A self-report measure of digital skills needed to use digital health tools among older adults—the Skills Measurement and Readiness Training for Digital Health (SMART Digital Health) Scale

Objective To identify a brief scale to accurately assess digital skills among older adults for use in identifying need for support to use digital health tools. Materials and Methods Patients age ≥50 speaking English, Spanish, or Cantonese completed surveys (n = 186) assessing digital health access, use, and skills. A subsample (n = 101) completed observational task assessments gauging competency on 4 tasks essential to digital health skills: (1) launch a video visit from an email/text message hyperlink, (2) visit a specific health website, (3) sign up for a patient portal, and (4) log in to a patient portal. We used exploratory factor analysis, receiver operator characteristic, logistic regression, and dominance analysis methods to identify and evaluate a scale measuring digital skills essential to using digital health tools. Results We found that a 9-item scale demonstrated unidimensionality and reliability (Cronbach’s alpha 0.93) in measuring digital skills. Mean score was 19.3 out of 36. For each task, handout/video support was inadequate in facilitating completion for one-quarter of participants. We found high accuracy of the scale in predicting digital health competency (area under the curve 0.77-0.88). Discussion The Skills Measurement and Readiness Training for Digital Health (SMART Digital Health) scale is a measure of digital skills with evidence of reliability and validity to be used as a diagnostic tool to identify patients requiring support to use digital health tools. Conclusion This early work supports the identification of patients with digital literacy needs who may require interventions to effectively engage in digital health communication and management.