230 7 Chapter 7 Invariance testing Invariance testing for subgroups based on age, gender, education and current diagnosis showed configural invariance, indicating that the overall factor structure of the eHLQ is the same between subgroups. We did not obtain full metric invariance in any of the subgroup comparisons (Table 3). Following the significant Δχ2 tests, we examined the univariate test scores and identified the item loadings which showed the strongest lack of invariance, indicated by larger chi-square values. Lifting between-group equality restrictions on these loadings, we obtained models of partial metric invariance: We lifted restrictions on loadings of items 15, 21, 23 and 26 for comparison of age groups; items 20, 19 and 29 for gender; items 10, 14, 22, 30 and 31 for educational level and items 11, 19, 23 and 25 for current diagnosis and. All models improved and partial metric invariance was supported, indicating that the model is partially metric invariant (see Table 3). Next, we applied between-group equality restrictions to item thresholds, which proved tenable according to the non-significant decreases in Δχ2 tests (Table 3). Closer examination of the non-invariant items showed comparable factor loadings between groups and standard errors below 0.1, except for item 19, hence we concluded that the items were sufficient invariant to allow comparison of scores between groups (See Additional file 3). Comparison of scores between groups Comparison of mean scores between subgroups are presented in Table 4. The group of people with people 45 years or older consistently had lower scores than the younger age group. Statistically significant differences were found for domains ‘2. Engagement in own health’, ‘3. Ability to actively engage with digital services’ and ‘ 7. Digital services that suit individual needs, however effect sizes were small (range 0.38 to 0.12). Comparison of mean scores across educational level (low vs. high) showed moderate effect sizes on the domain scores domains 2. ‘Engagement in own health’, 3. ‘Ability to actively engage with digital services’, 6. ‘Access to digital services that work’ and 7. ‘Digital services that suit individual needs’, with people with lower education scoring lower for all, except domain 4. ‘Feel safe and in control’. People with a current diagnosis scored significantly higher on domain 1. ‘Using technology to process health information’, 2. ‘Engagement in own health’ and 6. ‘Access to digital services that work’ but again effect sizes were small (range 0.13 to 0.26).
RkJQdWJsaXNoZXIy MTk4NDMw