The prostate cancer electronic health (eHealth) literacy instrument - a tool for eHealth design and patient communication

Sep 22, 2026

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Development and validation of the Prostate Cancer Electronic Health (eHealth) Literacy Instrument (P-CeHLI) addressed the lack of clear, validated eHealth literacy measurement for men with prostate cancer. Using a three-phase longitudinal study with 349 participants, exploratory and confirmatory factor analyses tested construct validity. The instrument was compared with the Transactional eHealth Literacy Instrument and related eHealth use and sociodemographic characteristics. Results supported a four-factor model with strong fit and reliability, and added predictive value for eHealth use beyond TeHLI.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Objective

Patients and Methods

Results

Conclusion

Introduction

BJU Int 2026; 138: Supplement 2: S88–S96 doi:10.1111/bju.70225 Original Article The prostate cancer electronic health (eHealth) literacy instrument: a tool for eHealth design and patient communication Stuart Robert Jackson 1 , Paul Yu2, Steven Sowter3, Stefano Occhipinti9,10, Suzanne Chambers4,5,6, Scott Leslie7,8 and Manish I. Patel1,2 1 The University of Sydney, Camperdown, 2Department of Urology Westmead Hospital, University of Sydney, 3University of New South Wales, 4Faculty of Health Sciences, Australian Catholic University, 5Faculty of Health, University of Technology, 6St Vincent’s Health Network, 7RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, 8Faculty of Health and Medicine, University of Sydney, Sydney, New South Wales, 9School of Applied Psychology, Grifﬁth University, Brisbane, Queensland, Australia, and 10Department of English and Communication, International Research Centre for the Advancement of Health Communication, Hong Kong Polytechnic University, Hong Kong, China Objective To describe the development and validation of the Prostate Cancer Electronic Health (eHealth) Literacy Instrument (P-CeHLI) . This is in response to: (i) a lack of clear and validated eHealth literacy measurement for men with prostate cancer; (ii) the unique information processing, decision making, and digital communication experience of men with prostate cancer as a single sex, older age, cancer cohort; and (iii) modern eHealth literacy theory and research, which now greatly considers the transactional nature of web technologies and digital communicative practice. Patients and Methods A total of 349 men with prostate cancer participated in a three-phase, longitudinal instrument development study. This was undertaken with end-user participation, and a multidisciplinary and international collaboration of prostate cancer, psychooncology, communication, and biostatistics experts. Exploratory and conﬁrmatory factor analysis evaluated construct validity. The P-CeHLI was compared to respondents’ eHealth literacy measured with the Transactional eHealth Literacy Instrument (TeHLI), as well as respondent eHealth utilisation and sociodemographic characteristics. Results A four-factor model was demonstrated with acceptable ﬁt properties (root mean square error of approximation = 0.074; comparative ﬁt index = 0.931; Tucker–Lewis index = 0.924; standardised root mean square residual = 0.051) and excellent reliability (subscale alphas of 0.85–0.96) . Domains of the P-CeHLI included cancer-speciﬁc functional, communicative, critical and translational eHealth literacy. Association between the scores of the scales and respondents’ characteristics were similar; however, for all four subdomains, the P-CeHLI added signiﬁcant predictive value when assessing eHealth use in men with prostate cancer whilst controlling for respective TeHLI scores. Conclusion The P-CeHLI establishes a novel cancer-speciﬁc multidomain eHealth literacy instrument, validated in men with prostate cancer, and positioned to respond to their needs in the digital cancer care era. The P-CeHLI provides a new opportunity for clinicians and researchers to accurately identify and enhance the eHealth literacy skills of patients with prostate cancer, which may improve future clinical outcomes through digital intervention and improved communicative practice. Keywords electronic (e)Health, digital, internet, prostate, cancer, literacy, communication 􀀁 2026 The Author(s) . [wileyonlinelibrary.com](wileyonlinelibrary.com) BJU International published by John Wiley & Sons Ltd on behalf of BJU [International. www.bjui.org](International. www.bjui.org) This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modiﬁcations or adaptations are made. Introduction For men

FAQs

What is the P-CeHLI designed to measure?

The P-CeHLI measures prostate cancer–specific electronic health (eHealth) literacy, covering functional, communicative, critical, and translational domains.

How was the instrument developed and validated?

A three-phase longitudinal study with 349 men with prostate cancer used exploratory and confirmatory factor analysis to evaluate construct validity and reliability.

What was the P-CeHLI compared against?

The P-CeHLI was compared with the Transactional eHealth Literacy Instrument (TeHLI), along with eHealth utilisation and sociodemographic characteristics.

What do the results show about prediction of eHealth use?

Although associations with participant characteristics were similar, the P-CeHLI added significant predictive value for eHealth use across all four subdomains after controlling for corresponding TeHLI scores.

Sep 22, 2026

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