Associations Between Health Literacy, eHealth Literacy, and COVID-19-Related Health Behaviors Among Chinese College Students: Cross-sectional Online Study

Coronavirus-related health literacy level of Turkish adults: psychometric properties of the scale

An adequate level of health literacy enables people to adopt protective behaviors to cope with the COVID-19 pandemic. Validated instruments are desired to assess such reactions. This study aims to determine the level of health literacy and validity and reliability of the Coronavirus-Related Health Literacy Questionnaire (HLS-COVID-Q22) adapted to Turkish. The present study was carried out with 452 participants in Turkey using an online survey. The scale was translated from English to Turkish using the back-translation technique. The cultural adaptation was outlined in the context of establishing the validity and reliability of the instruments. A coronavirus-related health literacy measure was validated (HLS-COVID-Q22) for the Turkish population through exploratory factorial analysis, followed by a confirmatory factorial analysis. The coronavirus-related health literacy level of the participants was found to be 2.92 (± 0.51). Cronbach's alpha internal consistency coefficient was found to be 0.95. A four-factor solution was confirmed with eigenvalues > 1.0, suggesting a four-factor solution and explaining 68.84% of the total variance. It was determined that the χ2/df and root mean square residual, root mean square error of approximation and comparative fit index values in the last model had a good fit and that the normed fit index, goodness-of-fit index and adjusted goodness-of-fit index values were acceptable. The coronavirus-related health literacy level of Turkish adults was moderate. HLS-COVID-Q22 was a reliable and valid instrument for measuring coronavirus-related health literacy in the Turkish population. Promoting population-based health literacy and making decisions on accurate and reliable information are important in coping with the epidemic.

Association of 24-hour movement guideline adherence, mental health and quality of life in young adults: the role of e-Health literacy

Background

The spread of Covid-19 and resultant infection prevention strategies have disturbed the life routine of Chinese young adults, led to reduced physical activity (PA), prolonged screen time (ST) and inadequate sleep duration (SP), and made immense influence on their mental health (MH) and quality of life (QoL). E-Health literacy (EHL) can enable citizens to use available online information to respond to the highly complex information environment and make appropriate health decisions.

Objective

This study aims to examine associations between adhering to 24-h movement (24HM) guidelines and MH and QoL among young adults, as well as to identify any mediating or moderating role of EHL in these associations.

Methods

1742 young adults (20.03 ± 1.54 years old, 68.6% females) from north and south China completed self-report measures of 24HM (PA, ST and SP), health indicators (MH and QoL), EHL and demographic information through an online survey between 4 Apr and 16 Jun 2022. Generalized linear mixed models were applied for data analysis.

Results

Results showed that adhering to PA, ST and SP guidelines were all positively connected with QoL while MH was associated with adhering ST or SP guidelines. Adhering to more of 24HM guidelines was linked to better MH and QoL. EHL significantly mediated the association of guideline adherence and QoL and moderate that of guideline adherence and MH.

Conclusion

This is the first study to investigate the role of EHL on the associations between 24HM and MH as well as QoL during the Covid-19. The findings may contribute to further empirical research or intervention that aims to promote MH or QoL among young adults more effectively or provide valuable references for developing relevant strategies or policy of health promotion or public health events in China.

Latent Profiles of Coronavirus-Related Health Literacy in Chinese Residents and Its Related Predictors

OBJECTIVES

This study aimed to explore the latent profiles of coronavirus-related health literacy among Chinese residents and investigate whether some predictive factors are linked with different latent subgroups of coronavirus-related health literacy.

DESIGN/SETTING

This study was a cross-sectional survey conducted among Chinese residents beginning in April 2020.

PARTICIPANTS

A total of 1610 Chinese residents aged 15 to 69 years were involved and were asked to complete the questionnaire about coronavirus-related health literacy, demographic information, and COVID-19 pandemic-related information.

MAIN OUTCOME MEASURE

Examined the latent profiles of coronavirus-related health literacy and explored the influencing factors of different profiles of coronavirus-related health literacy.

RESULTS

The results showed that there were 3 latent subgroups, namely, high coronavirus-related health literacy (45.53%), medium coronavirus-related health literacy (47.76%), and low coronavirus-related health literacy (6.71%). Logistic regression analysis showed that gender, education, and the frequency of exposure to news about the pandemic could predict group membership.

CONCLUSIONS

Most Chinese residents have medium coronavirus-related health literacy. Education is an important factor that has a long-term stable influence on coronavirus-related health literacy, and the frequency of exposure to news about the pandemic is a factor that can improve coronavirus-related health literacy in a short time.

Assessing Electronic Health Literacy in Individuals With the Post-COVID-19 Condition Using the German Revised eHealth Literacy Scale: Validation Study

BACKGROUND

The eHealth Literacy Scale (eHEALS) is a widely used instrument for measuring eHealth literacy (eHL). However, little is known so far about whether the instrument is valid for the assessment of eHL in persons who are affected by the post-COVID-19 condition. This is particularly important as people with the post-COVID-19 condition are frequently affected by false information from the internet.

OBJECTIVE

The objective of our study was to evaluate the validity and reliability of the German Revised eHealth Literacy Scale (GR-eHEALS) in individuals with the post-COVID-19 condition.

METHODS

A cross-sectional study was conducted from January to May 2022. The self-assessment survey consisted of the GR-eHEALS, health status- and internet use-related variables, sociodemographic data, and (post)-COVID-19-related medical data. Confirmatory factor analysis (CFA), correlational analyses, and tests of measurement invariance were deployed.

RESULTS

In total, 330 participants were included in the statistical analyses. CFA revealed that the 2-factor model reached an excellent model fit (comparative fit index=1.00, Tucker-Lewis index=0.99, root mean square error of approximation=0.036, standardized root mean square residual=0.038). Convergent validity was confirmed by significant positive correlations between eHL and knowledge of internet-based health promotion programs, experience in using these programs, and the duration of private internet use. In addition, a significantly negative relationship of eHL with internet anxiety supported convergent validity. Further, significant relationships of eHL with mental health status and internal health locus of control confirmed the criterion validity of the instrument. However, relationships of eHL with physical health status and quality of life could not be confirmed. The 2-factor model was fully measurement invariant regarding gender. Regarding age and educational level, partial measurement invariance was confirmed. The subscales as well as the overall GR-eHEALS reached good-to-excellent reliability (Cronbach α≥.86).

CONCLUSIONS

The GR-eHEALS is a reliable and largely valid instrument for assessing eHL in individuals with the post-COVID-19 condition. Measurement invariance regarding gender was fully confirmed and allows the interpretation of group differences. Regarding age and educational level, group differences should be interpreted with caution. Given the high likelihood that individuals with the post-COVID-19 condition will be confronted with misinformation on the Internet, eHL is a core competency that is highly relevant in this context, in both research and clinical practice. Therefore, future research should also explore alternative instruments to capture eHL to overcome shortcomings in the validity of the GR-eHEALS.

Analysis of the mediating effect between ehealth literacy and health self-management of undergraduate nursing students' mental health literacy

BACKGROUND

Good health self-management positively affects the health of healthcare providers and their ability to manage their patients' health. This study explored the relationship between ehealth literacy, health self-management skills, and mental health literacy among undergraduate nursing students. Some studies have confirmed the correlation between e-health literacy and health self-management skills, while mental health literacy may be correlated with both, and this study aims to explore the relationship between the three.

METHODS

A descriptive cross-sectional survey was conducted at a medical university in northwestern China among 385 Chinese undergraduate nursing students. Participants completed the General Information Questionnaire, the Adult Health Self-Management Skills Rating Scale, the Mental Health Literacy Rating Scale, and the eHealth Literacy Scale, and provided valid responses. The IBM SPSS 27.0 statistical software was used for data entry and descriptive analysis, t-test, ANOVA, and Pearson correlation analysis. The IBM Amos 26.0 was used to construct the mediation effect model, and the Bootstrap method was employed to test mediating effects.

RESULTS

Mental health literacy, ehealth literacy, and health self-management skills of undergraduate nursing students were at a moderate to high level. Mental health literacy, ehealth literacy, and health self-management were positively correlated. Mental health literacy, particularly, played a partial mediating role of 31.1% ( 95% CI [0.307-1.418] ) between ehealth literacy and health self-management.

CONCLUSIONS

Undergraduate nursing students' mental health literacy partially mediates the link between eHealth literacy and health self-management skills. Schools should emphasize the development of nursing students' e-health literacy and mental health literacy in order to improve their health self-management skills, which will not only bring about a better health outcome for the students, but will also benefit the health of the social population.

eHealth literacy of migrant domestic workers in Hong Kong in the COVID-19 pandemic: A mixed methods study

BACKGROUND

Health communication in the COVID-19 pandemic can be effectively implemented if all members of the populations, including marginalized population such as migrant domestic workers (MDWs), have good eHealth literacy. Lessons learned during this critical period may help improve planning and mitigation of the impacts of future health crises.

