Digital Health Literacy About COVID-19 as a Factor Mediating the Association Between the Importance of Online Information Search and Subjective Well-Being Among University Students in Vietnam

Effective use of online COVID-19 information and eHealth information literacy among US university students

Objective: This study aimed to understand students' ability to search the Internet for COVID-19 information and apply it to evaluate the veracity of specific statements. Participants: Undergraduate students (N = 239) at a US university completed a Web-based questionnaire in September-October 2020. Methods: The questionnaire included self-reported measures of online health information literacy, COVID-19 knowledge, and anxiety along with exercises on searching and evaluating COVID information online. Results: Students reported moderate levels of information literacy (76%, 3.8 out of 5), but did not perform as well while searching the Internet for COVID-19 information (average accuracy: 65%, 10.5 out of 16 points). Students with higher Internet exercise scores reported higher GPA, higher household income, and liberal political views, and were more likely to follow public health measures [ie, social distancing, mask wearing, and not self-medicating with (hydroxy)chloroquine]. Conclusions: University students may overestimate their information literacy while struggling with searching the Internet for accurate COVID-19 information.

Health literacy, worry about unmet needs for medical care, and psychological well-being among older Chinese adults

AIM

This study aims to examine the relationship between older adults' health literacy and their psychological well-being and the role of worry about future unmet needs for medical care in mediating this relationship.

METHODS

We adopted a sample of 965 older Chinese people aged 60+ (49.74% female) from the 2021 Chinese General Social Survey. A series of structural equation models (SEMs) were performed. Health literacy was measured by three items regarding older people's ability to understand medical professionals, ask them questions, and read medical instructions. A single-item question was adopted to measure participants' worry about unmet needs for future medical care. Psychological well-being was measured by three items regarding emotional problems and depressed or anxious mood in the past 4 weeks.

RESULTS

Worry about future unmet needs for medical care mediates the relationship between lack of health literacy and Chinese older people's psychological well-being. The indirect effect accounts for 22.3% of the total effect. The SEM model has a satisfactory model fit (goodness of fit index = 1.000, comparative fit index = 0.999, Tucker-Lewis index = 0.997, root mean square error of approximation = 0.009, standardized root mean square residual = 0.023, chi-square test = 50.96,  P = 0.321).

CONCLUSIONS

The findings of this study underscore the importance of improving communication quality between healthcare providers and older adults. Clinical interventions that promote health literacy and address worries about unmet needs for medical services may benefit older adults. Geriatr Gerontol Int 2024; 24: 202-207.

Profiles of digital health literacy among university students and its association with mental health during the COVID-19 pandemic: A latent profile analysis

Objective

Investigating the digital health literacy of university students can facilitate their effective acquisition of health information and adoption of appropriate protective behaviors. This study aims to explore the subtypes of digital health literacy among university students during the COVID-19 pandemic and their association with mental health outcomes.

Methods

From 17 November to 14 December 2022, a stratified random sampling approach was used to conduct an online questionnaire survey on digital health literacy, fear of COVID-19, and depression status among students at Jilin University, China. A total of 1060 valid responses were obtained in the survey. Latent profile analysis identified subtypes of digital health literacy and linear regression analyses were used to examine the association of digital health literacy to the mental health outcome.

Results

Three latent profiles were identified: Profile 1-low digital health literacy (n = 66, 6.23%), Profile 2-moderate digital health literacy (n = 706, 66.60%), and Profile 3-high digital health literacy (n = 288, 27.17%). Results from linear regression demonstrated a negative correlation between digital health literacy and fear of COVID-19 (B = -2.954, P < 0.001) as well as depression (B = -2.619, P < 0.001) among university students.

Conclusions

This study indicated that the majority of university students exhibit a moderate level of digital health literacy during the COVID-19 pandemic. Additionally, the study validates a negative correlation between digital health literacy and mental health among university students.

