Adapted Screening Tool Assesses Work-Related Health Information Literacy in Employees

A research team at Saarland University, working with a colleague affiliated with the University of Lübeck, has adapted an existing health information literacy screening instrument for workplace use and tested whether the revised version holds up statistically. The study, published in Frontiers in Public Health in the occupational health and safety section, introduces the EHILS@work scale, a workplace-oriented derivative of the Everyday Health Information Literacy Screening Tool. The work addresses a gap the authors identify directly: although health information literacy and health literacy increasingly intersect as determinants of preventive behavior, health outcomes, and day-to-day functioning at workplaces, these competencies remain insufficiently studied in occupational contexts.

The motivation for the adaptation is rooted in changing work environments. Organizations use a range of analogue and digital communication channels, and classical workplaces are being replaced by hybrid work conditions. In this landscape, employees’ ability to seek, evaluate, and apply work-related health information is gaining relevance, yet no established screening approach existed to capture it. The original German EHILS instrument was therefore revised through expert review so that its items reflect work-related information situations, and a single exploratory item on intranet access was added, bringing the scale to eleven items in total.

To test the adapted tool, the researchers conducted a cross-sectional online survey among the workforce of a public administration. Of 1,108 employees invited, 414 took part, corresponding to a participation rate of 37 percent. The analysis pipeline combined descriptive statistics, exploratory factor analysis, reliability testing, and Spearman correlations linking scale scores to work ability as well as sociodemographic and work-role characteristics.

The exploratory factor analysis, carried out with principal axis factoring and Promax rotation, supported a three-factor solution. The researchers labeled the factors Awareness and Engagement, Assessment and Application, and Access and Understanding. Together, the three factors accounted for 38.3 percent of the variance in responses. The newly added intranet item loaded onto the Access and Understanding factor, indicating that the question about internal digital channels fits within the dimension covering how employees obtain and comprehend information.

Reliability results tell a more cautious story. The original German EHILS scale had shown Cronbach’s alpha values between 0.50 and 0.60. The adapted EHILS@work improved on this, reaching an alpha of 0.658 for the three-factor solution. The authors characterize this as improved but still moderate reliability, a limitation they acknowledge openly rather than overstating the instrument’s psychometric strength.

The correlation analyses produced a pattern of positive associations. Higher EHILS@work scores were linked to better work ability, older age, higher educational attainment, and holding leadership responsibilities. Because the survey was cross-sectional, these findings represent associations at a single point in time rather than causal effects. The data cannot show, for example, whether stronger work-related health information literacy improves work ability or whether employees who feel more able to work also engage more confidently with health information.

What the scale offers, the authors argue, is practicality. EHILS@work is described as a practical, time-efficient screening tool for assessing work-related health information literacy. According to the study, it provides actionable insights into employees’ competencies and the barriers they perceive within everyday organizational information environments. The tool is framed as a way to make visible a competency that has often been overlooked: the everyday skill of seeking, evaluating, and applying health information at work.

The study’s scope and limitations are clearly framed. It was conducted in a single public administration, so the findings describe one organizational setting rather than the labor market at large. The three-factor structure explained just over a third of response variance, leaving substantial room for other influences on how employees respond to the scale items. The moderate reliability of 0.658 also means the instrument’s psychometric properties are not yet at the level of established, extensively validated scales, which the authors state as part of their conclusion.

Looking ahead, the authors call for broader validation across sectors, tailored information technology adaptations, and longitudinal research to examine how the tool performs in different organizational contexts and what role work-related health information literacy plays in shaping workplace health promotion. Until such studies are done, EHILS@work stands as a feasibility-tested first step toward assessing an increasingly relevant occupational competency in a structured, time-efficient way.

For researchers and occupational health practitioners, the study demonstrates a concrete methodological pathway: taking an existing screening instrument, adapting it through expert review to a new information context, adding targeted items, and testing the revised structure with standard factor analytic techniques. The reported associations with work ability, age, education, and leadership responsibility give the scale initial correlates to build on, while the moderate reliability and single-setting sample define exactly what the next phase of validation must address.

Subject of Research: Occupational Health

Article Title: Work-related health information literacy: a factor analytic feasibility study of an adapted health information literacy screening tool (EHILS@work)

Article References: Ochsmann, E., & Collins, O. M. (2026). Work-related health information literacy: a factor analytic feasibility study of an adapted health information literacy screening tool (EHILS@work). Frontiers in Public Health, 14, Article 1974525. https://doi.org/10.3389/fpubh.2026.1974525

Image Credits: AI Generated

DOI: 10.3389/fpubh.2026.1974525

Keywords: occupational health, health information literacy, EHILS@work, screening tool, work ability, workplace health promotion, exploratory factor analysis, public administration, survey research, hybrid work, Work-related, health