Development of the E-Nabız Usage Behavior Scale: Validity and Reliability Study

Abstract

Highlights What are the main findings? The 6-item e-Nabız Usage Behavior Scale (eNUBS) was developed as a unidimensional, structurally valid, and internally consistent instrument to measure real-world personal health record utilization. Psychometric analyses demonstrated acceptable construct reliability (α = 0.72), stable factor loadings (0.59 to 0.76), and adequate model fit indices via confirmatory factor analysis. What are the implications of the main findings? The eNUBS provides an ultra-brief, practical screening tool for clinicians and researchers to objectively assess and monitor patient engagement with national digital health portals. The scale serves as an adaptable global prototype that can be cross-culturally modified to evaluate user behaviors toward emerging digital healthcare infrastructures worldwide. Abstract Objective: This study aims to evaluate the validity and reliability of the “e-Nabız Usage Behavior Scale” (eNUBS), developed to measure user behaviors toward Türkiye’s national personal health record system. Methods: This methodological study included 304 voluntary adult, non-healthcare participants at a hospital. Data were collected via an 8-item sociodemographic form and a 6-item draft scale. Construct validity was evaluated using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA); reliability was assessed using Cronbach’s alpha and item-total correlations. Results: Participants were 61.8% male, with a mean age of 37.79 ± 9.40. EFA confirmed a unidimensional structure, explaining 46.21% of the total variance. The Cronbach’s alpha was 0.72, and corrected item-total correlations ranged from 0.43 to 0.59. CFA demonstrated adequate model fit indices. Conclusions: The eNUBS is a brief, valid, and reliable tool for assessing real-world digital health portal usage, offering valuable guidance for digital health policy and for monitoring patient engagement.