METHODS

This study aimed to examine and explore the eHealth literacy levels of the MDWs in Hong Kong during the COVID-19 pandemic by using a convergent mixed methods research design. A total of 1156 Hong Kong MDWs participated in a paper-based survey using a multistage cluster random sampling design for the quantitative component. eHealth literacy was measured using an eHealth literacy Scale (eHEALS). For the qualitative component, a purposive sampling of 19 MDWs participated in face-to-face, semi-structured, in-depth interviews. Descriptive statistics and multiple regression analyses were used to carry out the quantitative analysis, while thematic analysis was used for the qualitative analysis. Both quantitative and qualitative data were merged and integrated for mixed-methods analysis.

RESULTS

The meta-inferences of the quantitative and qualitative results mainly confirmed that MDWs in Hong Kong had good levels of eHealth literacy. The use of Instagram, YouTube and WhatsApp as the COVID-19 information sources, in addition to having an interest in the topic of the current spread of COVID-19 together with the Hong Kong government's policies related to COVID-19, were found to be associated with eHealth literacy.

CONCLUSIONS

The eHealth literacy level of MDWs in Hong Kong was shown to be good and it was influenced by the use of popular social media platforms including Instagram, YouTube, and WhatsApp. It is realistic to suggest that such platforms should be harnessed for health communication during the pandemic. Yet, regulations to combat false information on these media are also urgently needed.

Le comportement alimentaire des étudiants de l'Université de Yaoundé I, Cameroun : entre la littératie alimentaire, la littératie en santé et l'e-littératie alimentaire

CONTEXTE

Il est connu que les maladies non transmissibles s'originent dans les habitudes et les choix alimentaires, et la littératie en santé est le meilleur déterminant de la santé d'un individu au 21e siècle. Or, cet aspect reste peu exploré en contexte camerounais. Dès lors, cette étude examine la relation entre la littératie en santé, la littératie alimentaire, la littératie alimentaire numérique et le comportement alimentaire des étudiants de l'Université de Yaoundé I.

MÉTHODES

Un total de 240 étudiants âgés de 18 à 48 ans (M = 21,97 ans, ET = 7,03), dont 149 (62,1 %) femmes, sélectionnés par commodité, ont rempli un questionnaire composite comprenant des échelles de mesure de la littératie en santé (Health Literacy Survey European Union Questionnaire Short Form), de la littératie alimentaire (Short Food Literacy Questionnaire), de la littératie alimentaire numérique (eHealth Literacy Scale) et du comportement alimentaire (General Dietary Behavior Inventory). Les données ont été analysées grâce au logiciel SPSS, v.20, en utilisant des tests de Mann-Whitney, de Kruskal-Wallis, de Spearman et des modèles linéaires généralisés.

RÉSULTATS

Les résultats ont montré que le comportement alimentaire n'est pas associé aux caractéristiques sociodémographiques des étudiants. L'analyse des modèles linéaires généralisés a démontré que le comportement alimentaire des étudiants est influencé par la littératie alimentaire (β = 1,503, p < 0,001), la littératie en santé (β = 1,191, p < 0,05) et la littératie alimentaire numérique (β = 1,263, p < 0,001). De même, prises ensemble, elles entrainent une variation de 6,929 sur le comportement alimentaire (χ²(3) = 63,070, β = 6,929, p < 0,001).

CONCLUSION

L'étude suggère que plus de recherches sur d'autres sous-groupes de population sont nécessaires afin de fournir des données pour des interventions en faveur d'une alimentation saine.

The association between health literacy, COVID-19 knowledge and adherence to preventive measures in Turkey

Despite vaccination and various prevention policies, the coronavirus (COVID-19) pandemic maintains its negative effects globally. Therefore, people must be adequately informed and put this knowledge into practice in order to take the necessary precautions. This can be achieved with adequate health literacy. In this context, this study was conducted to determine the relationship between health literacy, COVID-19 knowledge and adherence to preventive measures. The sample of this descriptive cross-sectional online survey consisted of 1086 people. Data were collected using a demographics questionnaire, the European Health Literacy Scale, the COVID-19 Knowledge Assessment Questionnaire and the COVID-19 Adherence Assessment Questionnaire. Participants' health literacy index had a median score of 30.9, with 67.5% having inadequate or problematic health literacy. Gender, age, education, marital status, region of residence, employment status and economic status were associated with health literacy (p < 0.05). Participants' median knowledge and adherence scores were 40 and 54, respectively. There were significant positive correlations between health literacy index, knowledge and adherence scores (p < 0.001). This study demonstrated that health literacy, COVID-19 knowledge and adherence were associated with each other. As a result, strategies aimed at improving health literacy may be beneficial in terms of having better knowledge and demonstrating high adherence to measures, thus, eradicating the COVID-19 pandemic, reducing COVID-19-related conditions and promoting public health.

Relationship Between eHealth Literacy and Healthy Aging in Older Chinese People: The Mediating Effect of Health Behaviors

OBJECTIVES

Healthy aging is an important means of promoting the well-being of older individuals. However, no studies have examined the relationship between eHealth literacy and healthy aging or its mechanism. Therefore, this study aimed to examine the relationship between eHealth literacy and healthy aging and the mediating effect of health behaviors in older Chinese individuals.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

We recruited 2144 older individuals from Jinan, Shandong Province, China.

METHODS

We used the eHealth Literacy Scale to assess eHealth literacy. Healthy aging was evaluated based on multimorbidity, functional limitations, mild cognitive impairment, depressive symptoms, and social isolation. Moreover, health behaviors were assessed using the Health-Promoting Lifestyle Profile. Logistic and linear regression models were used to analyze the relationships between eHealth literacy, healthy aging, and its components. Finally, a structural equation model was used to analyze the mediation.

RESULTS

High eHealth literacy was associated with all healthy aging components (P < .05), including the absence of multimorbidity [odds ratio (OR), 1.014; 95% CI, 1.002-1.025], no functional limitation (OR, 1.035; 95% CI, 1.022-1.047), no mild cognitive impairment (OR, 1.042; 95% CI, 1.024-1.061), no depressive symptoms (OR, 1.049; 95% CI, 1.027-1.072), and no social isolation (OR, 1.033; 95% CI, 1.018-1.048). In the adjusted model, eHealth literacy (β = 0.174; 95% CI, 0.132-0.217) was positively correlated with healthy aging. Health behaviors had a partial mediating effect on the relationship between eHealth literacy and healthy aging.

CONCLUSIONS AND IMPLICATIONS

Higher eHealth literacy was associated with better healthy aging in older Chinese individuals, and health behaviors mediated this relationship. Improving eHealth literacy may be an effective intervention for achieving healthy aging.

Depression and Anxiety Symptoms and Their Associated Factors Among Chinese Residents After the Lifting of the Dynamic Zero-COVID Policy: A Cross-Sectional Study

Purpose

China lifted its strict zero-Covid approach on December 7, 2022. This study aimed to investigate depression and anxiety symptoms and their associations among Chinese residents after the change in public policy.

Methods

A cross-sectional sample of 925 Chinese residents (726 females and 199 males) was recruited using convenience and snowball sampling approach between 16 and 25 December 2022. Participants completed online questionnaires on basic information, depression, anxiety, COVID-19 related perceptions, and protective behaviors change.

Results

Mild and moderate-to-severe depression symptoms were reported by 35.6% and 19.1% of participants, respectively. Nearly 40% of participants reported mild anxiety and 18.7% reported moderate-to-severe anxiety. Results from multinomial logistic regression analysis indicated that male gender, younger age, the presence of chronic disease, poorer self-rated mental health status, perceived impact, and worry were risk factors for both depression and anxiety, while higher education and protective behaviors change were protective factors. Besides, living with or caring for children (4-6 years), family members or other housemates currently with influenza-like symptoms, and perceived severity were also risk factors for depression.

Conclusion

Our findings provided initial evidence that Chinese residents may face heightened depression and anxiety during the early stage after the policy was released. Furthermore, we identified some vulnerable populations in need of prioritizing mental health assistance and some potentially modifiable factors associated with depression and anxiety, which provides an important guide for developing timely and effective psychological interventions and preparing for future pandemics.

Safety of COVID-19 Vaccination in Patients With Breast Cancer: Cross-Sectional Study in China

BACKGROUND

The widespread use of vaccines against the novel coronavirus disease (COVID-19) has become one of the most effective means to establish a population immune barrier. Patients with cancer are vulnerable to COVID-19 infection, adverse events, and high mortality, and should be the focus of epidemic prevention and treatment. However, real-world data on the safety of vaccines for patients with breast cancer are still scarce.

