Social Media Use, eHealth Literacy, Disease Knowledge, and Preventive Behaviors in the COVID-19 Pandemic: Cross-Sectional Study on Chinese Netizens

The new role of nursing in digital inclusion: Reflections on smartphone use and willingness to increase digital skills among Chinese older adults

OBJECTIVE

This study explores the willingness of older adults to use smartphones and improve their digital skills and encourages nursing to actively participate in bridging the digital divide.

METHODS

Subject analysis was used to conduct qualitative research, and 23 older adults were interviewed.

RESULTS

We identified four themes: (1) the current situation of smartphone use; (2) the digital dilemma of smartphone use; (3) social support for digital skills; and (4) the willingness to learn digital skills. Older adults in China are willing to accept and use smartphones for simple operations, and peer learning may be an effective way to improve their digital skills.

CONCLUSION

Community support is necessary to develop the digital skills of older adults with smartphones and reduce the digital divide to the greatest extent possible. Nursing may play a role in promoting digital inclusion for older adults.

The relationship between eHealth literacy, social media self-efficacy and health communication intention among Chinese nursing undergraduates: A cross-sectional study

Background

With the popularization of the Internet, it has become possible to widely disseminate health information via social media. Medical staff's health communication through social media can improve the public's health literacy, and improving the intention of health communication among nursing undergraduates is of great significance for them to actively carry out health communication after entering clinical practice.

Objective

To explore the relationship among eHealth literacy, social media self-efficacy, and health communication intention and to determine the mediating role of social media self-efficacy in the relationship between eHealth literacy and health communication intention.

Design

A cross-sectional descriptive correlation design was used in this study.

Participants

Stratified cluster sampling was used to select 958 nursing students from four nursing colleges in Jiangsu Province, China, from June to July 2021.

Methods

Data were collected using the eHealth Literacy Scale, the Social Media Self-efficacy Scale, and the Health Communication Intention Questionnaire. Sociodemographic data were also collected. Correlation analysis and regression analysis were used to determine the relationship between eHealth literacy, social media self-efficacy, and health communication intention.

Results

Health communication intention is positively correlated with eHealth literacy and social media self-efficacy. There is a significant positive correlation between eHealth literacy and health communication intention (β = 0.57, p < 0.001), and social media self-efficacy played a mediating role in the influence of eHealth literacy on health communication intention (the mediating effect accounted for 37.2% of the total effect).

Conclusion

The study found that eHealth literacy and social media self-efficacy had an impact on health communication intention. Because there is a correlation between eHealth literacy and social media self-efficacy and health communication intention, in order to promote health communication intention of nursing students, it is also important to cultivate eHealth literacy and social media self-efficacy of nursing students. In view of these results, targeted educational programs must be developed to improve eHealth literacy and social media self-efficacy among nursing undergraduates, thereby promoting their health information transmission.

Exploring low-income migrant workers' health information-seeking behavior during COVID-19 in Taiwan: A qualitative study

Background

COVID-19 pandemic is reported to exacerbate existing vulnerabilities of marginalized groups, and the lack of self-care can lead to the spread of the virus across society. Therefore, effective responses to the challenges imposed by the health crisis should consider the health information needs of migrant workers.

Objective

We aimed to explore how migrant low-income workers seek health information and how their health-related information needs were met during a health crisis. We also investigated migrant workers’ preferred information sources and types of content with the theoretical concept of health literacy to understand the development of health competencies among migrant workers.

Methods

We conducted semi-structured interviews with Thai low-income migrant workers. A total of 13 Thai migrant workers participated in the study, among whom five were undocumented. The interviews were audio-taped, transcribed, and analyzed with the thematic analysis approach.

Results

Our findings indicated that migrant workers’ health literacy and health information behavior could be improved through technology when facing a health crisis. We found that participants sought health information proactively to reduce their perceived risks. However, there is still space for design to support the ability to process jargon information and apply local policy, such as providing easy-to-understand, accurate, and timely information. The findings of this study provide some insights for the authority and technological design to respond to migrant workers’ health information needs.

Conclusions

This study acknowledges and understands the needs of vulnerable migrant workers in society. The findings of this study provide insights for the authority and technological design to respond to migrant workers’ health information needs. We also outline the areas worth further investigation, such as the communication between information seekers and providers, and the navigation of the healthcare system for migrants in the host country.

The role of mobile health technologies in promoting COVID-19 prevention: A narrative review of intervention effectiveness and adoption

Background

Researchers have found innovative ways of using mobile health (mHealth) technologies to prevent the spread of coronavirus disease 2019 (COVID-19). However, fewer studies have been done to determine their adoption and effectiveness.

Objective

This review summarises the published evidence on the effect of mHealth technologies on the adoption of COVID-19 preventive measures, prevention knowledge acquisition and risk perception as well as technology adoption features for COVID-19 prevention.

Methods

PubMed, IEEE and Google Scholar databases were searched for peer-reviewed literature from 1 January 2020 to 31 March 2022 for studies that evaluated the effect of mHealth technologies on COVID-19 preventive measures adoption, prevention knowledge acquisition and risk perception. Thirteen studies met the inclusion criteria and were included in this review. All the included studies were checked for quality using the mHealth evidence reporting and assessment (mERA) checklist.

Results

The review found out that the utilisation of mHealth interventions such as alert text messages, tracing apps and social media platforms was associated with adherence behaviour such as wearing masks, washing hands and using sanitisers, maintaining social distance and avoiding crowded places. The use of contact tracing was linked to low-risk perception as users considered themselves well informed about their status and less likely to pose transmission risks compared to non-users. Privacy and security issues, message personalisation and frequency, technical issues and trust concerns were identified as technology adoption features that influence the use of mHealth technologies for promoting COVID-19 prevention.

Conclusion

Utilisation of mHealth may be a feasible and effective way to prevent the spread of COVID-19. However, the small study samples and short study periods prevent generalisation of the findings and calls for larger, longitudinal studies that encompass diverse study settings.

Vaccinated and Unvaccinated Risk Perceptions and Motivations for COVID-19 Preventive Measures Based on EPPM-A Polish Qualitative Pilot Study

COVID-19 has been a "major interrupting event" during which individuals largely relied on intuitive risk perceptions as precursors of COVID-19 health behaviors. Given the strong correlation between risk perceptions and the adoption of preventive measures, this pilot study attempts to explore how Polish society perceives COVID-19 health risks from the point of view of vaccinated and unvaccinated individuals. The Extended Parallel Process Model (EPPM) constitutes the basis for this research. Two focus group discussions (FGDs) were conducted, one with participants who had received COVID-19 vaccinations and the other with participants who had not. Conventional and directed content analyses were used to examine the data from the FGDs. Five categories emerged from the data: COVID-19 risk perceptions, coping with the pandemic, sources of knowledge, distrust, and pandemic fatigue. All categories fit into the theoretical constructs of the EPPM. Both groups have a high-perceived vulnerability to COVID-19 infection and recognize its seriousness. Individuals also have a high perceived response self-efficacy, given their awareness of COVID-19 preventive measures and how these should be applied. Nonetheless, particularly the unvaccinated, are skeptical about the effectiveness of the implemented measures, showing low perceived response efficacy. Future communication strategies should target the effectiveness of COVID-19 preventive measures, and one's perceived response efficacy, to improve adherence to public health measures.

Effects of information sources on public preventive behaviors in health emergencies: Evidence from a digital epidemiologic study during the COVID-19 pandemic

Introduction

It has been approved that information sources would affect public behaviors. However, due to the outbreak of COVID-19, this influence was enhanced and showed a distinctive pattern among different populations, which has been less noticed before. We aimed to investigate the potential roles of different information sources in COVID-19 preventive behaviors of different publics.

Methods

A cross-sectional online survey with 11,190 participants from 33 province-level regions in China was conducted during the COVID-19 pandemic. Sociodemographic characteristics, COVID-19 preventive behaviors, and information sources for COVID-19-related information were assessed. A mixed linear model was used to analyze risk factors of COVID-19 preventive behaviors. The effects of different information sources on COVID-19 prevention behaviors of different publics were analyzed.

Results

Generally, the Chinese public had good COVID-19 preventive behaviors, and the top three COVID-19 preventive behaviors with the higher action rate were avoiding eat bushmeat (76.1%), a healthy diet (74.8%), and avoiding contact with people with symptoms of respiratory diseases (73.0%). About information sources, 12320 telephone (National Public Health Hotline) (-0.62, 95% CI: -0.94 to -0.31) and acquaintances consulting (-1.00, 95% CI: -1.31 to -0.69) were negatively associated with COVID-19 preventive behaviors, while internet resources, family doctors, hospitals, and community health centers were positively associated with COVID-19 preventive behaviors (1.00 vs. 0.47 vs. 0.46 vs. 0.33, P < 0.05). For older adults, accessing to COVID-19-related information through family doctors and community health centers were positively associated with COVID-19 preventive behaviors. For the non-educated, family doctors and community health centers had positive effects on their COVID-19 preventive behaviors. Family doctors and internet resources were positively associated with COVID-19 preventive behaviors among those earning 5,000 yuans and above. The effects of family doctors, hospitals, and internet resources were higher for COVID-19 preventive behaviors of urban publics than for rural publics. Finally, the effect of internet resources on COVID-19 preventive behaviors of females was lower than males.

Conclusions

Obtaining COVID-19-related information through internet resources had the most significant effect on COVID-19 preventive behaviors, but was not significant among publics with old age, low education, low income, and living in rural area.

