Psychometric Properties of the TWente Engagement with Ehealth Technologies Scale (TWEETS) Among Patients with Hypertension in Italy.

Introduction: Engagement with mobile health (mHealth) technologies among patients with hypertension is linked to reduced blood pressure and improved patient understanding of the condition.

Aim: This study aimed to evaluate the psychometric properties (validity and reliability) of the TWente Engagement with Ehealth Technologies Scale (TWEETS) in an Italian cohort with hypertension. This study is the first attempt to evaluate the psychometric characteristics of the TWEETS in this population.

Methods: The study was conducted in three phases. The first phase encompassed the translation and cultural adaptation of the TWEETS to the Italian setting. The second phase involved an expert panel evaluating the instrument's face and content validities. The third phase was a cross-sectional study aiming to test construct validity and reliability. Adults diagnosed with hypertension were eligible for participation. Additional inclusion criteria included stable antihypertensive treatment for at least 2 weeks before enrolment and the provision of written informed consent. Patients were taught how to use two mHealth devices using the teach-back method.

Results: A total of 131 patients were enrolled. Exploratory and confirmatory factor analyses revealed that the TWEETS had a one-factor structure and a good level of fit. Cronbach's alpha coefficients suggested good internal consistency.

Conclusions: The findings indicate that the TWEETS is a valuable tool for assessing the engagement of patients with hypertension with mHealth devices. Further assessment is needed in various cohorts to confirm the psychometric equivalence of the construct across different groups with hypertension.