Predictors of well-being, future anxiety, and multiple recurrent health complaints among university students during the COVID-19 pandemic: the role of socioeconomic determinants, sense of coherence, and digital health literacy. An Italian cross-sectional study

The pandemic deeply changed young adults' life. Lockdown period and the social restrictions dramatically affected university students' mental health. The aim of our cross-sectional study was to describe psychological well-being, future anxiety (FA), and health complaints (HCs) in a sample of 3,001 students of the University of Florence in the middle of the first two pandemic waves. We assessed the role of subjective social status, chronic diseases, sense of coherence (SoC), and digital health literacy (DHL) as predictors of psychological well-being, FA, and HCs. Students expressed high levels of FA and reported being disturbed by not being able to achieve their desired future goals. About 40% reported a low or a very low well-being and 19.1% experienced two or more subjective health complaints more than once a week. The likelihood of having a better mental health status significantly increased with increasing SoC and among males. Subjective Social Status proved to be a predictor for FA. Enhancing SoC could improve the health status of the university students during the pandemic and beyond.

Assessing secondary school students' digital health literacy, information searching behaviours, and satisfaction with online COVID-19 information in Northern Ghana

Available evidence suggests that managing the complexities of health information and the behaviours associated with information search call for adequate digital health literacy (DHL). Students' ability to judge the relevance of health-related information largely affects their level of satisfaction with the information. The study assessed DHL, information searching behaviours, and the link between DHL and COVID-19 information. The cross-sectional study utilised the multi-stage sampling technique in the selection of 1392 secondary school students in the Northern Region of Ghana. A DHL questionnaire was used to survey the students. The students displayed inadequate level of DHL concerning the relevance of online information. Predictably, most of them had not searched for information in the past four weeks prior to the data collection. Search engine portals, websites of public bodies, and news portals were the predominant platforms used for information search. Majority of the participants reported not being satisfied with the information they found on the internet about coronavirus. A significant association between DHL levels and utilization of COVID-19 information platforms was identified, such that students who showed high levels of DHL used platforms which had reviewed/professional content compared to those with low levels of DHL. Advanced DHL may serve as a disincentive to the consumption of information from sources which are not credible. There is an urgent call for collaboration among the ministries/agencies responsible for education and health, telecommunication networks, and civil society organisations for interventions aimed at integrating DHL in schools..

A cross-sectional study of university students' pocket money variance and its relationship with digital health literacy and subjective well-being in Ghana

Background

Mental health concerns of university students are gaining more attention since the emergence of the coronavirus disease. Consequently, scholars in education, health and psychology-related fields have attributed the dwindling subjective well-being (SWB) of students to their low levels of digital health literacy (DHL). However, little attention has been paid to an important variable like pocket money (PM) which might serve as a buffer against reduced levels of SWB. In this study, we explored the dynamics of PM and its linkage with DHL and SWB among university students in Ghana.

Methods

With a cross-sectional design, a convenient sample of 1160 students was obtained from the University of Education, Winneba, Ghana. The COVID-DHL and WHO-5 Well-being instruments were used for the data collection for a 2 months period (February-March, 2021). Chi-square test, multivariate regression, simple linear regression, and PROCESS mediation analyses were performed with the use of SPSS software version 25.

Results

The study found that while most of the students were financially supported by their parents (n = 715, 61.6%), a larger proportion of them reported that their PM was either less sufficient or not sufficient (n = 550; 76.9%). Findings revealed a positive relationship between PM and SWB (B = -36.419, p < 0.001; B = -13.146, p = 0.012; B = -10.930, p = 0.043), with this relationship mediated by DHL (B = -1.139, confidence interval [CI] [-2.073, -0.263] vs. -2.300, CI [-4.290, -0.532] vs. -8.366, CI [-14.863, -1.908]).

Conclusions

Students with little to insufficient PM were vulnerable to mental health problems, although this could be buffered by the high DHL levels. In practical terms, not only should the PM of university students be increased, but the sources of PM should be complemented since the sufficiency level of PM was associated with the source of finance. More importantly, parents should be empowered through job creation so that sufficient levels of PM can be provided to university students.