Food Delivery Drivers' Health Literacy Regarding COVID-19 Prevention and Protective Behaviors During the COVID-19 Pandemic: Cross-sectional Survey in Southern Thailand

Background

In 2019, COVID-19 spread worldwide, causing a pandemic that has posed unprecedented challenges and pressure for health systems and economies. Food delivery services have become an important medium for consumer food purchases to limit human-to-human contact. Thus, delivery drivers are at high risk of exposure to COVID-19 infection at work. To the best of our knowledge, no studies have analyzed the dimensions of health literacy (HL) regarding COVID-19 prevention in this population.

Objective

This study aims to explore the HL status toward COVID-19 prevention and its associated factors among food delivery drivers in southern Thailand.

Methods

Following a cross-sectional survey from July to August 2021, Thai food delivery drivers in the upper-south and lower-south regions of southern Thailand were recruited to participate during the compulsory COVID-19 lockdown. An online structured questionnaire was administered verbally and recorded by the interviewer. Univariate and multivariate linear regressions were used to explore independently associated factors.

Results

Of 401 drivers, 291 (72.6%) were men. The median age was 31 years (range 19-64 years). The median number of months working as a driver was 12 months, and the median number of working hours was 9 hours per day. The median number of daily food orders was 20, while the median daily income was Thai baht (THB) 600 (US $15.90). Social media (Facebook and Line) was a common source of health information. The most common information required was about the COVID-19 vaccine, medications, and treatment. Most drivers (285/401, 71.1%) had excellent HL levels regarding COVID-19 prevention. Only the practical application of information was statistically correlated with behavior (r=0.38, P<.001). Drivers in the lower south of Thailand were more likely to have excellent HL than other drivers (β=7.03, P<.001). Those who frequently accessed information through YouTube (β=–2.17, P=.01) and relatives (β=–4.19, P<.001) were less likely to have excellent HL levels.

Conclusions

Understanding HL among food delivery drivers would be useful for planning effective interventions that target this population. Conventional health education through social media alone may not be effective at educating people about COVID-19 prevention. Information literacy skills could determine individuals’ HL and drivers’ behaviors.

Association between fear of COVID-19 and hoarding behavior during the outbreak of the COVID-19 pandemic: The mediating role of mental health status

Hoarding behavior can effectively improve people's ability to resist risks, so as to reduce the negative effects of risks. However, excessive hoarding behavior will seriously reduce people's quality of life. The COVID-19 pandemic can cause excessive hoarding in a large number of people in a short period of time, and also cause a series of economic problems such as social material shortage. It is unclear how hoarding levels are linked to fear and negative emotions caused by COVID-19 among people of different educational backgrounds and social status. The purpose of this study was to explore the relationship between fear of COVID-19 and hoarding behavior in different populations in school and social contexts, as well as the mediating role of negative emotions and the moderating role of subjective/objective social status and education level in this process. An online cross-sectional survey was conducted in various provinces in China in January 2022. Demographic information, the MacArthur Scale of Subjective Social Status, the Fear of COVID-19 scale, the Depression Anxiety Stress-21, and the Saving Inventory-Revised were used to evaluate the severity of individual hoarding symptoms, the frequency of hoarding, the degree of fear, and the negative emotions (depression, anxiety, stress) caused by COVID-19. Research data showed that fear of COVID-19 was significantly correlated with hoarding behavior (p &lt; 0.05). Fear of COVID-19 was significantly lower in the student sample than in the nonstudent sample (p &lt; 0.05). Negative emotions played a mediating role in the relationship between fear of COVID-19 and hoarding behavior (p &lt; 0.05). Educational and economic levels moderated this process, but social status did not. Compared with the student sample, educational background and income had less of a moderating effect on the depression, anxiety, and stress caused by fear of COVID-19 in the nonstudent sample. However, these factors had a more regulative effect on the clutter and excessive acquisition behavior caused by depression, anxiety, and stress, although not on difficulty discarding. These findings suggest that reduce negative emotions in the population, improve cognitive levels, and provide financial support from governments may be effective ways to reduce hoarding symptoms.

Predictors of the Public’s Aversion to Patients Infected with COVID-19 in China: The Mediating Role of Negative Physiology

COVID-19 has had a lasting impact on the public’s mental health. Understanding the mechanism of the formation of the public’s aversion to COVID-19-infected people can not only help eliminate the irrational stigma, rejection, and aversion of the public but also promote the creation of a harmonious and healthy social atmosphere. Based on stimulus–organism–response theory, this study explored the relationships between environmental stimuli, public negative physiology, and aversion responses. A cross-sectional, online-based survey study was conducted in April 2022. A total of 1863 effective questionnaires from respondents of various ages, genders, incomes, and education levels were acquired. Structural equation modeling was used to test the proposed model. The environmental stimuli including the use of social media and the perception of risk communication aggravated the negative physiology of the public, while the public’s perception of prevention measures reduced the public’s negative physiology during the epidemic. The negative physiology of the public increases the public’s aversion responses, including disgust, stigma, and avoidance, toward patients infected with COVID-19. The negative physiology of the public plays a mediating role in the relationship between the environmental stimuli and the public’s aversion to patients infected with COVID-19. The emergence of excessive information in social media and strict prevention measures in daily life, as well as the dissemination of a large amount of risk information in pseudo-environments and realistic environments, have all exerted an impact on public sentiment and cognition. In the case of the prolonged spread of the epidemic, the accumulation of negative physiology, such as anxiety, panic, and depression, is more likely to lead to the public’s aversion to people with COVID-19.

Photo Activity on Social Networking Sites and Body Dissatisfaction: The Roles of Thin-Ideal Internalization and Body Appreciation

Objective: According to sociocultural theory, media is associated with detrimental effects on body image. Due to the popularity of social networking sites (SNS) and the prevalence of body image disturbance among young women, the association between them is worth further exploration. This study examined the relationship between photo activity on SNS and body dissatisfaction (BD) and the roles of thin-ideal internalization (TII) and body appreciation (BA) in this relation. Materials and Methods: A total of 746 Chinese female undergraduate students (mean age 20.34 ± 1.47 years) completed a questionnaire measuring SNS photo activity, TII, BD, and BA. Results: (1) Photo activity on SNS was positively associated with BD (r = 0.10, p < 0.01), and TII could mediate this relation (β = 0.07, 95% CI = [0.04, 0.10]). (2) Both the direct effect of SNS photo activity on BD (β = −0.08, p < 0.05) and the mediating effect of TII (β = −0.09, p < 0.01) were moderated by BA. Specifically, these associations were more pronounced for students with lower BA. Conclusion: People exposed to ideal photos or images can shape women’s body image perception via TII, whether in the age of traditional media or the Internet, and BA did not buffer the effect of ideal photos on internalization. Our findings could provide practical suggestions for rational photo activity on SNS and the intervention for BD.

The Relationship Between Information Sources, Health Literacy, and COVID-19 Knowledge in the COVID-19 Infodemic: Cross-sectional Online Study in Japan

BACKGROUND

The COVID-19 pandemic has caused not only a disease epidemic but also an infodemic. Due to the increased use of the internet and social media, along with the development of communication technology, information has spread faster and farther during the COVID-19 infodemic. Moreover, the increased choice of information sources has made it more difficult to make sound decisions regarding information. Although social media is the most common source of misinformation, other forms of media can also spread misinformation. However, the media sources used by people with high health literacy and COVID-19 knowledge to obtain information are unclear. Furthermore, the association between the use of multiple information sources and health literacy or COVID-19 knowledge is ill-defined.

OBJECTIVE

This study aims to examine the following 3 aspects regarding the COVID-19 infodemic: (1) the relationship between health literacy, COVID-19 knowledge, and the number of information sources used; (2) the impact of media use on health literacy; and (3) the impact of media use on COVID-19 knowledge.

METHODS

An online cross-sectional study was conducted in November 2021. Participants were 477 individuals aged 20-69 years. After obtaining consent to participate in the study, participants were asked about sociodemographic indicators, sources of health-related information, health literacy, and COVID-19 knowledge. Sources of health-related information were categorized into 4 types: mass media, digital media, social media, and face-to-face communication. The Spearman rank correlation test was conducted to determine the relationship between health literacy, the number of correct answers to COVID-19 knowledge, and the number of information sources used. Multiple regression analysis was conducted with health literacy and the number of correct answers as dependent variables, the 4 media types as independent variables, and age and sex as adjustment variables.

RESULTS

Mass media was the most frequently used source of information, followed by digital media, face-to-face communication, and social media. Social media use was significantly higher among individuals aged 20-29 years than among other age groups. Significant positive correlations were found between health literacy, the number of positive responses to COVID-19 knowledge, and the number of information sources used. Multiple linear regression analysis showed that health literacy is associated with access to information from digital media and face-to-face communication. Additionally, COVID-19 knowledge was associated with access to information from mass media, digital media, and face-to-face communication.

CONCLUSIONS

Health literacy and COVID-19 knowledge could be improved using diverse information sources, especially by providing opportunities to use digital media and face-to-face communication. Furthermore, it may be important to improve health literacy and provide accurate knowledge about COVID-19 to young adults.

Infection preventive behaviors and its association with perceived threat and perceived social factors during the COVID-19 pandemic in South Korea: 2020 community health survey

BACKGROUND

This study examined why some individuals have not properly performed health prevention behavior during the coronavirus disease 2019 (COVID-19) pandemic. We used data from a community health survey conducted by public health centers in South Korea to identify factors affecting COVID-19 prevention behavior in urban and rural areas. Also, we examined whether individual-level demographic, socio-psychological, and structural variables affected COVID-19 prevention behavior by referring to a model explaining individuals' health prevention behavior. In particular, the study is significant as not many other measures were suggested besides compliance with personal quarantine rules during the early phase of the pandemic in 2020. We hope that the results of this study will be considered in further analysis of infection preventive behavior and in future health crises.

