We used two health literacy measures assessing different aspects of the concept. For health literacy, we used the Single Item Literacy Screener [19] which helps identify limited reading ability, an important aspect of health literacy. Participants responded to the question: “How confident are you filling out forms by yourself?” Response options included: not at all, a little bit, somewhat, quite a bit, extremely. We considered those with “extreme” or “quite a bit” of confidence to have adequate levels of health literacy. We assessed eHealth literacy using eHEALS, an 8-item scale, designed to “measure consumers’ combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems’’ [20]. Respondents indicated their level of agreement on a 5-point Likert-type scale (1 “Strongly disagree” to 5 “strongly agree”). Higher scores on the summation of responses reflect higher levels of eHealth literacy. The reliability and validity of eHEALS has been established in both English and Spanish [20,21]. Cronbach’s α for the scale was 0.96 for our Spanish-speaking subsample (N = 495) and 0.94 for our English-speaking subsample (N = 172).
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