OBJECTIVE

This study aims to compare the safety of COVID-19 vaccines between patients vaccinated before or after being diagnosed with breast cancer.

METHODS

Patients with breast cancer who sought medical advice from October 2021 to December 2021 were screened. Those who received COVID-19 vaccines were enrolled in this study to analyze the safety of the vaccines. The primary outcome was patient-reported adverse events (AEs). All events after vaccine injection were retrospectively documented from the patients.

RESULTS

A total of 15,455 patients with breast cancer from 41 hospitals in 20 provinces in China were screened, and 5766 patients who received COVID-19 vaccines were enrolled. Of those enrolled, 45.1% (n=2599) of patients received vaccines before breast cancer diagnosis, 41.3% (n=2379) were vaccinated after diagnosis, and 13.6% (n=784) did not known the accurate date of vaccination or cancer diagnosis. Among the patients vaccinated after diagnosis, 85.4% (n=2032) were vaccinated 1 year after cancer diagnosis and 95.4% (n=2270) were vaccinated during early-stage cancer. Of all 5766 vaccinated patients, 93.9% (n=5415) received an inactivated vaccine, 3.7% (n=213) received a recombinant subunit vaccine, and 2.4% (n=138) received other vaccines, including adenovirus and mRNA vaccines. In the first injection of vaccines, 24.4% (n=10, 95% CI 11.2-37.5) of patients who received an adenovirus vaccine reported AEs, compared to only 12.5% (n=677, 95% CI 11.6-13.4) of those who received an inactivated vaccine. Patients with metastatic breast cancer reported the highest incidence of AEs (n=18, 16.5%, 95% CI 9.5-23.5). Following the second injection, patients who received an inactivated vaccine (n=464, 8.7%, 95% CI 8.0-9.5) and those who received a recombinant vaccine (n=25, 8.7%, 95% CI 5.5-12.0) reported the same incidence of AEs. No significant differences in patient-reported AEs were found between the healthy population and patients with breast cancer (16.4% vs 16.9%, respectively); the most common AEs were local pain (11.1% vs 9.1%, respectively), fatigue (5.5% vs 6.3%, respectively), and muscle soreness (2.3% vs 3.6%, respectively). The type of vaccine and time window of vaccination had little impact on patient-reported AEs.

CONCLUSIONS

Compared with patients vaccinated before breast cancer diagnosis, there were no significant differences in patient-reported AEs in the patients vaccinated after diagnosis. Thus, it is safe for patients with breast cancer, especially for those in the early stage, to receive COVID-19 vaccines.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2200055509; https://tinyurl.com/33zzj882.

The impact of COVID-19 on health literacy among Chinese rural residents

The outbreak of the Coronavirus disease 2019 (COVID-19) pandemic is an opportunity to improve the health literacy of rural residents. This study aims to explore the levels of health literacy among rural residents during the COVID-19 pandemic and investigate the effects of COVID-19-related variables on the health literacy of rural residents. A total of 882 rural residents aged 15-69 years in Shaanxi province participated in this study and completed the questionnaires about health literacy and COVID-19-related variables. These results showed that although overall health literacy and three aspects of health literacy among rural residents were low and lower than those of Chinese national residents, there was no significant difference in health literacy about safety and emergency between rural residents and Chinese national residents. Additionally, COVID-19-related variables significantly predicted health literacy (i.e. scientific health, safety and emergency and infectious disease prevention). Importantly, unlike other types of health literacy, the effect of a COVID-19-related variable (i.e. the frequency of exposure to news about the COVID-19 pandemic) on infectious disease prevention was only slightly smaller than the effect of high education on infectious disease prevention, and low education was no longer a significant predictor of infectious disease prevention. To conclude, rural residents in Shaanxi province have low health literacy. Education is a major factor affecting the health literacy of rural residents, and the frequency of exposure to news about the pandemic may compensate for the negative impact of low education on health literacy.

The influence of health literacy and knowledge about smoking hazards on the intention to quit smoking and its intensity: an empirical study based on the data of China's health literacy investigation

OBJECTIVE

This study explored the relationship between smokers' health literacy, knowledge of smoking hazards, and their intention to quit.

METHODS

Based on data from the 2019 Health Literacy and Tobacco Use Surveillance among residents of a city in Zhejiang Province, 1120 male smokers were screened. Differential tests were used to analyze whether smokers with varying levels of health literacy and knowledge about smoking hazards differed in their intention to quit smoking and the intensity of their intention. A multi-factor logistic regression model was constructed to explore the extent of these differences.

RESULTS

Only 24.8% of smokers had higher health literacy. Among smokers, those with an intention to quit had a higher health literacy level compared to those without such intention (32.7% vs. 17.0%, p < 0.001). Health literacy levels did not differ significantly between groups with different intensity of intention to quit (34.2% vs. 31.9% vs. 30.1%, p = 0.435). About 48.7% of the smokers a higher level of knowledge about smoking hazards. It was more prevalent in the intent to quit group compared to the no intent to quit group (54.0% vs. 43.4%, p < 0.001), and the low intent to quit group had lower knowledge compared to the moderate and high intent to quit groups (49.1% vs. 56.6% vs. 63.4%, p = 0.011). After adjusting for other influences, smokers with lower health literacy were less likely to have intention to quit (OR = 0.659, p = 0.016). And the association between knowledge about smoking hazards and whether smokers have the intention to quit is no longer significant, but it significantly affects the intensity of the intention to quit among smokers who already have the intention (OR = 0.623, p = 0.005).

CONCLUSION

General health literacy may play a role in facilitating smokers' progression from the stage of no intent to quit to one of intent to quit, but a more specific understanding of the harms of smoking may be needed to increase the strength of intent to quit.

Respective roles of social deprivation, health literacy, and clinical factors for COVID-19: a case-control study in hospitalized patients

Introduction

To investigate the association between social deprivation and COVID-19 among hospitalized patients in an underprivileged department of the greater Paris area.

Methods

Individuals hospitalized for COVID-19 between March 1st and October 31, 2020, were included, matched on age and sex, and compared with patients hospitalized for any other reason with negative RT-PCR for SARS-CoV-2, through a case-control study. Clinical, socio-demographic characteristics, health literacy, and social deprivation, assessed by the EPICES score, were collected. Factors associated with COVID-19 in hospitalized patients were assessed using univariate and multivariate logistic regression models.

Results

69 cases and 180 controls were included. Participants were mostly men (N = 148: 59.4%) aged 65 or older (N = 109: 44.1%). Median EPICES score was 43.2 (IQR 29.4-62.9). EPICES score > 30.17 (precariousness threshold) was not significantly associated with COVID-19 in hospitalized patients (adjusted odds ratio (aOR) = 0.46; 95% Confidence Interval (CI) [0.21-1.01]). Advanced age, higher BMI, professional activity, home area of less than 25 m2 per person, and low health literacy, were significantly associated with COVID-19 in hospitalized patients.

Discussion

This study highlights probable risk factors for specific exposition in disadvantaged area: maintenance of professional activity, smaller home area, and low health literacy.

Moderation modelling of COVID-19 digital health literacy and sense of coherence across subjective social class and age among university students in Ghana

BACKGROUND

The study assessed the moderation modelling of digital health literacy and sense of coherence across subjective social class and age among university students in Ghana during the COVID-19 pandemic.

METHODS

A total of 1160 students were conveniently sampled from two universities namely, the University of Education, Winneba and University of Cape Coast, using the descriptive cross-sectional survey design. Preliminary analysis was performed using descriptive statistics, whilst multivariate multiple regression and moderation analyses (Haye's Model) were employed to analyze the main data.

RESULTS

The study revealed that COVID-19 digital health literacy is directly and positively associated with sense of coherence among university students. Further, higher subjective social class positively and strongly moderated the relationship between COVID-19 digital health literacy and sense of coherence among university students. Additionally, the relationship between COVID-19 digital health literacy and sense of coherence was indirectly prominent among relatively older university students than younger ones.

CONCLUSIONS

The findings have implications for university management/authorities and public health agencies to organize effective orientation and self-management training programmes for university students.

Determinants and outcomes of eHealth literacy in healthy adults: A systematic review

BACKGROUND

eHealth has shown many benefits in health promotion and disease prevention. For engaging in and taking advantage of eHealth, eHealth literacy is essential. This systematic review aims to summarise and examine the existing evidence on determinants and outcomes of eHealth literacy in healthy adults.