METHODS

Probability proportional and systematic sampling were used to collect data in 2020 from 229,269 individuals. After exclusion, the valid data from 141,902 adults (86,163 urban and 44,739 rural) were analyzed. We performed t-tests and analyses of variance to ascertain the differences in COVID-19 preventive behaviors according to demographic characteristics, and a post-hoc analysis was conducted using Scheffé's test. Factors that affected participants' COVID-19 preventive behaviors were analyzed using multiple regression analyses.

RESULTS

The variables significantly influencing COVID-19 preventive behaviors in urban areas were age, gender, living with two or more people, educational level, monthly household income, working status, influenza vaccination, daily life stress, and perceived threat. In rural areas, age, gender, living with two or more people, education level, influenza vaccination, daily life stress, perceived threat, and perceived social factors were significantly associated with increased COVID-19 preventive behaviors.

CONCLUSIONS

Several demographic characteristics were associated with urban and rural residents' COVID-19-related preventive behaviors. A different approach is needed for the two regions in future policy. Future studies should aim to improve the power of the model and include other factors that may be related to COVID-19 preventive behavior.

Emerging technologies adoption in healthcare: A SOHI model

The internet and emerging technologies have increased the utilisation of digital platforms. This study aims to draw on performance expectancy, social influence, and satisfaction to investigate a proposed model which is geared toward social media healthcare information (SOHI) adoption. The proposed model uses a structured online questionnaire, and 300 responses were evaluated using partial least squares and structural equation modelling [PLS-SEM]. From the findings, performance expectancy of social media (PESM) and satisfaction with social media (SATSM) were revealed to be significant predictors of behavioural intention towards social media (BISM). Satisfaction with social media (SATSM) had the greatest impact on BISM, accounting for 63.8 per cent of the variance in users' intentions to utilise SOHI. Similarly, PESM and social influence on social media (SISM) had the most predictive influence on SATSM, accounting for 50.5 per cent of the variance in users' social media satisfaction, which led to SOHI adoption. Unlike others, the social influence on social media (SISM) did not have a significant effect on BISM. BISM and satisfaction with social media (SATSM) were significant predictors of SOHI adoption, accounting for 54.5 per cent of the variance in SOHI adoption. The recommendations in this study would help healthcare professionals change their approach to digital healthcare engagement.

Perceived Information Distortion about COVID-19 Vaccination and Addictive Social Media Use among Social Media Users in Hong Kong: The Moderating Roles of Functional Literacy and Critical Literacy

During the COVID-19 pandemic, distorted information about the COVID-19 vaccination is widely disseminated through social media. The present study examined the association between perceived information distortion about COVID-19 vaccination on social media, individuals’ functional and critical literacy, and addictive social media use (SMU), as well as the moderating roles of functional and critical literacy in the association between perceived information distortion and addictive SMU among social media users in Hong Kong. A web-based, cross-sectional survey was conducted among 411 Chinese citizens from June to August 2021. Findings showed that after adjusting for significant background variables, including age, gender, marital status, education, occupation, and income, functional literacy was negatively associated with addictive SMU. In addition, significant moderation effects of functional literacy and critical literacy were also observed, such that a positive association between perceived information distortion on social media and addictive SMU was significant among participants with lower functional literacy or higher critical literacy. Findings highlight the importance of improving functional literacy in addictive SMU prevention for social media users. Special attention should also be paid to the potential influence of critical literacy on addictive SMUs.

The Roles of Health and e-Health Literacy, Conspiracy Beliefs and Political Sympathy in the Adherence to Preventive Measures Recommended during the Pandemic

Adherence to preventive measures is of the utmost importance for limiting the spreading of the coronavirus. Many predictors of adopting preventive behaviors have been analyzed in different countries during the COVID-19 pandemic. Objectives: The study’s main aim was to assess the roles of health (HL) and e-health literacy (eHL), conspiracy beliefs, political sympathy, and religious practices in the adherence to COVID-19 preventive measures after adjusting for sociodemographic factors. The analysis was based on the data obtained from a survey conducted among 2410 adult Internet users in Poland in October 2020. The survey was performed with a computer-assisted web-based interviewing technique. Survey data were analyzed through uni- and multivariable linear regression models. The multivariable regression model revealed that after adjusting for sociodemographic variables, the preventive measures score (PMS) was significantly associated with HL (B = 0.04, p < 0.001), eHL (B = 0.03, p < 0.001) and the COVID-19-related conspiracy beliefs score (C19CBS) (B = −0.24, p < 0.001). There was also a significant statistical relationship between PMS and political sympathies and religious practices. HL and eHL are key factors eligible for modification through appropriate interventions and showing positive effects in compliance with preventive measures. Conspiracy beliefs, political sympathy and religious beliefs are independently associated with the adherence.

Attitudes toward COVID-19 Pandemic among Fully Vaccinated Individuals: Evidence from Greece Two Years after the Pandemic

Background

Considering the major effects of COVID-19 pandemic on health, social, economic, and political dimensions of all countries, positive attitudes toward COVID-19 pandemic are essential to control the pandemic. In our study, we investigated attitudes toward COVID-19 pandemic among fully COVID-19 vaccinated individuals two years after the pandemic and we identified predictors of attitudes.

Materials and Methods

We conducted an on-line cross-sectional study with 815 fully COVID-19 vaccinated individuals in Greece during May 2022. A self-administered and valid questionnaire was disseminated through social media platforms. We measured socio-demographic variables and COVID-19-related variables as potential predictors of attitudes toward COVID-19 pandemic. The outcome variable was attitudes toward COVID-19 pandemic (compliance with hygiene measures, trust in COVID-19 vaccination, fear of COVID-19, and information regarding the COVID-19 pandemic and vaccination).

Results

We found a very high level of compliance with hygiene measures, a high level of trust and information about the COVID-19 pandemic and vaccination, and a moderate level of fear of COVID-19. Also, we identified that females, participants with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis adhered more in hygiene measures. Trust in COVID-19 vaccination was higher among females, older participants, those with a higher educational level, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis. Moreover, females, older participants, those with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, those that received a flu vaccine in previous season, and those without a previous COVID-19 diagnosis experienced more fear of COVID-19. Finally, level of information regarding COVID-19 pandemic and vaccination was higher for participants with a higher educational level, those without a chronic disease, those with a better self-perceived physical health, and those that received a flu vaccine in previous season.

Conclusions

Understanding predictors of attitudes toward COVID-19 pandemic among fully vaccinated individuals is crucial for developing appropriate public health campaigns in the future. Vaccination should be accompanied by positive attitudes in order to decrease the frequency of negative outcomes of COVID-19, such as hospitalization, complications and mortality.

The association between social media use and hesitancy toward COVID-19 vaccine booster shots in China: a web-based cross-sectional survey

COVID-19 vaccine booster shots are necessary to provide durable immunity and stronger protection against the emerging SARS-CoV-2 variants. As a major platform for access to information, social media plays an important role in disseminating health information. This study aimed to evaluate hesitancy toward COVID-19 vaccine booster shots in China, assess its association with social media use, and provide information to manage social media. We conducted a cross-sectional study across all 31 provinces in mainland China from November 12, 2021, to November 17, 2021. In total, 3,119 of 3,242 participants completed the questionnaire (response rate = 96.2%). COVID-19 vaccine booster shot hesitancy rate in China was 6.5% (95% CI: 5.6-7.3). Unemployment (adjusted odds ratio [aOR] 2.428, 95% CI: 1.590-3.670), low monthly income (aOR 2.854,95% CI: 1.561-5.281), low scores of knowledge (aOR 0.917, 95% CI: 0.869-0.968) and low level of cues to action (aOR 0.773, 95% CI: 0.689-0.869) were associated with vaccine hesitancy. Compared with public social media, lower vaccine hesitancy was associated with high perceived importance of social media (aOR 0.252, 95% CI: 0.146-0.445) and official social media use (aOR 0.671, 95% CI: 0.467-0.954), while higher vaccine hesitancy was associated with traditional media use (aOR 3.718, 95% CI: 1.282-10.273). More efforts are needed to regulate the content of social media and filtering out misinformation. The role of official social media in disseminating health information should be enhanced.

Development of a patient decision aid for COVID-19 vaccination with the Comirnaty vaccine

BACKGROUND

SARS-CoV-2 has been responsible for a pandemic since the beginning of 2020. Vaccine arrival brings a concrete solution to fight the virus. However, vaccine hesitancy is high. In France, the first available vaccine was Comirnaty from Pfizer-BioNTech. Shared decision-making, based on tools such as patient decision aids (PtDAs), can help patients make an informed choice about vaccination with Comirnaty.

OBJECTIVE

The French College of Teachers in General Practice (CNGE) aimed to create a PtDA for people who have to decide whether they will receive the Comirnaty vaccine.

METHODS

Development of the PtDA was performed according to the International Patient Decision Aids Standards (IPDAS). The initial design was based on a literature review and semistructured interviews with 17 patients to explore and clarify patients' expectations. A first draft of the PtDA was then alpha tested by a patient expert group and a physician expert group. The PtDA was finally beta tested in 14 prevaccine consultations. A steering group was consulted throughout the work. Patient support, community groups and the French National Authority for Health (HAS) were involved in the development process.

