Translation, Adaptation and Psychometric Testing of the Digital Health Technology Literacy Assessment Questionnaire (DHTL-AQ) in the Serbian Language

Background: The use of digital health technologies (DHTs), systems that use computing platforms, connectivity, software, and/or sensors for health care and related uses, is rapidly increasing. Assessing literacy in this area may be challenging given the absence of comprehensive instruments, especially those dedicated to health care professionals. The digital health technology literacy assessment questionnaire (DHTL-AQ) is a 34-item instrument that assesses an individual's ability to use DHTs, services, and data.

Aim: To translate and culturally adapt the DHTL-AQ and to evaluate the psychometric properties of the Serbian version.

Method: The DHTL-AQ English version was translated into Serbian, back-translated, and adapted via expert consensus discussion. Pilot testing was conducted among a population of community pharmacists. To gather evidence of initial validity, the culturally adapted version was tested in the same population as the pilot. Reliability was examined using Cronbach's alpha (Cα), and a test-retest methodology for temporary stability. Validity was explored through factor analysis.

Results: A pilot study (n = 22) included linguistic and cultural adjustments, confirming the item comprehensibility. The final Serbian DHTL-AQ consists of 5 questions and 25 items. The psychometric analysis (n = 162) indicated, satisfactory internal consistency (Cα = 0.822) and temporal stability (ICC = 0.981). Factor analysis identified 3 factors that explained 52% of the total variance, reducing the number of factors to 3 compared with 4 into the original questionnaire.

Conclusion: The culturally adapted DHTL-AQ Serbian version demonstrated strong psychometric properties. Practical application can support the development and implementation of customized education and training programs and new DHT-related services that pharmacists can offer patients.