METHODS

We searched the relevant peer-reviewed articles published in English in six databases: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library and ProQuest. The inclusion criteria of the review were: 1) studies examining 'eHealth literacy', which refers to the ability to search, select, judge and apply online health information to address or solve health problems and to improve wellbeing; 2) the type of study included observational and experimental studies, mixed method studies or qualitative studies; 3) the participants were healthy adults; 4) the main outcomes were the determinants (i.e. influencing or associated factors) and outcomes (i.e. benefits and disadvantages) of eHealth literacy. Articles were assessed by two reviewers using the Joanna Briggs Institute critical appraisal tool. A conceptual model to map the determinants and outcomes of eHealth literacy in healthy adults into the non-modifiable, individual, social and community networks and structural layers was developed to classify the identified determinants and outcomes.

RESULTS

Forty-four studies were included in this review, of which 43 studies were cross-sectional and one was qualitative. eHealth literacy determinants included age, sex, literacy factors, socioeconomic factors and language. eHealth literacy outcomes included better general health promotion behavior, COVID-19 preventive behaviors, psychological wellbeing, social support, self-rated health and health service utilisation.

CONCLUSIONS

Our results showed that eHealth literacy has multi-layered determinants and positive outcomes. Different strategies at different policy levels are needed to improve the eHealth literacy levels of healthy adults.

COVID-19 pandemic fatigue among well-educated egyptian population: Cross-sectional study

Aim

The study explores the emergence of COVID-19 pandemic fatigue among well-educated Egyptians measured in terms of their level of adherence toward COVID-19 protective measures along 20 months since the beginning of the pandemic.

Setting and Design

A cross-sectional study was conducted in October 2021, using an online questionnaire for well-educated Egyptians in different governorates.

Results

A total of 888 participants completed the questionnaire, their mean age was 39 ± 7.2 years and 60% of them were females. There was a strong association between the presence of either behavioral risk factors or chronic conditions and % of infection. The main sources of COVID-19 information were social media, followed by the Egyptian Ministry of health and population and WHO websites. A pandemic fatigue was observed after nearly 7 to 10 months from the pandemic emergence. The participant's age, previous COVID-19 infection, and occupation status were significant predictors for adherence to COVID-19 protective measures. The participants claimed that difficulty in remaining at home, feeling uncomfortable with face masks, the high cost of protective supplies, absence of governmental enforcement, and forgetfulness are the most perceptive barriers hindering their adherence to COVID-19 protective measures. They suggested some strategies for better adherence and reduced pandemic fatigue that includes: the implementation of governmental enforcement measures, including penalties for nonwearing masks, educational health programs, and availability of free protective supplies at the workplace.

Conclusions

Pandemic fatigue was observed after 7 to 10 months from the pandemic emergence even though the high education level of the participants.

Are health promotion activities and preventive health practices predictors of adolescent eHealth literacy?

Adolescents' general health status and health behaviors have been closely monitored in recent years. It is estimated that adolescents comprise one-sixth of the world's population. This study examined whether eHealth literacy was predicted via health promotion activities and preventive health practices among Turkish adolescents. This cross-sectional study was conducted between March and May 2022 with 706 adolescents in Çorum, Turkey. A face-to-face questionnaire form was used, including socio-demographic characteristics, preventive health practices, eHealth literacy scale and Adolescent Health Promotion Scale. The data of the research were analyzed with the SPSS 22.0 program. Percentage, mean, Pearson Correlation analysis, and multiple regression analysis were used in the analyzes. The p < 0.05 value was considered statistically significant in the evaluations. In the study, 55.8% were female, and the mean age of the whole group was 16.09 ± 2.63 years. The mean score on the eHealth literacy scale was 29.40 ± 6.29. The mean of the total scores obtained from the Adolescent Health Promotion Scale was 137.97 ± 21.87. There was a significant positive correlation between eHealth literacy and the Adolescent Health Promotion Scale (p < 0.001). Multiple linear regression analysis was performed to predict eHealth literacy using the variables of Adolescent Health Promotion and preventive health practices. eHealth literacy positively and significantly predicts health promotion activities (β = 0.27, t (695) = 7.54, p < 0.001). eHealth literacy increased annual weight measurement by more than 0.13 (β = 0.13), annual blood iron measurement by more than 0.16 (β = 0.16) and annual dental examination by more than 0.11 (β = 0.11). Developing eHealth literacy interventions will be necessary for environments with a high concentration of adolescents (schools and courses). Also, primary health care services should be integrated with the school environment.

Childhood environmental harshness and unpredictability negatively predict eHealth literacy through fast life-history strategy

Background

eHealth literacy-the ability to obtain, understand, evaluate, and use health information from the Internet-is important to maintaining and improving personal health. Prior research found that people differ notably in the levels of eHealth literacy, and this study tests a theoretical account of some of those individual differences. Drawing on life history theory, we propose that low eHealth literacy is partly the outcome of people adopting a resource-allocation strategy emphasizing early and fast reproduction, namely, a fast life-history strategy.

Methods

We conducted a cross-sectional survey study (N = 1,036) that measured Chinese adult respondents' eHealth literacy, childhood environmental harshness and unpredictability, and fast life-history strategy. Covariates included health-information seeking online, self-rated health, sex, age, education level, and monthly income.

Results

Supporting a life-history explanation of eHealth literacy, childhood environmental harshness and unpredictability negatively predicted eHealth literacy through fast life-history strategy and mainly the insight-planning-control dimension of it. Harshness, not unpredictability, also directly and negatively predicted eHealth literacy after fast life-history strategy was controlled for.

Conclusion

Our findings suggest that the psychological mechanisms associated with human life-history strategies produce at least some of the individual differences in levels of eHealth literacy, including those related to neuroticism, socioeconomic status, self-rated health and social capital. Thus, a possible way to increase future generation's eHealth literacy and thereby their health is to reduce the harshness and unpredictability of the environment in which they grow up, thereby making them more likely to adopt a relatively slow life-history in their adulthood.

Association between psychological stress, anxiety and oral health status among college students during the Omicron wave: a cross-sectional study

BACKGROUND

Within 3 years of the COVID-19 pandemic, increasing interest has been given to its potential influence on health status due to lockdowns caused by the pandemic. However, the impact is inadequately understood, especially for college students. This study aimed to investigate the potential association between psychological stress, anxiety and oral health of college students during the Omicron wave of the COVID-19 pandemic.

METHODS

An online survey with measurements of psychological stress, anxiety and oral health was completed by 1770 Chinese college students. The Perceived Stress Scale-14 (PSS-14) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure psychological stress and anxiety, respectively. Oral health status was self-reported including toothache, gingival bleeding, and oral ulcer. Multivariable logistic regressions were performed to determine underlying associations for outcome variables. Structural equation modeling (SEM) was performed to confirm the relationship between mental and oral health status.

RESULTS

Of the 1770 subjects, 39.2% presented high psychological stress and only 41.2% expressed no anxiety. A significant association was found between psychological stress, anxiety and oral health status. Anxiety has significant impacts on toothache (OR = 0.36; 95%CI: 0.23-0.55; p < 0.01), gingival bleeding (OR = 0.43; 95%CI: 0.29-0.65; p < 0.01), and oral ulcer (OR = 0.54; 95%CI: 0.36-0.80; p < 0.01). Anxiety significantly mediated the association between psychological stress and self-reported oral symptoms.

CONCLUSIONS

Anxiety may be a significant risk indicator for mental health among college students and demonstrates a significant relationship with the occurrence of self-reported oral symptoms. Concerns about academic and life changes caused by the pandemic were the two most significant sources of stress.

The Correlation Among COVID-19 Vaccine Acceptance, the Ability to Detect Fake News, and e-Health Literacy

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has seen a rise in the spread of misleading and deceptive information, leading to a negative impact on the acceptance of the COVID-19 vaccine and public opinion. To address this issue, the importance of public e-Health literacy cannot be overstated. It empowers individuals to effectively utilize information technology and combat the dissemination of inaccurate narratives.

OBJECTIVE

This study aimed to investigate the relationship between the ability to identify disingenuous news, electronic health literacy, and the inclination to receive the COVID-19 immunization.

METHODS

In this descriptive-analytical cross-sectional study conducted during summer 2021 in Isfahan, Iran, 522 individuals older than age 18 years, seeking medical attention at health centers, were surveyed. The participants were selected through a meticulous multistage cluster sampling process from the pool of individuals referred to these health centers. Along with demographic information, data collection instruments included the standard e-Health literacy questionnaire and a researcher-developed questionnaire designed to identify misinformation. The collected questionnaires were entered into SPSS 24 for statistical analysis, which included the Kruskal-Wallis test, the Chi-square test, the Spearman test, and logistic regression models.

KEY RESULTS

The study findings revealed a statistically significant relationship between acceptance of the COVID-19 vaccine and the ability to identify deceptive news. An increase of one unit in the score for recognizing misinformation led to a 24% and 32% reduction in vaccine hesitancy and the intention to remain unvaccinated, respectively. Furthermore, a significant correlation was found between the intention to receive the vaccine and e-Health literacy, where an increase of one unit in e-Health literacy score corresponded to a 6% decrease in the intention to remain unvaccinated. Additionally, the study found a notable association between the ability to detect false and misleading information and e-Health literacy. Each additional point in e-Health literacy was associated with a 0.33% increase in the capacity to identify fake news (Spearman's Rho = 0.333, p < .001).