RESULTS

A literature review identified one randomized trial on Comirnaty efficacy and safety. The first part of the PtDA allows patients to identify their own risk factors. The second part of the PtDA provides information on vaccination: benefits and risks, unknown data, and technical explanations about the mRNA vaccine.

CONCLUSIONS

We developed a PtDA to be used in primary care settings for shared decision-making regarding vaccination with Comirnaty.

The information‐seeking behavior of medical sciences students toward COVID‐19 in mass and social media: A cross‐sectional study

Background and Aims

During the COVID‐19 pandemic, college students can access health‐related information on the Internet to improve preventative behaviors, but they often judge the merits of such information and create challenges in the community. The aim of this study was to investigate information‐seeking behaviors in regard to COVID‐19 among students at Kerman University of Medical Sciences (KUMS) with the help of mass and social media.

Methods

The present study is a cross‐sectional study, which was conducted using an online researcher‐made questionnaire. An invitation to participate in the study was sent to 500 students at KUMS, of which 203 were selected according to the inclusion criteria and completed the questionnaire. Descriptive statistics were used to analyze the data.

Results

COVID‐19 news was mostly obtained through social media platforms such as WhatsApp, Telegram, Instagram, radio, and television, as well as online publications and news agencies. Social media platforms such as WhatsApp, Telegram, Instagram, and satellite networks such as BBC contained the most rumors about COVID‐19. Some of the most common misconceptions regarding COVID‐19 were as follows: “COVID‐19 is the deadliest disease in the world,” “COVID‐19 is a biological attack,” and “COVID‐19 disappears as the air temperature rises.” In addition, most of the virtual training provided through mass media focused on “refraining from visiting holy places and crowded locations such as markets,” “observing personal hygiene and refraining from touching the eyes, nose, and mouth with infected hands,” and “the role of quarantine in reducing the incidence of COVID‐19.”

Conclusion

Our findings demonstrated that during the pandemic, students used social media platforms the most to obtain health‐related information and these media have a significant impact on their willingness to engage in preventative behaviors and take the COVID‐19 risk seriously.

The Impact of Government Social Media Information Quality on Public Panic During the Infodemic

The COVID-19 pandemic triggered the first global “Infodemic” in the era of social media. Understanding how governments deal with the negative impacts of the infodemic (e.g., public panic) has become a priority. This paper uses the theoretical framework of the Elaboration Likelihood Model (ELM) to explore mechanisms for alleviating panic associated with the infodemic. It considers, in particular, the quality of information circulated on Government Social Media (GSM) as the central route and local government trust as the peripheral route. An empirical study was conducted using data from a focus group interview and a questionnaire survey collected within the first three weeks following the citywide lockdown of Wuhan, China. The results show that as: (1) Quality of GSM information does not significantly reduce public panic, but local government trust significantly increases people’s pandemic prevention knowledge; (2) Pandemic prevention knowledge is a critical mediator between information quality of GSM and public panic, as well as local government trust and public panic; and (3) Information quality of GSM significantly increases people’s trust in local governments. This paper contributes to the literature on infodemic and government social media and provides implications for practice.

Electronic health literacy among older adults in the context of the COVID-19 pandemic: A mixed methods study

Aim

This study aimed to investigate eHealth literacy about coronavirus disease 2019 (COVID‐19) among older adults during the pandemic.

Background

The COVID‐19 pandemic promoted the development of online health care. Higher demand for accessing information from the Internet was seen.

Methods

This was a sequential explanatory mixed‐method study, involving a survey of older adults to explore the status and influencing factors of eHealth literacy regarding COVID‐19. Semi‐structured interviews were used to understand experiences and challenges regarding information retrieval, judgment and utilization.

Results

A total of 337 older adults participated in the online questionnaire survey. Overall, older adults had slightly higher scores on eHealth literacy during the COVID‐19 pandemic. Participants' location in the past month and current health issues were associated with eHealth literacy. Qualitative data were collected from nine older adults and included that some older adults retrieved health‐related information during the pandemic. However, those who used non‐smartphones described difficulties in information retrieval. A glut of misinformation has resulted in an ‘infodemic’, which has not only increased the difficulty of judging information but also posed challenges in information utilization for older adults.

Conclusion

Improving older adults' eHealth literacy is essential in promoting an improved response to major public health events and in providing better health care for this group in the future. It is essential that government health agencies and health care providers provide evidence‐based health information via social media platforms. Further efforts are needed to combine aspects of traditional and online health care services and provide reliable and updated online information and resources for older adults.

Implications for Nursing Management

Providing evidence to eHealth literacy improvement and health management of older adults in the context of public health events.

Do Chinese netizens cross-verify the accuracy of unofficial social media information before changing health behaviors during COVID-19? A Web-based study in China

Background

As social media platforms have become significant sources of information during the pandemic, a significant volume of both factual and inaccurate information related to the prevention of COVID-19 has been disseminated through social media. Thus, disparities in COVID-19 information verification across populations have the potential to promote the dissemination of misinformation among clustered groups of people with similar characteristics.

Objective

This study aimed to identify the characteristics of social media users who obtained COVID-19 information through unofficial social media accounts and were (1) most likely to change their health behaviors according to web-based information and (2) least likely to actively verify the accuracy of COVID-19 information, as these individuals may be susceptible to inaccurate prevention measures and may exacerbate transmission.

Methods

An online questionnaire consisting of 17 questions was disseminated by West China Hospital via its official online platforms, between May 18, 2020, and May 31, 2020. The questionnaire collected the sociodemographic information of 14,509 adults, and included questions surveying Chinese netizens’ knowledge about COVID-19, personal social media use, health behavioral change tendencies, and cross-verification behaviors for web-based information during the pandemic. Multiple stepwise regression models were used to examine the relationships between social media use, behavior changes, and information cross-verification.

Results

Respondents who were most likely to change their health behaviors after obtaining web-based COVID-19 information from celebrity sources had the following characteristics: female sex (P=.004), age ≥50 years (P=.009), higher COVID-19 knowledge and health literacy (P=.045 and P=.03, respectively), non–health care professional (P=.02), higher frequency of searching on social media (P<.001), better health conditions (P<.001), and a trust rating score of more than 3 for information released by celebrities on social media (P=.005). Furthermore, among participants who were most likely to change their health behaviors according to social media information released by celebrities, female sex (P<.001), living in a rural residence rather than first-tier city (P<.001), self-reported medium health status and lower health care literacy (P=.007 and P<.001, respectively), less frequent search for COVID-19 information on social media (P<.001), and greater level of trust toward celebrities’ social media accounts with a trust rating score greater than 1 (P≤.04) were associated with a lack of cross-verification of information.

Conclusions

The findings suggest that governments, health care agencies, celebrities, and technicians should combine their efforts to decrease the risk in vulnerable groups that are inclined to change health behaviors according to web-based information but do not perform any fact-check verification of the accuracy of the unofficial information. Specifically, it is necessary to correct the false information related to COVID-19 on social media, appropriately apply celebrities’ star power, and increase Chinese netizens’ awareness of information cross-verification and eHealth literacy for evaluating the veracity of web-based information.

eHealth Literacy of Chinese Residents During the Coronavirus Disease 2019 Pandemic: A Cross-sectional Survey

The Coronavirus Disease 2019 (COVID-19) pandemic has become a leading societal concern. eHealth literacy is important in the prevention and control of this pandemic. The purpose of this study is to identify eHealth literacy of Chinese residents about the COVID-19 pandemic and factors influencing eHealth literacy. A total of 15 694 individuals clicked on the link to the questionnaire, and 15 000 agreed to participate and completed the questionnaire for a response rate of 95.58%. Descriptive statistics, χ2 test, and logistic regression analysis were conducted to analyze participants' level of eHealth literacy about COVID-19 and its influencing factors. The results showed 52.2% of participants had relatively lower eHealth literacy regarding COVID-19 (eHealth literacy score ≤ 48). The scores of the information judgment dimension (3.09 ± 0.71) and information utilization dimension (3.18 ± 0.67) of the eHealth literacy scale were relatively lower. The logistics regression showed that sex, age, education level, level of uncertainty, having people around the respondent diagnosed with COVID-19, relationship with family, and relationship with others were associated to eHealth literacy (χ2 = 969.135, P < .001). The public's eHealth literacy about COVID-19 needs to be improved, especially the ability to judge and utilize online information. Close collaboration among global health agencies, governments, healthcare institutions, and media is needed to provide reliable online information to the public. Interventions to improve eHealth literacy should take into account and accentuate the importance of sex, age, educational background, level of uncertainty, exposure to disease, and social support.

Problem-Based mHealth Literacy Scale (PB-mHLS): Development and Validation

Background

Mobile devices have greatly facilitated the use of digital health resources, particularly during the COVID-19 pandemic. Mobile health (mHealth) has become a common and important way to monitor and improve health conditions for people from different social classes. The ability to utilize mHealth affects its effectiveness; therefore, the widespread application of mHealth technologies calls for an instrument that can accurately measure health literacy in the era of mobile media.

Objective

We aimed to (1) identify the components of mHealth literacy for ordinary users and (2) develop a systematic scale for appropriately measuring individuals’ self-perceived mHealth literacy through a problem-based framework.

Methods

We conducted an exploratory study involving in-depth interviews and observations (15 participants) in January 2020 and used exploratory factor analysis and confirmatory factor analysis to identify the components of mHealth literacy and develop an item pool. In February 2020, we conducted a pilot survey with 148 participants to explore the factor structures of items identified during the exploratory study. Subsequently, 2 surveys were administrated using quota sampling. The first survey (conducted in Guangdong, China) collected 552 responses during March 2020; we assessed composite reliability, convergent validity, and discriminant validity. The second survey (conducted in China nationwide) collected 433 responses during October 2021; we assessed criterion-related validity using structural equation modeling.