Digital health literacy and subjective wellbeing in the context of COVID-19: A cross-sectional study among university students in Ecuador

Background

The COVID-19 pandemic has generated an avalanche of information, which, if not properly addressed, generates uncertainty and limits healthy decision-making. On the other hand, the pandemic has exacerbated mental health problems among young people and adolescents, causing a worsening of their wellbeing. Previous studies have found that digital health literacy has a positive impact on people's attitudes toward the disease. This study aimed to analyze the association between digital health literacy on COVID-19 with subjective wellbeing in university students.

Methods

A cross-sectional study was developed in 917 students from Ecuador. Subjective wellbeing was measured with the World Health Organization WellBeing Scale. Digital health literacy was assessed using the Spanish-translated version of the Digital Health Literacy Instrument adapted to the context of the COVID-19 pandemic. Bivariate and multivariate linear regressions were performed.

Results

Digital health literacy and subjective wellbeing proofed to be significantly higher among males and among students with higher social status. The association between digital health literacy and subjective wellbeing was significant; for each increase of one point in the digital health literacy scale, an average increase of 9.64 points could be observed on the subjective wellbeing scale (IC 95% 5.61 - 13.67, p-value <0.001). This correlation persisted after adjust by demographic and socioeconomic variables.

Conclusion

Improving digital health literacy in health would improve the subjective wellbeing of university students. It is suggested strengthen the digital health literacy through public and university policies that promote access, search skills and discernment of digital information. Socioeconomic and gender inequalities related to digital health literacy need to be further investigated.

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.

Digital health literacy and well-being among university students: Mediating roles of fear of COVID-19, information satisfaction, and internet information search

Background

Digital health literacy (DHL) enables healthy decisions, improves protective behaviors and adherence to COVID-19 measures, especially during the era of the “infodemic”, and enhances psychological well-being.

Objective

We aimed to explore the mediating roles of fear of COVID-19, information satisfaction, and the importance of online information searching on the association between DHL and well-being.

Methods

A cross-sectional web-based survey was conducted among 1631 Taiwanese university students, aged 18 years and above, from June 2021 to March 2022. The collected data include sociodemographic characteristics (sex, age, social status, and financial satisfaction), the importance of online information searching, information satisfaction, fear of COVID-19, DHL, and well-being. A linear regression model was utilized to investigate factors associated with well-being, followed by a pathway analysis to assess the direct and indirect relationship between DHL and well-being.

Results

The scores of DHL and overall well-being were 3.1 ± 0.4 and 74.4 ± 19.7, respectively. Social status (B = 2.40, 95% confidence interval (CI) 1.73–3.07, p < 0.001), DHL (B 0.29, 95% CI 0.10–0.49, p < 0.001), importance of online information searching (B = 0.78, 95% CI 0.38–1.17, p < 0.001), and information satisfaction (B = 3.59, 95% CI 2.22–4.94, p < 0.001) were positively associated with well-being, whereas higher fear of COVID-19 scores (B = −0.38, 95% CI −0.55-(−0.21), p < 0.001) and female (B = −2.99, 95% CI −5.02–0.6, p = 0.004) were associated with lower well-being, when compared with lower fear scores and male, respectively. Fear of COVID-19 (B = 0.03, 95% CI 0.016–0.04, p < 0.001), importance of online information searching (B = 0.03, 95% CI 0.01–0.05, p = 0.005), and information satisfaction (B = 0.05, 95% CI 0.023–0.067, p < 0.001) were significantly mediated the relationship between DHL and well-being.

Conclusion

Higher DHL scores show direct and indirect associations with higher well-being scores. Fear, importance of online information searching, and information satisfaction significantly contributed to the association.

Digital literacy level and associated factors among health professionals in a referral and teaching hospital: An implication for future digital health systems implementation

Background

In Ethiopia and other developing countries, electronic medical record systems and other health information technology are being introduced. However, a small proportion of low-income countries have successfully implemented national health information systems. One cause for this can be the lack of digital literacy among medical practitioners. As a result, this study aimed to assess health professionals' digital literacy level and associated factors in Northwest Ethiopia.