CONCLUSION

The study outcomes demonstrate a positive correlation between the COVID-19 vaccine acceptance, the ability to identify counterfeit news, and proficiency in electronic health literacy. These findings provide a strong foundation for policymakers and health care practitioners to develop and implement strategies that counter the dissemination of spurious and deceitful information related to COVID-19 and COVID-19 immunization. [HLRP: Health Literacy Research and Practice. 2023;7(3):e130-e138.].

Mental health literacy and COVID-19 related stress: The mediating role of healthy lifestyle in Tabriz

Introduction

Data concerning the relationship between Mental Health Literacy (MHL) and COVID-19 stress are limited. The study explored the relationship between COVID-19-related stress, MHL, and healthy lifestyle and their components. The current study aimed to investigate the moderating role of a healthy lifestyle in the relationship between MHL and COVID-19-related stress among people referring to health complexes in Tabriz.

Methods

In this descriptive-correlational study, 1011 people who referred to health complexes in Tabriz were selected using cluster sampling and responded to the COVID-19 Stress Scale (CSS), Mental Health Knowledge Questionnaire (MHKQ), and Lifestyle Questionnaire (LSQ). Data analysis was performed using structural equation modeling. SPSS ver.19 and LISREL ver. 8.5 statistical software is used to classify, process, and analyze data and test research hypotheses.

Results

The results indicated that stress caused by COVID-19 has a negative relationship with lifestyle and MHL. The relationship between lifestyle and MHL was positive, and it has the positive effect on a healthy lifestyle (with a standardized coefficient of 0.23). In addition, MHL had a negative effect on the stress related to the coronavirus (with a standard coefficient of -0.22), and the relationship between a healthy lifestyle was also negative on the stress related to the coronavirus (with a standard coefficient of -0.20). The evaluation of the hypothetical research model using fit indices showed that the hypothetical model fits the measurement model (Comparative Fit Index (CFI) = 0.97, Goodness of Fit Index (GFI) = 0.95, Root Mean Square Error of Approximation (RMSEA) = 0.055). All the comparative indices as well as the comparative fit index were found to be close to one and greater than 0.90.

Conclusion

This study highlights that healthcare providers must develop effective preventive and therapeutic interventions to deal with COVID-19-related stress and pay attention to the issue of increasing the level of MHL during international crises taking into consideration the moderating role of a healthy lifestyle, and develop educational and treatment programs.

Willingness to Use Mobile Health Devices in the Post-COVID-19 Era: Nationwide Cross-sectional Study in China

BACKGROUND

Despite the increased development and use of mobile health (mHealth) devices during the COVID-19 pandemic, there is little knowledge of willingness of the Chinese people to use mHealth devices and the key factors associated with their use in the post-COVID-19 era. Therefore, a more comprehensive and multiangle investigation is required.

OBJECTIVE

We aimed to probe Chinese attitudes regarding the use of mHealth and analyze possible associations between the attitude of willingness to use mHealth devices and some factors based on the socioecological model.

METHODS

A survey was conducted using quota sampling to recruit participants from 148 cities in China between June 20 and August 31, 2022. Data from the survey were analyzed using multiple stepwise regression to examine the factors associated with willingness to use mHealth devices. Standardized regression coefficients (β) and 95% CIs were calculated using multiple stepwise regression.

RESULTS

The survey contained a collection of 21,916 questionnaires and 21,897 were valid questionnaires, with a 99.91% effective response rate. The median score of willingness to use mHealth in the post-COVID-19 era was 70 points on a scale from 0 to 100. Multiple stepwise regression results showed that the female gender (β=.03, 95% CI 1.04-2.35), openness personality trait (β=.05, 95% CI 0.53-0.96), higher household per capita monthly income (β=.03, 95% CI 0.77-2.24), and commercial and multiple insurance (β=.04, 95% CI 1.77-3.47) were factors associated with the willingness to use mHealth devices. In addition, people with high scores of health literacy (β=.13, 95% CI 0.53-0.68), self-reported health rating (β=.22, 95% CI 0.24-0.27), social support (β=.08, 95% CI 0.40-0.61), family health (β=.03, 95% CI 0.03-0.16), neighbor relations (β=.12, 95% CI 2.09-2.63), and family social status (β=.07, 95% CI 1.19-1.69) were more likely to use mHealth devices.

CONCLUSIONS

On the basis of the theoretical framework of socioecological model, this study identified factors specifically associated with willingness of the Chinese people to use mHealth devices in the post-COVID-19 era. These findings provide reference information for the research, development, promotion, and application of future mHealth devices.

The relationship between depression, anxiety, e-health literacy, and health-promoting behavior in nursing students during COVID-19

The purpose of this study was to identify the correlation between depression, anxiety, e-health literacy (eHL), and health-promoting behaviors among nursing students during the coronavirus disease 2019 (COVID-19) pandemic, and to identify the factors affecting health-promoting behaviors. A cross-sectional study was conducted online, recruiting 301 nursing students recruited from 4 universities in the Chungcheng Province and Daejeon Metropolitan City in South Korea between May 28 and June 30, 2021. Data were analyzed using SPSS WIN 27.0. The general characteristics of the study participants were analyzed by frequency and percentage, and the degree of depression, anxiety, eHL, and health-promoting behaviors were calculated as averages and standard deviations. Differences in health-promoting behaviors according to general characteristics were analyzed using independent t tests and analysis of variance, and a post hoc Scheffe test was conducted. Correlations between depression, anxiety, eHL, and health-promoting behaviors were measured using Pearson correlation matrices. Stepwise multiple regression was performed to identify factors affecting health-promoting behaviors. During the COVID-19 pandemic, the average level of depression and anxiety was reported to be 3.93 (4.71) and 3.40 (4.30), respectively; 33.2% of nursing students experienced more than mild depression and 29.2% experienced anxiety. The average eHL level was 3.91 (0.56), and the average of health-promoting behaviors was 2.43 (0.45). Depression was positively correlated with anxiety (R = 0.734, P < .001) and negatively correlated with health-promoting behaviors (r = -0.198, P = .001), whereas eHL had a positive correlation with health-promoting behaviors (R = 0.347, P < .001). The factors affecting health-promoting behaviors were religion (β = -0.160, standard error [SE] = 0.048), current health status (β = -0.097, SE = 0.032), frequency of searching the Internet for health-related information in a week (β = -0.070, SE = 0.026), interest in health (β = -0.191, SE = 0.039), and critical eHL (β = 0.243, SE = 0.040); the explanatory power was 27.4%. Results demonstrate that during the COVID-19 pandemic, higher depression and anxiety among nursing students decreased health-promoting behaviors, while higher eHL increased health-promoting behaviors, and eHL was a major factor affecting health-promoting behaviors. These results contribute to the provision of basic data for the development of nursing intervention programs and educational strategies that can establish correct health-promoting behaviors by managing depression and anxiety among nursing students and improving eHL.

Digital and physical factors influencing an individual's preventive behavior during the COVID-19 pandemic in Taiwan: A perspective based on the S-O-R model

COVID-19 has caused considerable stress to individuals and communities. Daily press briefings on public health during the COVID-19 pandemic have increased individuals' feelings of social pressure. Abrupt changes to a person's immediate environment, such as the changes caused by COVID-19, can substantially affect their mental health and cognitive adjustment. On the basis of the stimulus-organism-response (S-O-R) framework, we examined the effects of digital and physical stimuli related to COVID-19 in Taiwan on individuals' psychological states and preventive behavior, including social distancing and personal hygiene. The data obtained from 498 valid survey questionnaires indicated that digital and physical factors including informativeness, social pressure, and severity exerted direct effects on cognitive assimilation and anxiety, which in turn affected individuals' preventive behavior. Moreover, cognitive assimilation and anxiety had significant mediating effects on the relationships of informativeness, social pressure, and severity with individuals' preventive behavior. The results of this study indicate how digital and physical stimulus factors affect cognitive assimilation and anxiety, which influence preventive behavior during a pandemic.

A study on the effects of health behavior and sports participation on female college students' body mass index and healthy promoting lifestyle

Objective

Life form and body composition may affect the health of college students. This study will explore the relationship between the demographic variables of female college students and their body composition and health promoting lifestyle, so as to provide useful reference for the future design and planning of college students' physical and mental health courses and improving their physical activity level.