Results

We identified 78 items during the exploratory study. The final scale—the Problem-Based mHealth Literacy Scale—consists of 33 items that reflect 8 domains of mHealth literacy. The first web-based survey suggested that mHealth literacy consists of 8 factors (ie, subscales), namely, mHealth desire, mobile phone operational skills, acquiring mHealth information, acquiring mHealth services, understanding of medical terms, mobile-based patient–doctor communication, evaluating mHealth information, and mHealth decision-making. These factors were found to be reliable (composite reliability >0.7), with good convergent validity (average variance extracted >0.5) and discriminant validity (square root of average variance extracted are greater than the correlation coefficients between factors). The findings also revealed that these 8 factors should be grouped under a second-order factor model (χ²/df=2.701; comparative fit index 0.921; root mean square error of approximation 0.056; target coefficient 0.831). The second survey revealed that mHealth use had a significant impact (β=0.43, P<.001) on mHealth literacy and that mHealth literacy had a significant impact (β=0.23, P<.001) on health prevention behavior.

Conclusions

This study revealed the distinctiveness of mHealth literacy by placing mHealth needs, the ability to understand medical terms, and the skills in patient–doctor interactions in the foreground. The Problem-Based mHealth Literacy Scale is a useful instrument for comprehensively measuring individuals’ mHealth literacy and extends the concept of health literacy to the context of mobile communication.

Evaluating the Psychometric Properties of the eHealth Literacy Scale (eHEALS) among Polish Social Media Users

Social media have become mainstream online tools that allow individuals to connect and share information. Such platforms also influence people’s health behavior in the way they communicate about personal health, treatment, or physicians. Individuals’ ability to find and apply online health information on specific health problems can be measured using a valid and reliable instrument, the eHealth Literacy Scale (eHEALS). The objective of this study was to evaluate the psychometric aspects of the Polish version of this instrument (eHEALS-Pl) among social media users, which has not been explored so far. We examined the translated version of the eHEALS in a representative sample of Polish social media users (n = 1527). CAWI (computer-assisted web interviews) was a method to collect data. The reliability of the eHEALS-Pl was measured by calculating the Cronbach alpha coefficients and analyzing the principal components. Exploratory factor analysis and hypothesis testing was used to assess the construct validity of the instrument. The internal consistency of the eHEALS-Pl was sufficient: Cronbach alpha = 0.84. The item-to-total correlations ranged from r = 0.514 to 0.666. EFA revealed a single structure explaining 47.42% of the variance, with high factor loadings of the item ranging from 0.623 to 0.769. Hypothesis testing also supported the validity of eHEALS-Pl. The eHEALS-Pl evaluation supported by social media users reviled its equivalence to the original instrument developed by Norman and Skinner in 2006 and it can be used to measure e-health literacy. Since there is no prior validation of the eHEALS among social media users, these findings may indicate important directions in evaluating digital skills, especially in relation to the current challenges related to the COVID-19 pandemic.

Social Media and COVID-19—Perceptions and Public Deceptions of Ivermectin, Colchicine and Hydroxychloroquine: Lessons for Future Pandemics

The capacity for social media to influence the utilization of re-purposed medicines to manage COVID-19, despite limited availability of safety and efficacy data, is a cause for concern within health care systems. This study sought to ascertain links between social media reports and utilization for three re-purposed medicines: hydroxychloroquine (HCQ), ivermectin and colchicine. A combined retrospective analysis of social media posts for these three re-purposed medicines was undertaken, along with utilization and clinical trials data, in South Africa, between January 2020 and June 2021. In total, 77,257 posts were collected across key social media platforms, of which 6884 were relevant. Ivermectin had the highest number of posts (55%) followed by HCQ (44%). The spike in ivermectin use was closely correlated to social media posts. Similarly, regarding chloroquine (as HCQ is not available in South Africa), social media interest was enhanced by local politicians. Sentiment analysis revealed that posts regarding the effectiveness of these repurposed medicines were positive. This was different for colchicine, which contributed only a small number of mentions (1%). Of concern is that the majority of reporters in social media (85%) were unidentifiable. This study provides evidence of social media as a driver of re-purposed medicines. Healthcare professionals have a key role in providing evidence-based advice especially with unidentifiable posts.

Predictors of eHealth Literacy and Its Associations with Preventive Behaviors, Fear of COVID-19, Anxiety, and Depression among Undergraduate Nursing Students: A Cross-Sectional Survey

Background: The infodemic has been co-existing with the COVID-19 pandemic with an influx of misinformation and conspiracy theories. These affect people’s psychological health and adherence to preventive measures. eHealth literacy (eHEALS) may help with alleviating the negative effects of the infodemic. As nursing students are future healthcare professionals, having adequate eHEALS skills is critically important in their clinical practice, safety, and health. This study aimed to (1) explore the eHEALS level and its associated factors, and (2) examine the associations of eHEALS with preventive behaviors, fear of COVID-19 (FCV-19S), anxiety, and depression among nursing students. Methods: We surveyed 1851 nursing students from 7 April to 31 May 2020 from eight universities across Vietnam. Data were collected, including demographic characteristics, eHEALS, adherence to preventive behaviors (handwashing, mask-wearing, physical distancing), FCV-19S, anxiety, and depression. Linear and logistic regression analyses were performed appropriately to examine associations. Results: The mean score of eHEALS was 31.4 ± 4.4. The eHEALS score was significantly higher in males (unstandardized regression coefficient, B, 0.94; 95% confidence interval, 95% CI, 0.15 to 1.73; p = 0.019), and students with a better ability to pay for medication (B, 0.79; 95% CI, 0.39 to 1.19; p < 0.001), as compared to their counterparts. Nursing students with a higher eHEALS score had a higher likelihood of adhering to hand-washing (odds ratio, OR, 1.18; 95% CI, 1.15 to 1.22; p < 0.001), mask-wearing (OR, 1.15; 95% CI, 1.12 to 1.19; p < 0.001), keeping a safe physical distance (OR, 1.20; 95% CI, 1.15 to 1.25; p < 0.001), and had a lower anxiety likelihood (OR, 0.95; 95% CI, 0.92 to 0.99; p = 0.011). Conclusions: Nursing students who were men and with better ability to pay for medication had higher eHEALS scores. Those with higher eHEALS scores had better adherence to preventive measures, and better psychological health. The development of strategies to improve eHEALS of nursing students may contribute to COVID-19 containment and improve their psychological health.

A Shot in the Arm for Vaccination Intention: The Media and the Health Belief Model in Three Chinese Societies

This large-sample study of three Chinese societies-Mainland China, Taiwan, and Hong Kong-demonstrates the importance of media exposure for people's vaccination intentions during the COVID-19 pandemic. By employing two constructs (i.e., perceived susceptibility and severity) in the health belief model (HBM), the study identifies significant indirect effects of media exposure on individuals' vaccination intention in all three Chinese societies. That said, media trust negatively moderated the path from perceived severity to vaccination intention in Mainland China and Taiwan. In these two societies, the higher an individual's trust in media, the less influence of perceived severity on his/her vaccination intention. It suggests that the level of trust in media is a contextual factor in explaining individuals' decision-making on health issues. Generally, the combination of the HBM and media trust has been proven to be useful for understanding individuals' vaccination intentions. These findings provide practical considerations for governmental agencies, public institutions, and health campaign designers to promote vaccination in the pandemic.

Information Usage and Compliance with Preventive Behaviors for COVID-19: A Longitudinal Study with Data from the JACSIS 2020/JASTIS 2021

The influence of different types of information sources on individual preventive behaviors remains unclear. We aimed to investigate the associations between individual information usage to obtain information about COVID-19 and compliance with preventive behaviors. This longitudinal study was based on an Internet survey conducted in August−September 2020 and February 2021. We used compliance with four preventive behaviors for COVID-19, “wearing a mask”, “ventilation”, “social distancing”, and “avoiding crowds” as outcome variables, and 20 types of information sources based on people or institutions (Medical worker, Government, etc.) and media (TV news, Twitter, etc.) as predictors. Absolute differences and 95% confidence intervals were estimated using generalized estimating equations adjusted for possible confounders. Among the 18,151 participants aged 20−79, the mean age was 51.7 (SD = 15.9) in 2020, and 51.3% were male. In total, compliance with “wearing a mask”, “ventilation”, “social distancing”, and “avoiding crowds” was seen in 86.2%, 46.9%, 45.4%, and 62.6% of individuals in 2020, and 89.3%, 38.2%, 47.2%, and 61.6% of individuals in 2021, respectively. In the multivariate analysis, “medical workers”, “professionals”, “the government”, “Twitter”, “news websites”, and “TV news” were positively associated with compliance with two or more preventive behaviors (p < 0.05). The type of information source may play an important role in providing information for COVID-19 prevention.

Evaluating e-health literacy, knowledge, attitude and practice regarding COVID-19 prevention and Self-Protection among Iranian students: a cross-sectional online survey

BACKGROUND

The coronavirus 2019 (COVID-19) pandemic requires integrated intervention by both the governments and individuals. University students have a great role in distributing reliable information about disease prevention behaviors. The aim of this study was to identify the Knowledge, Attitude and Practice of COVID-19 Prevention and Self-Protection behaviors in students.

