digital Health Literacy; Digital Health Readiness; Digital Learnability; Digital Literacy; Digital Skills; Digital Usage; Face Validity; Health Literacy; Telemedicine

Authors
Scherrenberg, Martijn; Falter, Maarten; Kaihara, Toshiki; van Leunen, Mayke; Kemps, Hareld; Kindermans, Hanne; Dendale, Paul

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Purpose

The DHRQ measures digital readiness and learnability within a healthcare context.

Validity

Face/Content Validity: An expert panel was consulted to ensure the content validity of the DHRQ, and their suggestions were utilized to optimize the questionnaire. Face validity testing confirmed that all questions were clear and easy to understand.

Reliability

Internal Consistency: The Cronbach’s alpha coefficients for the variables ranged from 0.735 (Digital usage) to 0.937 (Digital literacy), indicating good internal consistency across all domains.

Factor Analysis

Confirmatory Factor Analysis: The chi-square test for overall model fit was significant (χ2160=5590, P<.001). The fit indices demonstrated a reasonably good fit: standardized root-mean-square residual = 0.065, root-mean-square error of approximation = 0.098 (95% CI 0.09-0.106), Tucker-Lewis fit index = 0.895, and comparative fit index = 0.912.

Instrument: Digital Health Readiness Questionnaire (DHRQ)

Test Type: Original
Format: Items are rated on a 5-point Likert scale, where responses are “strongly disagree,” “disagree,” “neutral,” “agree,” and “strongly agree,” assigned values of 1-5, respectively. A higher score indicates better digital readiness. The administration method is paper-based.
Language Available: Dutch; English
Population Group: Human (Male; Female; Outpatient)
Age Group: Adulthood (18 yrs & older); Young Adulthood (18-29 yrs); Thirties (30-39 yrs); Middle Age (40-64 yrs); Aged (65 yrs & older); Very Old (85 yrs & older)
Population Details:

• Location: Belgium

• Respondents: Adult (aged 21-97 years) Cardiology Patients
  Test Methodology: Test Validity; Content Validity; Test Reliability; Internal Consistency; Factor Analysis; Confirmatory Factor Analysis

Keywords
Digital Access; Digital Health; Digital Health Literacy; Digital Health Readiness; Digital Learnability; Digital Literacy; Digital Skills; Digital Usage; Face Validity; Health Literacy; Telemedicine

Authors

• Scherrenberg, Martijn

  • Author ORCID Identifier: http://orcid.org/0000-0001-9483-3828

  • Affiliation: Heart Centre Hasselt, Jessa Hospital

  • Email addresses: [email protected]

  • Correspondence Address: Jessa Hospital, Heart Centre Hasselt, Stadsomvaart 11, Hasselt, Belgium, 3500

• Falter, Maarten

  • Author ORCID Identifier: http://orcid.org/0000-0001-7407-115X

  • Affiliation: Heart Centre Hasselt, Jessa Hospital

  • Email addresses: No data is Available

• Kaihara, Toshiki

  • Author ORCID Identifier: http://orcid.org/0000-0003-0941-8035

  • Affiliation: Heart Centre Hasselt, Jessa Hospital

  • Email addresses: No data is Available

• Xu, Linqi

  • Author ORCID Identifier: http://orcid.org/0000-0002-4346-0547

  • Affiliation: No data is Available

  • Email addresses: No data is Available

• van Leunen, Mayke

  • Author ORCID Identifier: http://orcid.org/0000-0002-5048-3747

  • Affiliation: Department of Cardiology, Maxima Medical Centre

  • Email addresses: No data is Available

• Kemps, Hareld

  • Author ORCID Identifier: No data is Available

  • Affiliation: Department of Cardiology, Maxima Medical Centre

  • Email addresses: No data is Available

• Kindermans, Hanne

  • Author ORCID Identifier: http://orcid.org/0000-0003-2723-1645

  • Affiliation: Faculty of Medicine and Life Sciences, Hasselt University

  • Email addresses: No data is Available

• Dendale, Paul

  • Author ORCID Identifier: No data is Available

  • Affiliation: Heart Centre Hasselt, Jessa Hospital

  • Email addresses: No data is Available

Permissions & Fee and Test Year

Permissions: May use for Research/Teaching.
Commercial: No
Fee: No
Test Year: 2023
Web Site: creativecommons.org/licenses/by/4.0/

References

Scherrenberg, M., Falter, M., Kaihara, T., Xu, L., van Leunen, M., Kemps, H., Kindermans, H., & Dendale, P. (2023). Development and internal validation of the Digital Health Readiness Questionnaire: Prospective single-center survey study. Journal of Medical Internet Research, 25, Article e41615. https://doi.org/10.2196/41615

Items of the Digital Health Readiness Questionnaire (DHRQ)

Test Items Available: Yes, located in the Supplemental Material, Pages 1-5 (Source: 2023-88383-001).
Number of items: This is a 20-item measure.
Factors and Subscales:

• Digital usage

• Digital skills

• Digital literacy

• Digital health literacy

• Digital learnability

A) Digital access

1. I use the internet
   (1 = Never / I don’t have access to the internet; 2 = Rarely; 3 = Sometimes; 4 = Often; 5 = Daily)

2. I use a computer and/or laptop
   (1 = Never / I don’t have a computer and/or laptop; 2 = Rarely; 3 = Sometimes; 4 = Often; 5 = Daily)

3. I use a smartphone and/or tablet
   (1 = Never / I don’t have a smartphone and/or tablet; 2 = Rarely; 3 = Sometimes; 4 = Often; 5 = Daily)

4. I use a wearable (fitness tracker, smartwatch, other)
   (1 = Never / I don’t have any wearable; 2 = Rarely; 3 = Sometimes; 4 = Often; 5 = Daily)

B) Usage of digital technology

1. I am able to write and send an email independently.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

2. I use social media such as Facebook, Instagram, other.
   (1 = No; 2 = Rarely; 3 = Sometimes; 4 = Often; 5 = Daily)

3. I am able to perform videocalling.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

4. I am able to take a picture and to send it to another person.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

5. I am able to register and review my daily step count.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

C) Digital Literacy
Being able to use digital technology to reach information.

1. I know how to find helpful and reliable information on the internet.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

2. I feel safe when looking up information on the internet.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

3. I feel in control when looking up information on the internet.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

D) Digital Health Literacy
Being able to use digital technology to look up, use and work with health information.

1. I use the internet to find more information about my symptoms, health status and/or medication.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

2. I use health-related applications to follow up my health status.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

3. I am able to identify trustworthy, reliable health information on the internet.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

E) Learnability
Motivation and interest to engage with new technology.

1. I am motivated to learn more about digital technology and how to use it myself.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

2. I feel confident that I can learn more about digital technology and how to use it myself.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

3. I believe that I will learn quickly when offered written information about digital technology.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

4. I believe that I will learn quickly when offered personal guidance about digital technology.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)

5. I expect that learning digital skills can positively impact my health.
   (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree nor disagree; 4 = Agree; 5 = Strongly agree)