Methods

Using the method of questionnaire and bioelectrical resistance measurement, a questionnaire on healthy lifestyle of college students was constructed on the basis of consulting a large number of relevant research literature. Relevant survey samples were obtained through random sampling, and their body composition was measured; use SPSS21.0 statistical analysis software to conduct statistical analysis on relevant indicators.

Results and conclusions

(1) at present, female college students generally lack leisure activities and sleep, the proportion of regular fitness habits is low, and the number of snacks and average daily online time are generally too high; The overweight rate and body fat rate of female college students are generally too high, while the standard rate of muscle weight is generally too low. (2) Female college students' health promoting lifestyle has the highest score of self-realization, followed by interpersonal support and the worst behavior of sports participation; The older the college students, the worse their sports participation and overall health promotion behavior; The better the Conscious health status, the better the self-realization, exercise participation and nutritional behavior; The more exercise time per day, the higher their participation in sports and the stronger their health responsibility; The more time spent on the Internet every day, the worse the health responsibility and sports participation. (3) The more time female college students spend on the Internet every day, the higher the probability of overweight. Those with regular exercise habits have a lower proportion of overweight and high body fat rate, while the better their sleep and night snack behavior, the lower their body fat rate. The older college students are, the larger their visceral fat area is, the better their exercise habits and sleep behavior are, the smaller their visceral fat area is, and the lower their visceral fat level is.

Association of digital health literacy and information-seeking behaviors among physicians during COVID-19 in Ethiopia: A cross-sectional study

Background

Universal access to health information is a requirement for all global health strategies in the era of pandemics. Getting health information from the internet is a great concern for the quality of patient healthcare. This study aimed to determine the association between digital health literacy and information-seeking behavior among physicians during COVID-19.

Methods

An institutional-based cross-sectional study was conducted from December to February 2021 with a total sample size of 423. A pretest was performed among physicians before the actual data collection. After the data collection, the data were checked, cleaned, and exported into STATA v. 14. Descriptive statistics, binary logistic regression, and multivariable logistic regression analysis were applied. Then a 95% CI and a p-value of less than 0.05 were used to declare statistical significance.

Results

The study revealed that 53.81% of physicians had high digital health literacy and 52.46% had high information-seeking behaviors. Health information-seeking behaviors were determined by digital health literacy, which was 2.25 times more likely than those who had low digital health literacy (AOR = 2.25, 95% CI: [1.11-4.57]). Health-related websites (67.5%) were the most common sources of health information, and 63.30% of physicians find digital health literacy easy or very easy to learn. However, 206 (50.92%) find it difficult or very difficult to decide if the information is reliable, verified, and up-to-date. Internet access (AOR = 1.90, 95% CI: [1.16-3.12]), frequency of searching for information (AOR = 5.35, 95% CI: [2.01-14.29]). All were discovered to be significantly associated with physicians' health information-seeking behaviors.

Conclusions

Digital health literacy is a key to seeking health information online for appropriate decision-making. Increasing internet access, and providing ICT training, and integrate it into the health information revolution agendas, helping to disseminate health information and provide timely, reliable, and relevant news and genuine information needed for their work.

Relationship between health literacy and COVID-19 knowledge: A cross-sectional study

Background

Health literacy (HL) is a protective factor for some chronic diseases. However, its role in the Coronavirus Disease 2019 (COVID-19) pandemic has not been clarified. This study aims to explore the association between HL and COVID-19 knowledge among residents in Ningbo.

Methods

A total of 6,336 residents aged 15-69 years in Ningbo were selected by multi-stage stratified random sampling method. The "Health Literacy Questionnaire of Chinese Citizens (2020)" was used to evaluate the relationship between COVID-19 knowledge and HL. Chi-square test, Mann-Whitney U test and logistic regression were used to analyze the data.

Results

The HL and COVID-19 knowledge levels of Ningbo residents were 24.8% and 15.7%, respectively. After adjusting for confounding factors, people with adequate HL were the more likely to have adequate COVID-19 knowledge compared with those with limited HL (OR = 3.473, 95% CI = 2.974-4.057, P <0.001). Compared with the limited HL group, the adequate HL group had a higher rate of COVID-19 knowledge, a more positive attitude, and a more active behavior.

Conclusion

COVID-19 knowledge is significantly associated with HL. Improving HL may influence people's knowledge about COVID-19, thereby changing people's behaviors, and finally combating the pandemic.

Associations between health literacy, digital skill, and eHealth literacy among older Chinese adults: A cross-sectional study

Objective

Digital divide in health-related technology use is a prominent issue for older adults. Improving eHealth literacy may be an important solution to this problem. This study aimed to explore the associations between health literacy, digital skills, and eHealth literacy among older Chinese adults.

Methods

A total of 2,144 older adults (mean age, 72.01  ±  6.96 years) from Jinan City, China participated in this study. The eHealth Literacy Scale was used to measure eHealth literacy in older adults. A linear regression model was used to analyze the associations among health literacy, digital skills, and eHealth literacy in older Chinese adults.

Results

The mean eHealth literacy score of the older adults was 17.56  ±  9.61. After adjusting for sociodemographic characteristics and experience of Internet usage, the results of the linear regression showed that health literacy (B  =  0.258, 95% confidence interval (CI)  =  0.215-0.302, P< 0.001) and digital skills (B  =  0.654, 95% CI  =  0.587-0.720, P < 0.001) were positively associated with eHealth literacy. Sensitivity analyses revealed that this association remained robust.

Conclusions

The level of eHealth literacy in older Chinese adults is low. Health literacy and digital skills are associated with eHealth literacy in older adults. In the future, eHealth literacy intervention research should be considered from the perspective of health literacy and digital skills.

Cut-off value of the eHEALS score as a measure of eHealth skills among rural residents in Gansu, China

Background

In this study, our aim was to quantify eHealth literacy and determine a cut-off value for eHEALS scores that signifies adequate eHealth literacy among rural residents in Gansu, China.

Methods

This cross-sectional investigation encompassed 18 rural areas across three cities-Lanzhou, Wuwei, and Dingxi-in Gansu. A total of 451 residents were recruited and underwent evaluations for both eHealth literacy and eHealth skills, utilizing the eHEALS and self-constructed tasks, respectively. A receiving operator characteristic curve was plotted with eHealth skills as the dependent variable and eHealth literacy levels as the independent variable, aiming to determine a cut-off value for eHEALS indicating adequate eHealth literacy and evaluate its predictive capacity.

Results

Among the 451 respondents, 10.9% did not possess a personal electronic device with Internet access, while 6.4% owned but had never used them. Within the remaining 373 residents, the mean eHealth literacy score was 25.85 (SD:10.93), item scores ranged from 3.12 (SD:1.45) to 3.42 (SD:1.60). Completion rates for three eHealth skills varied from 39.1% to 59.8%. The cut-off value was 29.5 determined by the Youden index. The area under the receiver operating curve was 0.829, with a sensitivity of 86.7%, and a specificity of 66.8%.

Conclusions

Our findings emphasized that eHealth literacy among rural residents remains at a low level. Moreover, we identified a cut-off value of 29.5 for eHEALS scores that signifies adequate eHealth literacy within this demographic.

Changes in the health literacy of residents aged 15-69 years in central China: A three-round cross-sectional study

Introduction

Health literacy is an effective strategy to promote more cost-effective use of health care services and a crucial tool for preventing the spread of infectious diseases. The main objective of this study was to analyze changes in health literacy from 2019 to 2021.

Methods

Data were from the latest three-round cross-sectional studies with the same study design.

Results

Although the prevalence of adequate health literacy rose significantly over time, increasing from 26.9% (95% CI 20.1-33.7) in 2019 to 34.1% (32.9-35.3) in 2021, it was still at a relatively low level. The most significant decrease was observed for health skills among the three aspects and health information literacy among the six dimensions. Working as medical staff was a protective factor for adequate health literacy, health skills literacy, and health information literacy. Risk factors for adequate health literacy and health information literacy were older age and lower education level. Furthermore, adequate health information literacy was positively related to annual family income.

Discussion

More practical and effective policies targeting health literacy for critical aspects and groups in Central China, are urgently needed, especially during the epidemic.

The association and intervention effect between eHealth literacy and lifestyle behaviors among Chinese university students

OBJECTIVE

Our aim was to evaluate the association between eHealth literacy and lifestyle behaviors to intervene among Chinese university students.

METHOD

The Chinese eHealth Literacy Scale (C-eHEALS) questionnaire was used to investigate the eHealth literacy level and association with lifestyle behaviors among Chinese university students. Independent sample t-test and Pearson's correlation coefficient were used by statistical software SPSS v20.

RESULTS

In the first round, 5,151 university students participated in the study, including 71.46% female and 28.54% male, aged 18-22 (93.13%).The average eHealth literacy score was 26.81 ± 5.83. Four lifestyle behaviors (e.g., exercise, smoking, drinking and sleeping) were all significantly correlated with eHealth literacy scores and demonstrated significant differences. In the second investigation (N = 2,939), the average eHealth literacy score was 31.64 ± 6.44, a notable improvement compared with the first investigation.