METHODS

This cross-sectional online survey was conducted on Iranian university students. All students filled a questionnaire consisting of demographic characteristics, e-Health Literacy Scale (EHEALS) questionnaire and a researcher-made knowledge, attitude and practice (KAP) questionnaire. Data was analyzed using the SPSS software.

RESULTS

A total of 925 students (69.9% female) participated in this study. The median age of the students was 23 years old. Majority of students (641, 69.3%) were non-medical students. The median and interquartile range (IQR) for knowledge, attitude, practice and P-EHEALS scores in Medical students were 52.00 (27.00), 4.00 (1.00), 28.00 (8.00), and 26.00 (9.00), respectively which were significantly higher than non-medical students, 28.00 (15.00), 3.00 (2.00), 20.00 (8.00), and 26.00 (9.00), respectively (p < 0.001). Practice score was a significant related to knowledge (p < 0.001), attitude (p < 0.001), having a COVID-19 infected family member (p < 0.001), older age (p < 0.001), medical field of education (p = 0.001), higher EHEALS score (p = 0.018), and female gender (p = 0.013). Knowledge, attitude and having a COVID-19 infected person in family were the strongest predictors of preventive practices.

CONCLUSIONS

KAP and E-Health literacy of university students, especially non-medical students, should be considered in order to improve COVID-19 preventive behaviors in the society.

Predictors of COVID-19 preventive behaviours in a sample of the Turkish population

AIM

This research aimed to determine predictors of COVID-19 preventive behaviours in a sample of the Turkish population.

METHODS

The study was conducted with 575 individuals. COVID-19 preventive behaviours were evaluated with a 19-item scale scored from 19 to 95. Knowledge on COVID-19 was evaluated with a 22-item scale scored from 0 to 22. General health literacy was evaluated with the Turkey Health Literacy Scale (THLS), which was scored from 0 to 50.

RESULTS

The average COVID-19 preventive behaviours score was moderately high in this sample of the Turkish population. Being female, having a higher level of education, better economic status, being a non-smoker, having a higher level of COVID-19 knowledge and better general health literacy score were significant predictors of COVID-19 preventive behaviours (P < 0.05).

CONCLUSION

Sociodemographic characteristics, knowledge of COVID-19 and general health literacy are crucial in preventing COVID-19 infections in a sample of the Turkish population.

Covid-19 and beyond: broadening horizons about social media use in oncology. A survey study with healthcare professionals caring for youth with cancer

Objectives

Methods

Results

Conclusion

A biopsychosocial model of severe fear of COVID-19

Introduction

COVID-19 is a respiratory infection that causes not only somatic health issues, but also frequently psychosocial burdens. The aims of this study were to investigate biopsychosocial factors that might further aggravate fear of COVID-19, and to establish a biopsychosocial model of severe fear of COVID-19.

Methods

368 participants were included in this study. Biopsychosocial factors observed comprised biological factors (somatic risk), psychological factors (state/trait anxiety, physical symptoms of anxiety, severe health anxiety, specific phobias, depression), and psychosocial factors (social support, financial losses, social media consumption, social contacts with COVID-19 infected people). Psychometric questionnaires included State-Trait Anxiety Inventory, Beck’s Anxiety Inventory, Whiteley-Index / Illness Attitude Scales, Specific Phobia Questionnaire, WHO-5 and Social Support Survey.

Results

162/368 (44.0%) participants had almost no fear, 170/368 (46.2%) participants had moderate fear, and 45/368 (12.2%) participants had severe fear of COVID-19. Female participants showed higher levels of fear of COVID-19 than male participants (gender: χ2 = 18.47, p<0.001). However, the level of fear of COVID-19 increased in male participants when they had contact with people who were infected with COVID-19, while in contrast the level of fear of COVID-19 decreased in female participants when they had such contacts [ANCOVA: fear of COVID-19 (contact x gender): F(1,363) = 5.596, p = .019]. Moreover, participants without relationships showed higher levels of fear of COVID-19 (marital status: χ2 = 14.582, p = 0.024). Furthermore, financial losses due to the COVID-19 were associated with higher levels of fear of COVID-19 [ANCOVA: fear of COVID-19(financial loss x gender): F(1, 363) = 22.853, p< .001]. Multiple regression analysis revealed female gender, severe health anxiety (WI-IAS) and state /trait anxiety (STAI) as significant predictors of severe fear of COVID-19.

Conclusion

In this study significant predictors of severe fear of COVID-19 were female gender, pre-existing state and trait anxiety, as well as severe health anxiety. The finding of significant predictors of fear of COVID-19 might contribute to detect people who might suffer most from severe, overwhelming fear of COVID-19 at an early stage.

Medical students and doctors' perceptions toward COVID-19 health communication on social media

BACKGROUND

Ineffective health communication could cause the increase of COVID-19 cases in Indonesia. Medical students can involve in efforts in health communication on social media to positively impact prevention behaviors during a pandemic. This study aims to identify and analyze medical students' and internship doctors' perceptions toward health communication related to COVID-19 through social media.

MATERIALS AND METHODS

A mixed method with exploratory sequential used. A qualitative study was done using phenomenology approach through deep and semi-structured interviewing. After data analysis, the draft of the instrument prepared. Items in the draft selected based on the respondents' answer. Then, a quantitative cross-sectional study was used. The data obtained from 399 medical students and doctors at a University in Indonesia using Google Form on October 14 to October 20, 2020 through media social. Data were analyzed using Pearson Correlation and Chi-square (alternative: Fisher's exact test) and logistic regression analysis with P < 0.05 and 95% confidence interval, respectively.

RESULTS

Based on interview, respondents communicate health on social media because the condition of COVID-19 in Indonesia is dangerous, feel vulnerable to COVID-19, understand the benefits, obligations, or responsibilities as a candidate and/or medical personnel and believe they can create content/find valid sources. Meanwhile, the perception of limited knowledge is their biggest obstacle in conducting health communication. There were a relationship between gender (P = 0.028, PR = 0.657), perceived severity (P = 0.044, PR (Prevalence Ratio) =4.844 [0.725-32,354]), perceived susceptibility (P = 0.005, PR = 1.803 [1.182-2.750]), perceived barrier (P < 0.001, PR = 2.543 [1.908-3.388]), and self-efficacy (P = 0.012, PR = 1.810 [1.120-2.926]) with health communication behavior. The perceived barrier (P < 0.001, RR = 4.278 [2.709-6.754]) and perceived susceptibility (P = 0.004, PR = 2.304 [1.302-4.077]) were the most influenced behavior.

CONCLUSIONS

This study showed that perceived severity, perceived susceptibility, perceived barrier, and self-efficacy are predictor factors of health communication behavior related to COVID-19 on social media with perceptions of susceptibility and perceived barriers as the most influential variables. It is necessary to provide communication learning on social media as effectively and applied directly to reduce perceived barriers and increase self-efficacy.

Associations of COVID-19 Risk Perception, eHealth Literacy, and Protective Behaviors Among Chinese College Students Following Vaccination: A Cross-Sectional Study

Background

In spite of strict regulation of coronavirus disease 2019 (COVID-19) preventive measures and containment in China, there are still confirmed cases sporadically occurring in many cities. College students live in groups and have active social activities so that it will trigger a serious public health event once an infection event occurs. Thus, identifying the status and related factors of protective behaviors among them after receiving vaccination will be crucial for epidemic control. This study aimed to gather information on the protective behaviors and to identify the associations of COVID-19 risk perception, eHealth literacy, and protective behaviors for Chinese college students following vaccination.

Methods

A cross-sectional survey of college students engaged in protective behaviors post vaccination was conducted using the COVID-19 risk perception scale, eHealth literacy scale, and protective behaviors following vaccination questionnaire in one of the groups. Multiple linear regression analysis was used to confirm the correlation among the COVID-19 risk perception, eHealth literacy, and protective behaviors for Chinese college students.

Results

A total of 5,641 Chinese college students were included. Male students comprised 59.01% with an average age of (21.39 ± 2.75) years and most students rating their health as very good (44.85%) or pretty good (46.98%). A smaller percentage (13.76%) believed that they would likely or most likely be infected with COVID-19 after getting vaccinated. In addition, more than 1 in 10 (10.35%) college students had ever suspected to suffer from post-vaccination reactions following the COVID-19 vaccination. The mean score of protective behaviors was 26.06 ± 3.97. Approximately one-third (30.42%) of the students always or often did not wear a mask when going out. Some college students (29.25%) did not maintain distance of at least 1 m from others in social situations. Older female college students who were in good health and perceived as being at a low risk of getting infected with COVID-19, and those never suspected to suffer from post-vaccination reactions expected to engage in post-vaccination protective measures. Those with a higher level of perceived risk, severe risk perception and eHealth literacy, and a lower level of unknown risk perception were more likely to engage in further protective behaviors after getting vaccinated.

Conclusions

Overall, the level of protective behaviors among the Chinese college students following vaccination could be improved, especially for male, younger college students in poor health. This study revealed the predictive effects of risk perception and eHealth literacy on protective behaviors, recommending that the negative and positive effects of risk perception should be balanced in epidemic risk management, and eHealth literacy promotion should also be emphasized for public health and social measures.

Predicting hand washing, mask wearing and social distancing behaviors among older adults during the covid-19 pandemic: an integrated social cognition model

BACKGROUND

Older adults are at a higher risk from COVID-19. Individual preventive behaviors including frequent hand washing, mask wearing, and social distancing play important roles in reducing the transmission of COVID-19 in the community. This study aimed to identify the determinants of three preventive behaviors of older adults during the COVID-19 pandemic by using an Integrated Social Cognition Model.

