Collective Empowerment in Online Health Communities: Scale Development and Empirical Validation
Collective Empowerment in Online Health Communities: Scale Development and Empirical Validation
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DOI：
10.2196/14392
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发表时间：
2019-11-20
影响因子：
7.4
通讯作者：
Petric, Gregor
中科院分区：
文献类型：
--
作者：
Atanasova, Sara;Petric, Gregor
背景：近年来，在线健康社区（OHCs）在患者赋权方面的作用越来越大，并得到了越来越多的研究。研究主要集中在患者赋权的个人主义概念上，很少关注OHCs在患者集体赋权发展中的作用。虽然OHCs在超越个人的授权方面具有巨大潜力，但在OHCs中集体授权的概念和规模尚未得到发展或验证。目的：本研究旨在开发一套在线健康社区（CE-OHC）集体赋权的测量工具，并通过调查其因子结构、信度、构念效度和预测效度来检验其质量。方法：采用严格的编制方法，编制有效可靠的CE-OHC量表。最初的20个项目在2016年进行的试点研究中首次进行了测试，使用了斯洛文尼亚最大的OHC的280名注册用户的样本。2018年，在同一OHC的3万名注册用户随机抽样的主要研究中，测试了一个包含11个项目的改进版本。最终样本包含784个用户。采用探索性因子分析（EFA）和验证性因子分析（CFA）对量表的因子结构、判别效度和收敛效度进行研究。采用Cronbach alpha系数确定CE-OHC量表的内部一致性。为了建立预测效度，我们采用普通最小二乘回归来检验CE-OHC在用户公民参与中的作用。结果：全民教育产生了一个双因素解决方案，资源知识和集体行动的资源动员这两个因素共同解释了63.8%的方差。二阶CFA与数据拟合良好（近似均方根误差=0.07），量表具有良好的内部一致性（alpha= 0.86）。虽然该量表的收敛效度得到了部分证明，但其判别效度仍未得到证实。总体而言，CE-OHC被证实是用户公民参与的预测因子，但在两个子尺度上的影响有些弱且不一致。结论：CE-OHC量表是一个可靠且相对有效的工具，可以作为一个良好的基线来推进OHC背景下集体赋权的测量。这是为此目的开发的第一个量表，未来的研究应侧重于开发与OHC环境相关的集体赋权结构的明确的法理网络。
Background: The role of online health communities (OHCs) in patient empowerment is growing and has been increasingly studied in recent years. Research has focused primarily on individualistic conception of patients' empowerment, with much less attention paid to the role of OHCs in the development of patients' collective empowerment. Although OHCs have immense potential for empowerment that goes beyond the individual, the concept and scale of collective empowerment in OHCs have not yet been developed or validated.Objective: This study aimed to develop an instrument for measuring collective empowerment in online health communities (CE-OHC) and to test its quality by investigating its factorial structure, reliability, construct validity, and predictive validity.Methods: The CE-OHC scale was developed according to a strict methodology for developing valid and reliable scales. An initial set of 20 items was first tested in the pilot study conducted in 2016 using a sample of 280 registered users of Slovenia's largest OHC. A refined version with 11 items was tested in the main study conducted in 2018 on a random sample of 30,000 registered users of the same OHC. The final sample comprised 784 users. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to investigate the factorial structure, discriminant validity, and convergent validity of the scale. Cronbach alpha coefficient was used to determine the CE-OHC scale's internal consistency. To establish the predictive validity, ordinary least squares regression was performed to test the role of CE-OHC in users' civic participation.Results: The EFA resulted in a two-factor solution, and the two factors-knowledge of resources and resource mobilization for collective action-together explain 63.8% of the variance. The second-order CFA demonstrated a good fit to the data (root mean square error of approximation=0.07) and the scale had a good internal consistency (alpha=.86). Although evidence of the scale's convergent validity was partially provided, discriminant validity of the scale remained unconfirmed. Overall, CE-OHC was confirmed to be a predictor of users' civic participation, but the influence was somewhat weak and inconsistent across two subscales.Conclusions: The proposed CE-OHC scale is a reliable and relatively valid instrument and serves as a good baseline to advance the measurement of collective empowerment in OHC contexts. This is the first scale developed for this purpose, and future research should focus on the development of a clear nomological network of the collective empowerment construct in relation to the OHC settings.