Method

A quantitative cross-sectional study was employed among 423 health professionals working in a teaching and referral hospital in Northwest Ethiopia. We modified and applied the European commission's framework for digital competency to assess the level of digital literacy among health professionals. We used stratified random sampling with proportional allocation to the size of the departments in the hospital to select study participants. Data were collected using a semi-structured, self-administered, and pretested questionnaire. Descriptive and binary logistic regression analysis techniques were used to describe respondents' digital literacy level and identify its associated factor, respectively. The odds ratio with 95% CI and value of p were used to assess the strength of the association and statistical significance, respectively.

Results

Out of 411 participants, 51.8% (95% CI, 46.9-56.6%) of health professionals had adequate digital literacy. Holding a master's degree (Adjusted OR = 2.13, 95% CI: 1.18-3.85), access to digital technology (AOR = 1.89, 95% CI: 1.12-3.17), having training in digital technology (AOR = 1.65, 95% CI: 1.05-2.59), and having a positive attitude towards digital health technology (AOR = 1.64, 95% CI: 1.02-2.68) were found to be significant factors associated with health professionals digital literacy level of health professionals.

Conclusion

Low level of digital literacy among health professionals was observed, with nearly half (48.2%) of them having poor digital literacy levels. Access to digital technology, training on digital technology, and attitude toward digital health technology were significant factors associated with digital literacy. It is suggested to increase computer accessibility, provide a training program on digital health technology, and promote a positive attitude toward this technology to improve the deployment of health information systems.

Association of Digital Health Literacy with Future Anxiety as Mediated by Information Satisfaction and Fear of COVID-19: A Pathway Analysis among Taiwanese Students

Digital Health Literacy (DHL) helps online users with navigating the infodemic and co-existing conspiracy beliefs to avoid mental distress and maintain well-being. We aimed to investigate the association between DHL and future anxiety (FA); and examine the potential mediation roles of information satisfaction and fear of COVID-19 (F-CoV). A web-based cross-sectional survey was carried out among 1631 Taiwanese university students aged 18 years and above from June 2021 to March 2022. Data collected were socio-demographic characteristics (sex, age, social status, university location), information satisfaction, F-CoV, DHL and FA (using Future Dark scale). The linear regression model was used to explore factors associated with FA. The pathway analysis was further used to evaluate the direct and indirect relationship between DHL and FA. A higher score of DHL (B = -0.21; 95% CI, -0.37, -0.06; p = 0.006), and information satisfaction (B = -0.16; 95% CI, -0.24, -0.08; p < 0.001) were associated with a lower FA score, whereas a higher F-CoV score was associated with a higher FA score (B = 0.43; 95% CI, 0.36, 0.50; p < 0.001). DHL showed the direct impact (B = -0.1; 95% CI, -0.17, -0.04; p = 0.002) and indirect impact on FA as mediated by information satisfaction (B = -0.04; 95% CI, -0.06, -0.01; p = 0.002) and F-CoV (B = -0.06, 95% CI, -0.08, -0.04; p < 0.001). Strategic approaches to promote DHL, information satisfaction, lower F-CoV are suggested to reduce FA among students.

Assessing the validity of digital health literacy instrument for secondary school students in Ghana: The polychoric factor analytic approach

The emergence of the coronavirus pandemic resulted in the heightened need for digital health literacy among the youth of school-going age. Despite the relevance of digital health literacy among the general public (including students), it appears the measurement of digital health literacy is still a challenge among researchers. Recently, Dadackinski and colleagues adapted existing digital health literacy measures to fit the COVID-19 situation. Since this development, the instrument has been widely used with few validation studies with none in Africa and specifically, in Ghana. The purpose of the study was to assess the validity of the digital health literacy instrument (DHLI) for secondary school students in Ghana using the polychoric factor analysis. We sampled 1,392 students from secondary schools in Ghana. The digital health literacy instrument was administered to the respondents, thereof. The study confirmed the four latent structure of the DHLI. Further, sufficient validity evidence was found regarding the construct validity of the DHLI. The findings from the study support the validity of the DHLI and its utility within the Ghanaian context. With the growing need for digital health literacy among younger people globally, the DHLI provides sufficient grounds for scaling them based on their level of literacy. There is a need for the instrument to be adapted and re-validated in Ghana and among different populations to widen its reproducibility.