METHODS

Using a prospective study design, 516 Chinese older adults from Hubei province of China (mean age = 67.55 years, SD = 6.60, 57.9% females) completed two online questionnaire surveys. The demographics, social cognition constructs (motivational self-efficacy, risk perception, attitude, subjective norm, health knowledge, intention, volitional self-efficacy, planning, action control) and three preventive behaviors were measured during the first-wave online survey from 18 May 2020 to 7 June 2020. One month later, three preventive behaviors were measured again during the second-wave online survey. Data were analyzed by structural equation modelling.

RESULTS

Models showed attitude, motivational self-efficacy and subjective norm were consistent predictors of intention, motivational self-efficacy was a consistent predictor of volitional self-efficacy, planning and volitional self-efficacy were consistent predictors of action control, and health knowledge was a consistent predictor of behaviors across all three preventive behaviors. In addition, mediating relationships were found in the model of hand washing behavior. In particular, planning (β = .109, p = .042) and action control (β = .056, p = .047) mediated between volitional self-efficacy and hand washing respectively. Action control also mediated between planning and hand washing (β = .087, p = .044). Moreover, the inclusion of past behaviors in three models attenuated most of the structural relations.

CONCLUSIONS

The current study's findings basically supported the Integrated Social Cognition Model and identified key modifiable determinants of preventive behaviors. Based on this model, future interventions aiming to promote COVID-19 preventive behaviors among older adults are warranted.

COVID-19 Study on Scientific Articles in Health Communication: A Science Mapping Analysis in Web of Science

The COVID-19 pandemic continues to cause a collapse in the health systems and econo-mies of many countries around the world, after 2 years of struggle and with the number of cases still growing exponentially. Health communication has become as essential and necessary for control of the pandemic as epidemiology. This bibliometric analysis identifies existing contributions, jointly studying health communication and the pandemic in scientific journals indexed. A systematic search of the Web of Science was performed, using keywords related to COVID-19 and health communication. Data extracted included the type of study, journal, number of citations, number of authors, country of publication, and study content. As the number of scientific investigations has grown, it is necessary to delve into the areas in which the most impactful publications have been generated. The results show that the scientific community has been quick to react by generating an extraordinary volume of publications. This review provides a comprehensive mapping of contributions to date, showing how research approaches have evolved in parallel with the pandemic. In 2020, concepts related to mental health, mass communication, misinformation and communication risk were more used. In 2021, vaccination, infodemic, risk perception, social distancing and telemedicine were the most prevalent keywords. By highlighting the main topics, authors, manuscripts and journals since the origin of COVID-19, the authors hope to disseminate information that can help researchers to identify subsisting knowledge gaps and a number of future research opportunities.

Measuring Electronic Health Literacy: Development, Validation, and Test of Measurement Invariance of a Revised German Version of the eHealth Literacy Scale

Background

The World Wide Web has become an essential source of health information. Nevertheless, the amount and quality of information provided may lead to information overload. Therefore, people need certain skills to search for, identify, and evaluate information from the internet. In the context of health information, these competencies are summarized as the construct of eHealth literacy. Previous research has highlighted the relevance of eHealth literacy in terms of health-related outcomes. However, the existing instrument assessing eHealth literacy in the German language reveals methodological limitations regarding test development and validation. The development and validation of a revised scale for this important construct is highly relevant.

Objective

The objective of this study was the development and validation of a revised German eHealth literacy scale. In particular, this study aimed to focus on high methodological and psychometric standards to provide a valid and reliable instrument for measuring eHealth literacy in the German language.

Methods

Two internationally validated instruments were merged to cover a wide scope of the construct of eHealth literacy and create a revised eHealth literacy scale. Translation into the German language followed scientific guidelines and recommendations to ensure content validity. Data from German-speaking people (n=470) were collected in a convenience sample from October to November 2020. Validation was performed by factor analyses. Further, correlations were performed to examine convergent, discriminant, and criterion validity. Additionally, analyses of measurement invariance of gender, age, and educational level were conducted.

Results

Analyses revealed a 2-factorial model of eHealth literacy. By item-reduction, the 2 factors information seeking and information appraisal were measured with 8 items reaching acceptable-to-good model fits (comparative fit index [CFI]: 0.942, Tucker Lewis index [TLI]: 0.915, root mean square error of approximation [RMSEA]: 0.127, and standardized root mean square residual [SRMR]: 0.055). Convergent validity was comprehensively confirmed by significant correlations of information seeking and information appraisal with health literacy, internet confidence, and internet anxiety. Discriminant and criterion validity were examined by correlation analyses with various scales and could partly be confirmed. Scalar level of measurement invariance for gender (CFI: 0.932, TLI: 0.923, RMSEA: 0.122, and SRMR: 0.068) and educational level (CFI: 0.937, TLI: 0.934, RMSEA: 0.112, and SRMR: 0.063) were confirmed. Measurement invariance of age was rejected.

Conclusions

Following scientific guidelines for translation and test validation, we developed a revised German eHealth Literacy Scale (GR-eHEALS). Our factor analyses confirmed an acceptable-to-good model fit. Construct validation in terms of convergent, discriminant, and criterion validity could mainly be confirmed. Our findings provide evidence for measurement invariance of the instrument regarding gender and educational level. The newly revised GR-eHEALS questionnaire represents a valid instrument to measure the important health-related construct eHealth literacy.

Knowledge of COVID-19 and Its Relationship with Preventive Behaviors and Vaccination among Adults in Northern Thailand's Community

(1) Background: the 2019 coronavirus disease outbreak (COVID-19) has posed a major threat to public health and had a significant impact on all areas of people's lives. Vaccines against COVID-19 have been developed to control the disease, and an array of personal hygiene measures has been introduced. As a result, information that will support and promote vaccination among populations as well as other health measures against COVID-19 are urgently needed. The goal of this research was to look into the knowledge about COVID-19 and how it relates to preventive behaviors and vaccination among people living in rural areas of northern Thailand. (2) Methods: a cross-sectional study was performed in four upper northern provinces of Thailand. A total of 1524 participants were recruited using the probability sampling technique. Questionnaires were distributed to collect data on general health information, as well as knowledge and preventive behaviors regarding COVID-19. (3) Results: more than half (55.9%) of the participants were female and had not received the COVID-19 vaccine (67.2%). Their mean age was 44.13 years. The majority had moderate COVID-19 knowledge and engaged in preventive behaviors (65.5% and 42.0%, respectively). A linear regression model showed that the COVID-19 knowledge score was related to the COVID-19 preventive behaviors score, with a standardized coefficient of 0.510, after adjusting for age, underlying disease, and body mass index (B = 2.64; 95%CI = 2.42, 2.87). Binary logistic regression revealed that after controlling for age, education, occupation, financial status, and current disease (AOR = 1.87; 95%CI = 1.64-2.13), the score of COVID-19 knowledge was significantly associated with having the COVID-19 vaccine. (4) Discussion: knowledge of COVID-19 is very important for people in rural regions to engage in COVID-19 prevention behaviors and vaccination. Relevant government agencies and health network partners should support proactive education campaigns emphasizing the risk of contracting the disease and its severity in order to promote vaccination against COVID-19 among unvaccinated groups. These campaigns can highlight COVID-19's positive benefit-risk balance in the short and long term and ensure public safety measures against COVID-19.

Social Media Use, eHealth Literacy, Knowledge, Attitudes, and Practices Toward COVID-19 Vaccination Among Chinese College Students in the Phase of Regular Epidemic Prevention and Control: A Cross-Sectional Survey

Background

College students are at a high risk of being infected with COVID-19, and they are one of the key population clusters that should be vaccinated. The present study aimed to investigate the knowledge, attitudes, and practices (KAP) toward COVID-19 vaccination among Chinese college students, and to determine the relationships among social media use, eHealth literacy, and KAP toward COVID-19 vaccination among Chinese college students.

Methods

A cross-sectional survey was conducted by administering questionnaires to evaluate KAP toward COVID-19 vaccination, social media use, and eHealth literacy in one of the groups of Chinese college students. Multiple linear regression analysis was performed to determine the association among social media use, eHealth literacy, and KAP regarding COVID-19 vaccination.

Results

Among the 3,785 validated questionnaires collected from Chinese college students, male students accounted for 59.74%, and the mean age of the college students was (20.90 ± 3.14) years. More than four-fifths (83.43%) of the college students spent <2 h a week on social media, and the official and public social media were most common social media types. Additionally, the scores for KAP toward COVID-19 vaccination ranging from 0 to 48 among college students were high (39.73 ± 5.58), lowest for knowledge domain (3.07 ± 0.76), and the highest for practice domain (3.47 ± 0.63). Female college students who were in good health status and who spent more time browsing social media, frequently used official and public social media, rarely used aggregated social media, and had a relatively strong self-perception of eHealth literacy and information acquisition of eHealth literacy were more likely to have high levels of KAP regarding COVID-19 vaccination.

Conclusions

Overall, Chinese college students have excellent KAP toward COVID-19 vaccination. Based on the findings of this study, we recommend that health counseling regarding COVID-19 vaccination should target male students and those with inferior health status. Dissemination of health education regarding COVID-19 vaccination should be purposely conducted, and cooperation with official and public social media platforms should be promoted. Finally, eHealth literacy, which is one of the predictors of the level of KAP regarding COVID-19 vaccination, should be emphasized.