CONCLUSION

Those in the group with high eHealth literacy scores have a healthier lifestyle than those in the low-score group. Training in eHealth-related resources is a positive measure to improve university students' eHealth literacy.

Health Literacy, Misinformation, Self-Perceived Risk and Fear, and Preventive Measures Related to COVID-19 in Spanish University Students

The "infodemic" is one of the main obstacles in the fight against the COVID-19 pandemic. In order to face it, health literacy (HL) is essential since it allows for knowledge about COVID-19 and the practice of preventive measures to be fostered. This is especially relevant in university students due to their idiosyncrasy. This study aims to evaluate the level of HL related to COVID-19 (HLC), risk perception, misinformation, and the attitudes and behaviors adopted to prevent the spread of coronavirus in Spanish university students. An online questionnaire was administered to 499 Spanish university students. The HLC index presented a mean of 33.89 out of 50; a total of 63.8% had an inadequate level of HLC. They practiced a mean of 7.54 out of 9 preventive behaviors, and the mean knowledge score was 10.40 out of 13. The HLC showed significantly different scores for the degree, the practice of preventive measures, and some sources of information. The level of HL correlates with the adoption of preventive measures. The higher the severity and perceived susceptibility, the more preventive measures are taken by the students. Therefore, there is a need to strengthen the HL skills of university students and address the dissemination of misinformation. Although caution should be taken when generalizing these results due to the limitations inherent within a cross-sectional study and the convenience sampling, our results can guide the establishment of health education strategies and policies for the management of the infodemic in pandemic situations, according to this target population.

Literacy and Mental Health of Portuguese Higher Education Students and Their Use of Health Promotion Strategies during Confinement in the COVID-19 Pandemic

The pandemic of COVID-19 caused significant changes in economies and societies with a major impact on the entire education process. However, these changes did not invalidate a constant effort of adaptation. This cross-sectional, descriptive, and correlational study used an online questionnaire administered to students from various study cycles at higher education institutions in Portugal, with the aim of exploring the influence of literacy and mental health on the use of mental health promotion strategies during COVID-19 confinement. A total of 329 students from higher education institutions participated in this study, mostly from the age group 18-24 years (n = 272; 82.7%) and female (n = 265, 80.5%). The most mentioned health promotion strategies during this period included studying (n = 170; 51.7%); physical activities (n = 151, 45.9%); social networking (n = 124, 37.7%); cooking activities (n = 120, 36.5%); and listening to music (n = 118, 35.9%). Academic success is self-reported, and it is weakly correlated with the MHI5 (r = 0.103, p = 0.063). Students in the pre-graduate programs studied more during the times of the pandemic and used this activity as a mental-health-promoting strategy with a statistically significant difference (p = 0.033). Although it was difficult to improve health literacy related to COVID-19 in such a short period of time, there was a very strong motivation to access, understand, evaluate, communicate, synthesize, and apply information and knowledge to maintain mental health through self-care using health promotion strategies.

Identifying Health Equity Factors That Influence the Public's Perception of COVID-19 Health Information and Recommendations: A Scoping Review

The COVID-19 pandemic has impacted global public health and public trust in health recommendations. Trust in health information may waver in the context of health inequities. The objective of this scoping review is to map evidence on public perceptions of COVID-19 prevention information using the PROGRESS-Plus health equity framework. We systematically searched the MEDLINE, Cochrane Central Register of Controlled Trials, PsycInfo, and Embase databases from January 2020 to July 2021. We identified 792 citations and 31 studies published in 15 countries that met all inclusion criteria. The majority (30/31; 96.7%) of the studies used an observational design (74.2% cross-sectional, 16.1% cohort, 6.5% case study, 3.2% experimental trials). Most studies (61.3%) reported on perception, understanding, and uptake, and 35.5% reported on engagement, compliance, and adherence to COVID-19 measures. The most frequently reported sources of COVID-related information were social media, TV, news (newspapers/news websites), and government sources. We identified five important equity factors related to public trust and uptake of recommendations: education and health literacy (19 studies; 61.3%), gender (15 studies; 48.4%), age (15 studies; 48.4%), socioeconomic status (11 studies; 35.5%), and place of residence (10 studies; 32.3%). Our review suggests that equity factors play a role in public perception of COVID-19 information and recommendations. A future systematic review could be conducted to estimate the impact of equity factors on perception and behavior outcomes.

The relationship between COVID-19-related prevention cognition and healthy lifestyle behaviors among university students: Mediated by e-health literacy and self-efficacy

BACKGROUND

At present, few studies have explored the mediating effect of e-Health literacy and self-efficacy on prevention cognition and healthy lifestyle behaviors during the normalization stage of COVID-19 prevention and control. This study aimed to determine the associations among COVID-19-related prevention cognition, self-efficacy, e-Health literacy, and healthy lifestyle behaviors at university students.

METHODS

By using a stratified cluster random sampling method, 971 students from five universities were recruited between May and August 2021 in Guangzhou, China. We collected participants' demographic characteristics, and assessed self-efficacy, COVID-19-related prevention cognition, e-Health literacy, and healthy lifestyle behaviors. A structural equation model was used for mediation analysis.

RESULTS

The overall mean value of healthy lifestyle behaviors of college students was 0.307 (SD 0.389). Between COVID-19-related prevention cognition, e-Health literacy, self-efficacy, and healthy lifestyle behaviors (r = 0.132-0.505, P < 0.01) were a significant positive correlation. The COVID-19-related prevention cognition had a direct and positive predictive effect on healthy lifestyle behaviors, with a direct effect value of 0.136. e-Health literacy and self-efficacy played both an independent mediating and serial-multiple mediating roles in the association between COVID-19-related prevention cognition and healthy lifestyle behaviors, and the indirect effect values were 0.043, 0.020 and 0.035, respectively.

CONCLUSIONS

The results showed that the emphasis on improving college students' prevention cognition, supplemented by improving e-Health literacy and self-efficacy, could improve college students' healthy lifestyle behaviors.

LIMITATIONS

This study was a cross-sectional investigation with no causal relationship between variables.

Association of eHealth Literacy with Health Promotion Behaviors of Community-Dwelling Older People: The Chain Mediating Role of Self-Efficacy and Self-Care Ability

In the digital age, electronic health literacy (eHealth literacy) of community-dwelling older people plays a potentially important role in their health behaviors which are critical for health outcomes. Researchers have documented that self-efficacy and self-care ability are related to this relationship. This study aimed to assess the relationship between eHealth literacy and health promotion behaviors among older people living in communities and explore the chain mediating role of self-efficacy and self-care ability. For this cross-sectional study, we used data from 425 older adults at 3 communities in Qingdao, Shandong Province in Northeastern China, from June to September 2021. Path analysis using the structural equation model was performed. We found that eHealth literacy was significantly associated with health promotion behaviors in older people. Additionally, eHealth literacy indirectly affected health promotion behaviors through self-efficacy and self-care ability, respectively. In addition, the chain mediation effect was identified in the relationship of eHealth literacy and health promotion behaviors: eHealth literacy→ self-efficacy→ self-care ability→ health promotion behaviors. These findings offer promising directions for developing interventions to modify older adults' health behaviors through enhancing their eHealth literacy. These interventions should integrate components that target improving the self-efficacy and self-care ability of older people.

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.

Psychosocial and Physical Predictors of Stress in University Students during the COVID-19 Pandemic: An Observational Study

Currently, university students are at a high risk of stress due to university adjustment, educational interruption, and alterations in daily life because of the COVID-19 pandemic. This study examined the relationship of psychosocial and physical factors with stress in university students during the pandemic. Demographic, psychosocial, physical, and self-perceived stress level information were obtained from 409 Thailand university students. A multiple regression analysis was performed, with stress level as the dependent variable and gender, age, study period, study program, social support, self-esteem, health literacy, health behavior score, sedentary behavior, and physical activity (PA) as independent variables. Most participants had moderate stress levels (68.9%), high self-esteem (83.9%) and social support (66.5%), fair health literacy (41.1%) and health behavior (32%), sedentary lifestyle (85.3%), and PA-levels lower than 600 min per week (57.46%). The regression analysis showed that 45.7% of the variability in stress level was predicted by self-esteem, study period, social support, travel domain of PA, and health behavior. COVID-19 and the attendant restrictions resulted in moderate levels of stress in Thailand university students. High self-esteem, long duration of study, great social support, and having healthy behavior may contribute to the prevention of stress in this population.

