Below are sample measures used by ODPHP to evaluate users'
level of engagement with online prevention content and their level of
self-efficacy. Also included are sample measures for the acceptability and
applicability of Web content as well as a proxy measure for health
The eHealth Engagement Scale* was
adapted from commercial advertising research. The scale includes rating 10
descriptors (α = 0.90), including absorbing, attention-grabbing,
stimulating, surprising, suspenseful, thought-provoking, convincing,
believable, not dull, and clever (1 = Strongly Agree; 5 = Strongly Disagree).
Internal reliability of each of the two multi-item subscales of the eHealth
Engagement Scale was 0.878 for "Involving" and 0.805 for "Credible."
The self-efficacy scale was adapted from the Guide for
Constructing Self-Efficacy Scales, where Bandura proposes measuring self-efficacy by having
participants rate their level of confidence in taking an action. The scale used
by ODPHP includes the following three items: "This information made me feel
more confident that I can do something"; "This information made me feel more
prepared to do something"; and "This information made me feel more prepared to
do something in the next month" (1 = Strongly Agree; 5 = Strongly
Acceptability is the extent to which the intended users
like the tool/content and find it easy to use. ODPHP operationalized
acceptability (based on the 2006 report, Expanding the Reach and Impact of
Consumer E-Health Tools) with two
items. They include "This information was easy to use" and "This information
was presented in ways that I could easily understand" (1 = Strongly Agree; 5 =
Applicability is the extent to which the tool/content is
relevant to the needs of the intended user; in other words, does it help him or
her in his or her everyday life? ODPHP operationalized applicability (based on
the 2006 report, Expanding the Reach and Impact of Consumer E-Health
Tools) with two items. They include "This information was useful to me"
and "This information gave me some specific ideas about what to do" (1 =
Strongly Agree; 5 = Strongly Disagree).
Limited Health Literacy
ODPHP used proxy measures to identify a limited health
literacy sample based on statistics from the health literacy component of the
2003 National Assessment of Adult Literacy. Individuals included in the limited
health literacy sample met the following criteria: have a high school education
or below, have an annual household income below the poverty threshold (under
$40,000), and have not searched for health information online in the past
Lefebvre, R. C., Tada, Y., Hilfiker, S., & Baur, C. (in press). The
assessment of user engagement with ehealth content: The eHealth Engagement
Scale. Journal of Computer-Mediated Communication.
Bandura, A. (2006). Guide for creating self-efficacy
scales. In T. Urdan & F. Pajares (Eds.), Self-efficacy beliefs of
adolescents (pp. 307337). Charlotte, NC: Information Age Publishing.
Office of Disease Prevention and Health
Promotion. (2006). Expanding the reach and impact of consumer e-health
tools. Rockville, MD: Author. Retrieved from