The Relationship between Internet Use and Population Health: A Cross-Sectional Survey in China

Given the increasing use of the Internet in China, the relationship between Internet use and population health has been receiving increased academic attention. However, the current literature has not yet reached a unified conclusion; thus, further research is very necessary. This study used the 2018 China Family Panel Studies (CFPS) data to explore the relationship between Internet use and the health of the population and to evaluate the possible heterogeneity of the association between different groups and the mediation path. This study revealed that Internet use has a positive association with the subjective health of the population. The results of the heterogeneity analysis revealed that Internet use is more significantly associated with the health of non-agricultural workers and those with higher education levels than that of agricultural workers and those with lower education levels. Further analysis revealed that health behavior is an important mediator between Internet use and population health. These results remain robust even after using propensity score matching (PSM) to eliminate sample selection bias.

Government Communication, Perceptions of COVID-19, and Vaccination Intention: A Multi-Group Comparison in China

Government communication has been playing an important role in mass vaccination to conduct the largest vaccination campaign of the world for COVID-19 and to counter vaccine hesitancy. This study employs the health belief model to examine the association between government communication and the COVID-19 vaccination intention. A survey of Chinese adults (N = 557) was conducted in March 2021, and partial least squares structural equation modeling was employed to estimate the multi-construct relationships. The findings indicate that government communication has both direct positive association with vaccination intention and indirect association with vaccination intention through the mediation of perceived severity, benefits, and barriers. Multi-group comparisons suggest that individuals from private sectors are more easily mobilized to receive COVID-19 vaccination by government communication than those from public sectors. Similarly, the correlation between government communication and the vaccination intention of individuals with a good health status was stronger than that of those with a poor health status. The theoretical and practical implications of these findings are further discussed.

Social Media Use and Misinformation Among Asian Americans During COVID-19

Social media has been crucial for seeking and communicating COVID-19 information. However, social media has also promulgated misinformation, which is particularly concerning among Asian Americans who may rely on in-language information and utilize social media platforms to connect to Asia-based networks. There is limited literature examining social media use for COVID-19 information and the subsequent impact of misinformation on health behaviors among Asian Americans. This perspective reviews recent research, news, and gray literature to examine the dissemination of COVID-19 misinformation on social media platforms to Chinese, Korean, Vietnamese, and South Asian Americans. We discuss the linkage of COVID-19 misinformation to health behaviors, with emphasis on COVID-19 vaccine misinformation and vaccine decision-making in Asian American communities. We then discuss community- and research-driven responses to investigate misinformation during the pandemic. Lastly, we propose recommendations to mitigate misinformation and address the COVID-19 infodemic among Asian Americans.

COVID-19 Infodemic: Evaluating Information-Seeking Behaviour Among Healthcare Workers During a Pandemic

Introduction

With the surge in coronavirus disease 2019 (COVID-19) cases across nations worldwide, World Health Organization (WHO) declared it a pandemic on March 11, 2020. Besides various policy guidelines and directions issued from time to time to combat the menace, there was the dissemination of a lot of misinformation and disinformation through social media or otherwise. This led to emotional, psychological, and mental agonies in the general population as well as Healthcare Workers (HCWs).

Methods

A cross-sectional quantitative study using purposive sampling techniques was done to assess the health-seeking behavior during the pandemic among HCWs of a tertiary care hospital in North India, designated as a dedicated COVID-19 hospital by the Ministry of Health and Family Welfare, India. A semi-structured questionnaire validated by experts with a reliability value (r=0.92) was taken. To maintain minimal contact and to follow COVID-19 Appropriate Behavior (CAB), a web-based link was used to obtain the data. Privacy of the participants and confidentiality of data obtained was maintained.

Results

Out of the total 250 participants enrolled in the study, the response rate was 81% (203). For 123 (60%) respondents, social media was one of the sources of access to information during the pandemic. The most common social media app(s) accessed were WhatsApp 82 (40%), Facebook, and Instagram 67 (33%). Social media had both positive as well as negative impacts on the mindset of respondents as 147 (72%) agreed that social media networks helped to further improve their understanding, whereas 178 (88%) stated that it aroused fear and panic among them.

Conclusion

During epidemics, timely, accurate, and authentic information is vital in shaping public opinion; on the contrary, an infodemic can pose a serious threat and panic in society by disseminating false and wrong information as was seen in the COVID-19 pandemic.

Managing urban citizens' panic levels and preventive behaviours during COVID-19 with pandemic information released by social media

Reducing citizens' panic and promoting their preventive behaviours are critical parts of pandemic management for the government. However, the effects of pandemic information types (daily statistical vs. detailed case information) and sources (official vs. unofficial social media accounts) on the psychological states and behaviours of urban citizens need to be explored further. Furthermore, the heterogeneity of these effects for citizens from areas with different epidemic levels also needs further investigation. Therefore, we conducted a survey during the COVID-19 outbreak in mainland China in March 2020, and 1298 urban citizens (592 from Wuhan) offered reliable data. Results of linear regression analysis indicated that non-Wuhan urban citizens who were more concerned about detailed case information (e.g., patients' movement paths) exhibited more preventive behaviours than those concerned about daily statistical information (e.g., case numbers) and did not show higher panic levels. Additionally, regarding social media information sources, unofficial social media caused both Wuhan and non-Wuhan urban citizens to have higher levels of panic than official media but had no significant impacts on their preventive behaviours. These findings contribute to urban management through the discovery of the effects of different information types and social media information sources on urban citizens during pandemics.

Factors associated with eHealth literacy focusing on digital literacy components: A cross-sectional study of middle-aged adults in South Korea

Background

Digital technology has dramatically changed the world in which we live, and the ability to access and understand information through these new technologies is becoming increasingly important. eHealth literacy is closely related to digital literacy, and some concepts may overlap to a certain extent. Identifying personal and digital-related factors related to eHealth literacy levels in middle-aged adults would be useful for planning tailored interventions and health promotion strategies.

Objective

We aimed to identify the differences in digital literacy and eHealth literacy levels according to demographic features, and to elucidate the factors associated with eHealth literacy in the middle-aged population.

Methods

We conducted a cross-sectional, observational study from 4th to 8th February 2021. A total of 320 South Korean participants aged 40–64 years were recruited and completed an online questionnaire, where demographic features, chronic disease status, frequency of Internet use, digital skills, digital competence, and eHealth literacy were measured. eHealth literacy was measured with the eHEALS. We used multiple regression analysis to elucidate the factors associated with eHealth literacy.

Results

Multiple regression analysis revealed that digital competence was the highest contributor to an individual's eHealth literacy (β = 0.330, P < 0.001), while digital skills was not significantly associated with eHealth literacy (β = 0.086, P = 0.267). In addition, eHealth literacy was positively associated with increasing age (β = 0.258, P < 0.001), female gender (β = −0.118, P = 0.022), and higher education levels (β = 0.114, P = 0.041), while marital state, chronic disease, and frequency of internet use were not significantly associated with eHealth literacy.

Conclusions

Our study provides valuable information on digital literacy and eHealth literacy in middle-aged adults and may be used to guide tailored interventions for improving eHealth literacy. Future studies should consider the differences in digital literacy levels across generations when assessing eHealth literacy or planning digital health interventions.

COVID-19 infodemic and digital health literacy in vulnerable populations: A scoping review

Background

People from lower and middle socioeconomic classes and vulnerable populations are among the worst affected by the COVID-19 pandemic, thus exacerbating disparities and the digital divide.

Objective

To draw a portrait of e-services as a digital approach to support digital health literacy in vulnerable populations amid the COVID-19 infodemic, and identify the barriers and facilitators for their implementation.

Methods

A scoping review was performed to gather published literature with a broad range of study designs and grey literature without exclusions based on country of publication. A search was created in Medline (Ovid) in March 2021 and translated to Medline, PsycINFO, Scopus and CINAHL with Full Text (EBSCOhost). The combined literature search generated 819 manuscripts. To be included, manuscripts had to be written in English, and present information on digital intervention(s) (e.g. social media) used to enable or increase digital health literacy among vulnerable populations during the COVID-19 pandemic (e.g. older adults, Indigenous people living on reserve).

Results

Five articles were included in the study. Various digital health literacy-enabling e-services have been implemented in different vulnerable populations. Identified e-services aimed to increase disease knowledge, digital health literacy and social media usage, help in coping with changes in routines and practices, decrease fear and anxiety, increase digital knowledge and skills, decrease health literacy barriers and increase technology acceptance in specific groups. Many facilitators of digital health literacy-enabling e-services implementation were identified in expectant mothers and their families, older adults and people with low-income. Barriers such as low literacy limited to no knowledge about the viruses, medium of contamination, treatment options played an important role in distracting and believing in misinformation and disinformation. Poor health literacy was the only barrier found, which may hinder the understanding of individual health needs, illness processes and treatments for people with HIV/AIDS.

Conclusions

The literature on the topic is scarce, sparse and immature. We did not find any literature on digital health literacy in Indigenous people, though we targeted this vulnerable population. Although only a few papers were included, two types of health conditions were covered by the literature on digital health literacy-enabling e-services, namely chronic conditions and conditions that are new to the patients. Digital health literacy can help improve prevention and adherence to a healthy lifestyle, improve capacity building and enable users to take the best advantage of the options available, thus strengthening the patient’s involvement in health decisions and empowerment, and finally improving health outcomes. Therefore, there is an urgent need to pursue research on digital health literacy and develop digital platforms to help solve current and future COVID-19-related health needs.

Physicians’ Perceptions of Telemedicine Use During the COVID-19 Pandemic in Riyadh, Saudi Arabia: Cross-sectional Study (Preprint)

Background

Objective

Methods

Results

Conclusions