The COVID-19 pandemic rapidly accelerated the adoption of telehealth, expanding access to care while simultaneously exposing disparities in digital skills, technology access, and familiarity with virtual platforms—collectively termed telehealth literacy. These barriers disproportionately affect older adults, individuals with sensory or cognitive impairments, and those with limited broadband access, potentially limiting equitable participation in virtual care. To address this gap, the Telehealth Literacy Screening Tool (TLST) was developed to identify patient-specific barriers, and this study aimed to complete a multi-phase validation of its revised version (TLSTv2), evaluating usability, reliability, and validity. We conducted a six-step validation process guided by established survey validation frameworks and adapted to the telehealth context. Expert review and cognitive interviews refined item clarity, readability, and accessibility. A pilot study (n=183) demonstrated feasibility, with a 69.3% response rate and minimal item nonresponse. Exploratory factor analysis identified three core domains—technology access, platform navigation, and patient confidence—accounting for 76% of cumulative variance. Internal consistency was strong, with a Cronbach’s alpha of 0.80. Construct validity was supported by a strong correlation (r = 0.96) between TLSTv2 scores and successful completion of telehealth video visits. Overall, the TLSTv2 is a reliable and valid 17-item instrument that effectively identifies barriers to telehealth engagement. As telehealth continues to expand, this tool offers a practical strategy to mitigate digital health disparities and promote more equitable access to virtual care.

Authors:
Audrey Shawley, Scripps Mercy Hospital San Diego, United States
Lily Morrison, Sutter Santa Rosa, United States
Rohit Rajendran, The University of Texas Houston, United States
Rana Mehdizadeh, The University of Massachusetts Worcester, United States
Kathy Jo Carstarphen, Ochsner Health System, United States

About the Presenter(s)
Audrey Shawley is currently an internal medicine resident physician at Scripps Mercy Hospital San Diego in San Diego, USA.

Connect on Linkedin
https://www.linkedin.com/in/audrey-shawley-44623523b

See this presentation on the full schedule – Thursday Schedule

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