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.