Validation of the COVID-19 Digital Health Literacy Instrument in the Italian Language: A Cross-Sectional Study of Italian University Students

The Coronavirus Disease 19 (COVID-19) pandemic and the associated “infodemic” have shown the importance of surveillance and promotion of health literacy, especially for young adults such as university students who use digital media to a very high degree. This study aimed to assess the validity and reliability of the Italian version of the COVID-19 adapted version of the Digital Health Literacy Instrument (DHLI). This cross-sectional study is part of the COVID-19 University Students Survey involving 3985 students from two Italian universities. First, item analysis and internal consistency were assessed. Then, Principal Component Analysis (PCA) and Confirmatory Factor Analyses (CFA) were performed comparing different models. The Italian DHLI showed good psychometric characteristics. The protecting privacy subscale was excluded, given the criticalities presented in the validation process. CFA confirmed the four-factor structure, also including a high-order factor. This result allows using the scale to measure a global level of digital health literacy and consider its levels separately for each construct component: searching the web for information, evaluating reliability, determining personal relevance, and adding self-generated content.

Evidence of the Relationship between Social Vulnerability and the Spread of COVID-19 in Urban Spaces

Modeling the social-spatial structure of urban spaces can facilitate the development of guidelines aimed at curbing the spread of the COVID-19 pandemic while also acting as an instrument that helps decision-making concerning mitigation policies. The modeling process starts with categorization of urban spaces based on the concept of social vulnerability. A model is created based on this concept and the theory of analysis of social areas. Statistical techniques of factor analysis and geostatistics are applied. This generates a map of social differentiation that, when related to data on the evolution of the contagion, generates a multidimensional model of social vulnerability. The application of this model towards people (social structure) and the environment where they live (spatial structure) is specified. Our model assumes the uniqueness of cities, and it is intended to be a broadly applicable model that can be extrapolated to other urban areas if pertinent revisions are made. Our work demonstrates that aspects of the social and urban structures may be validly used to analyze and explain the spatial spread of COVID-19.

Digital health literacy, online information-seeking behaviour, and satisfaction of Covid-19 information among the university students of East and South-East Asia

During the COVID-19 pandemic, there is a growing interest in online information about coronavirus worldwide. This study aimed to investigate the digital health literacy (DHL) level, information-seeking behaviour, and satisfaction of information on COVID-19 among East and South-East Asia university students. This cross-sectional web-based study was conducted between April to June 2020 by recruiting students from universities in China, Malaysia, and the Philippines. University students who have Internet access were invited to participate in the study. Items on sociodemographic variables, DHL, information-seeking behaviour, and information satisfaction were included in the questionnaire. Descriptive statistics and logistic regression analysis were conducted. A total of 5302 university students responded to the survey. The overall mean score across the four DHL subscales was 2.89 (SD: 0.42). Search engines (e.g., Google, Bing, Yahoo) (92.0%) and social media (88.4%) were highly utilized by the students, whereas Websites of doctors or health insurance companies were of lower utilization (64.7%). Across the domains (i.e., adding self-generated content, determining relevance, evaluating reliability, and protecting privacy) higher DHL was positively associated with higher usage of trustworthy resources. Providing online information on COVID-19 at official university websites and conducting health talks or web-based information dissemination about the strategies for mental health challenges during pandemic could be beneficial to the students. Strengthening DHL among university students will enhance their critical thinking and evaluation of online resources, which could direct them to the quality and trustworthy information sources on COVID-19.

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

Background

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

Objective

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

Methods

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

Results

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

Conclusions

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