Validation and reliability of the eHealth Literacy Scale (eHEALS) in patients with chronic noncommunicable diseases

Background/Aim: eHealth literacy is an essential competency for people with chronic non-communicable diseases (NCDs), facilitating their ability to access, appraise and use online health information for self-management, adherence and lifestyle modification. Despite the increasing prevalence of NCDs in Indonesia and the expanding use of digital health tools, validated instruments for evaluating eHealth literacy in clinical populations remain limited. This study aimed to assess the psychometric properties of the Indonesian version of the eHealth Literacy Scale (eHEALS) among patients with chronic NCDs.Methods: A cross-sectional study was conducted among patients with chronic NCDs recruited from two hospitals in Jember Regency, Indonesia. Content validity was examined by expert review, construct validity was assessed using exploratory factor analysis (EFA), reliability was evaluated with Cronbach's Alpha and item-total correlations and convergent validity was assessed against the Health Literacy Scale-European Union (HLS-EU-16).Results: The Indonesian version of eHEALS demonstrated item-level and average scale-level content validity indices indicating expert agreement, indicating expert consensus. EFA supported a unidimensional structure, explaining more than 75 % of the variance with high factor loadings. Reliability analysis indicated excellent internal consistency (Cronbach's Alpha = 0.94) and high item-total correlations. Convergent validity was supported by a significant positive correlation (r = 0.78) with the HLS-EU-16, indicating an association with general health literacy.Conclusion: The Indonesian version of eHEALS is a culturally appropriate, reliable and valid instrument for assessing eHealth literacy in patients with chronic NCDs. Further research is required to longitudinally evaluate its use in clinical interventions and its impact on patient outcomes.