大學生網路健康素養量表建構及其與健康行為之關係研究

Development and Validation of the E-health Literacy Scale and Investigation of the Relationships between E-health Literacy and Healthy Behavior among Undergraduate Students in Taiwan

研究目的：本研究旨在建構網路健康素養量表，並進一步探討網路健康素養與健康行為之關係。研究方法：本研究採取分層叢集抽樣的方式，資料蒐集時間自2014年3月至5月，正式樣本來自臺灣地區13所大專院校共455位大學生。研究結果：經預試分析後，網路健康素養量表可區分為「互動性」、「功能性」及「批判性」三層面，各層面Cronbach α信度介於.70至.83之間，全量表信度為.84，可解釋總變異量為61.10%。接著以正式樣本進行驗證性因素分析，結果顯示量表個別項目的信度介於.36至.74之間；標準化因素負荷量介於.60至.86（p<.001）；而潛在變項的組合信度為.75至.84之間；平均變異抽取量為.50至.52之間。測量模式的各項指標顯示基本適配度良好，整體模式適配度指標數值相當理想，而內在適配度亦大致符合。此外，大學生在網路健康素養與健康行為各層面的得分均呈現顯著差異，其次，不同「性別」、「就讀科系」、「健康關注程度」的大學生在網路健康素養或健康行為之得分呈現顯著差異，而網路健康素養與健康行為之間具有顯著的正向關係，「較重視健康」、「網路批判性健康素養」可以正向預測健康行為。研究結論：本研究所建構之網路健康素養量表可區分為「互動性」、「功能性」與「批判性」等三層面，且具有不錯的信效度，此外，網路批判性健康素養越佳者，越會採取飲食、運動及睡眠等健康行為。

Purpose: The purpose of this study was to construct an e-health literacy scale(EHLS) and to investigate the relationship between e-health literacy and healthy behavior among undergraduate students in Taiwan. Methods: A nationally representative sample of college students was surveyed, and 455 valid responses obtained in formal study. Results: In the pilot study (N=148), items loaded on 3 dimensions in the exploratory factor analysis: functional, interactive, and critical e-health literacy. The Cronbach α was between .70 and .83. The Cronbach α of the EHLS was .84, and total variance was 61.10%. In the formal study (N=455), we used structural equation modeling to examine the measurement model. The reliability of the individual EHLS items ranged from .36 to .74. Standardized factor loading ranged from .60 to .86 (p<.001). Composite reliability ranged from .75 to .84, and the average variance extracted for each dimension ranged from .50 to .52. The indicators demonstrated a good fit for the measurement model. We identified significant differences for each dimension of e-healthy literacy and healthy behavior. E-health literacy and health behavior were positively correlated. We found that significant differences in e-health literacy or healthy behavior from undergraduate students with different majors, genders, and degree of health concern. Specifically, we found that undergraduate students who demonstrated strong concern for health and had higher critical e-health literacy were more likely to engage in healthy behaviors. Conclusions: The EHLS is a reliable and valid measure of functional, interactive and critical e-health literacy. In addition, those who demonstrated higher critical e-health literacy tended to adopt a healthier lifestyle with respect to diet, exercise, and sleep behaviors.