How to improve the COVID-19 health education strategy in impoverished regions: a pilot study

Background

It is of great challenge to raise the public coronavirus disease 2019 (COVID-19) related health literacy (CRHL) in impoverished regions due to the limits of poor infrastructure, large proportion of vulnerable groups, etc. However, those limits cannot be solved in the short term. Therefore, this study chose Liangshan Yi Autonomous Prefecture, one of the poorest areas in China, as a pilot, to reveal the quantitative relationships among different dimensions under the COVID-19 health education framework, clarify the key points for health promotion, and provide specific suggestions for COVID-19 health education strategy in impoverished regions.

Methods

A cross-sectional questionnaire survey was conducted in five regions of Liangshan Yi Autonomous Prefecture in 2020. There were 2,100 individuals sampled by multi-stage method. This survey mainly measured the four dimensions: CRHL, COVID-19 related tense psychological reactions (CRTPR), COVID-19 related information report acquisition (CRIRA), and general health literacy (GHL). The multivariate logistic regression was used to explore the influence of demographic characteristics on each dimension. Furthermore, to quantify the relationships among different dimensions, this study employed the structural equation model (SEM), and analyzed the mediating effects of CRHL and CRIRA as well as the moderating effects of regional characteristic variables.

Results

The CRHL played an important role in promoting COVID-19 health education, reaching 52.5% in Liangshan Yi Autonomous Prefecture. The GHL (β = 0.336) and age (β = 0.136) had statistically positive impacts on CRHL. The CRHL affected CRTPR negatively (β = − 0.198) and CRIRA positively (β = 0.052). The CRHL played significant mediating roles among the four dimensions (P < 0.05). Effectiveness of government prevention and control as well as the ethnicity moderated not only the relationships between CRHL and other dimensions, but also the mediating effect of CRHL (P < 0.05). People with lower income and education levels had lower GHL (β = 0.286, 1.292). The youth were more likely to show CRTPR (β = − 0.080).

Conclusions

By proposing and verifying the theoretical framework, this study put forward specific suggestions on how to improve COVID-19 health education strategies in impoverished regions via implementation methods, key groups and effect evaluation, which also provided references about future public health emergencies for other impoverished regions of the world.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s40249-022-00963-3.

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.

Digital Health Literacy and Information-Seeking Behavior among University College Students during the COVID-19 Pandemic: A Cross-Sectional Study from Denmark

The COVID-19 pandemic and the concomitant infodemic have emphasized the importance of digital health literacy (DHL) to global public health research and practice. The aim of this study was to examine information-seeking behavior, the ability to find, understand and deal with health information among university college students in Denmark and/in addition we wanted to examine the impact of their close social network on students' ability to find and understand health information. This research was carried out as part of the COVID-HL university student survey by using a uniform questionnaire consisting of elaborated scales. Data were collected from a cross-sectional survey conducted at University College South during 4 weeks in April and May 2020. To capture DHL, four subscales of the DHL instrument were adapted to the pandemic context. A total of 59.9% of the students have sufficient DHL-most students find it rather easy to find information and are satisfied with the information they find on the internet. However, some (28.1%) students find it difficult to judge the quality and reliability of the information. Students with a sufficient level of DHL are more likely to seek information through search engines and websites of official institutions, while students with a limited level of DHL more often use social media for health information. Students with sufficient DHL more often share health information and less often ask for support in their network.

Building a Health Literacy Indicator from Angola Demographic and Health Survey in 2015/2016

Health literacy is a determinant factor for population health. It is important both for the prevention of health problems and the better management of those problems and unexpected situations that happen. Low health literacy has been consistently associated with poor health outcomes. This study aimed to develop a health literacy indicator for Angola and to analyze pertinent demographic characteristics related to it. Data were obtained from the first Angola Demographic and Health Survey conducted in 2015/16; we included 10 questions related to the American National Academy of Medicine definition of health literacy. Using factor analysis, we extracted one i indicator corresponding to four dimensions of health literacy. The indicator was dichotomized, and we used Logistic Regression to estimate factors associated with health literacy level: we obtained data from 19,785 adolescents and adults, aged 15–49 years. The internal consistency of the i indicator was reliable (Cronbach’s α  =  0.83). Adjusting for other variables, males with complete secondary education or above and living in urban areas were more likely to have a high level of health literacy. There were substantial differences between the 18 regions. This is the first study evaluating health literacy in Angola using the American National Academy of Medicine definition and a Demographic and Health survey. Our study shows unfavorable results for women, individuals living in rural areas and those less educated.

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.

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.

A Visualized and Scientometric Analysis of Health Literacy Research

Purpose

The health literacy concerned by numerous policy and advocacy organizations is springing up rapidly and has evolved substantially over the past few decades. During the period of COVID-19, people who are in the absence of effective treatment and limited availability of vaccination need a higher health literacy to protective themselves. In order to provide a summary of the health literacy research, a visualized and Scientometric analysis is applied in this study.

Methods

Based on a scientific review of 3,670 data on health literacy from Web of Science, this research uses Citespace software to systematically and objectively describe health literacy to determine the knowledge evolution structure between articles and investigate research trends.

Results

The results show that the annual outputs of publications have grown rapidly since 2003. The USA and Australia make larger contributions compared with other countries in terms of quantity of publications and worldwide collaboration relationship between them. The “Soc Sci Med,” “J Health Commun.” “Patient Educ Couns” and “J Gen Intern Med” pay more attention to health literacy research. The leading authors with influence and authority are Wolf MS, Osborne RH, and Paasche-Orlow MK. Health literacy research in this field focuses on care, knowledge, and education, and so on. An emerging trend of health literacy with Covid-19, online tools, nursing, and obesity will spread across the globe.

Conclusion

Compared with simply reviewing existing articles, the major contribution in this study is a comprehensive review of yearly scientific output, journals, countries, institutions, contributors, highly cited papers, and keywords for health literacy research. The review also provides valuable and seminal guidelines for interested researchers on health literacy research.

Letramento em saúde de adolescentes na pandemia de COVID-19: revisão integrativa

RESUMO Objetivo: analisar a produção científica sobre o letramento em saúde (LS) de adolescentes durante a pandemia de COVID-19. Método: revisão integrativa, nas bases de dados MEDLINE, LILACS, CINAHL e Web of Science, entre março de 2020 e agosto de 2021. Foram incluídos artigos originais nos idiomas inglês, espanhol e português. Resultados: dos 65 estudos encontrados na busca, oito foram incluídos para análise, não havendo nenhuma publicação no Brasil, com cinco publicações no ano de 2021, predominância na língua inglesa (n=7) e todos classificados com nível de evidência VI. Dos instrumentos utilizados, eHealth literacy foi a ferramenta mais aplicada (n=2). Televisão, família e internet foram apontadas como as principais fontes de informações de saúde durante a pandemia. Considerações finais: a literatura sinalizou que o LS pode interferir na tomada de decisão dos adolescentes e que um baixo LS pode levar a decisões e ações de exposição física e mental dos adolescentes.

Health literacy of adolescents in the COVID-19 pandemic: an integrative review

ABSTRACT Objective: to analyze the scientific production on health literacy (HL) of adolescents during the COVID-19 pandemic. Method: an integrative review, in the MEDLINE, LILACS, CINAHL and Web of Science databases, between March 2020 and August 2021. Original articles in English, Spanish and Portuguese were included. Results: of the 65 studies found in the search, eight were included for analysis, with no publication in Brazil, with five publications in 2021, predominantly in English (n=7) and all classified with level of evidence VI. Of the instruments used, eHealth literacy was the most applied instrument (n=2). Television, family and the internet were identified as the main sources of health information during the pandemic. Final considerations: the literature has indicated that HL can interfere with adolescents’ decision making and that a low HL can lead to decisions and physical and mental exposure actions of adolescents.

Role of factors in eHealth literacy in period of COVID-19: a study of Turkey

Purpose

This study aims to understand the eHealth literacy skills of chronic patients and to explore the relations, patterns between eHealth literacy skills and different factors such as demographics, search strategies and health information sources and to explain their effects on eHealth literacy in Turkey in Izmir in COVID-19 outbreak.

Design/methodology/approach

A quantitative method was used in the study including a questionnaire. A total of 604 chronic patients responded to the questionnaire who applied the five popularly identified hospitals in Izmir in Turkey. CHAID analysis method was implemented to explore the strongest correlation between eHealth literacy and independent variables.

Findings

Using different social media types were correlated with patients’ eHealth literacy scores. Using Facebook, Twitter were the supportive predictors for the eHealth literacy scores. However, digital literacy was highly important for eHealth literacy.

Originality/value

This study shows that the social media channels which provides much more information such as Facebook and Twitter for the chronic patient. This could be beneficial for the eHealth tools and social media content developers in terms of the supply of health information. Moreover, the study gives ideas about the effect of digital literacy and the importance of health information provided.