EHealth Literacy and Beliefs About Medicines Among Taiwanese College Students: Cross-sectional Study.
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ABSTRACT: Background
Good eHealth literacy and correct beliefs about medicines are beneficial for making good health care decisions and may further influence an individual's quality of life. However, few studies have discussed these two factors simultaneously. Moreover, gender differences are associated with health literacy and beliefs about medicines. Therefore, it is important to examine the multiple relationships between college students' eHealth literacy and beliefs about medicines, as well as gender differences.Objective
This study aims to (1) examine the multiple relationships between eHealth literacy and beliefs about medicines and (2) analyze gender differences in eHealth literacy and beliefs about medicines with Taiwanese college students.Methods
We used a paper-and-pencil questionnaire that included age, gender, 3-level eHealth literacy, and beliefs about medicines to collect data. In total, 475 data points were obtained and analyzed through independent t tests and canonical correlation analyses.Results
The t test (t473=3.73; P<.001; t473=-2.10; P=.04) showed that women had lower functional eHealth literacy and more specific concerns about medicines than men. Canonical correlation analyses indicated that the first and second canonical correlation coefficients between eHealth literacy and beliefs about medicines reached a significant level, implying that a multivariate relationship indeed existed.Conclusions
These findings reveal that women in Taiwan have lower functional eHealth literacy and stronger concerns about medicines than men. In addition, students with higher eHealth literacy have more positive perceptions of and beliefs about medicines.
SUBMITTER: Huang CL
PROVIDER: S-EPMC8672294 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:Electronic health (eHealth) literacy has become an important topic in health fields. Studies have found that individuals with higher eHealth literacy are more likely to use preventive care services and to have effective interactions with their physicians. In addition, previous studies have revealed a gender difference in the utilization of physician access and outpatient services. Nevertheless, few studies have explored the effect of the three levels of eHealth literacy (functional, interactive, and critical levels) on the four aspects of health services utilization (type, site, purpose, and time interval). It is unclear whether the associations between these three levels of eHealth literacy and the four aspects of health services utilization among college students are positive or negative. OBJECTIVE:The objective of this study was to investigate the associations among gender, eHealth literacy, and health services utilization. METHODS:We used the eHealth Literacy Scale, a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy, and the Health Services Utilization Scale, which is a 10-item instrument developed to measure the four aspects of health services utilization by college students. A nationally representative sample of 489 college students in Taiwan was surveyed. We conducted multiple regression analysis to examine the associations among gender, eHealth literacy, and health services utilization. RESULTS:The study found that being female was negatively related to the purpose aspect of health services utilization (t487=-2.85, P<.01). However, the R2 value of gender on the purpose aspect was low enough to be ignored. Critical (t484=2.98-4.23, P<.01) and interactive eHealth literacy (t484=2.43-2.89, P<.05) were related to three aspects of the health services utilization, and functional eHealth literacy was related to the purpose aspect (t484=-4.99, P<.001). CONCLUSIONS:This study showed that Taiwanese college students with interactive eHealth literacy were more likely to have a higher rate of outpatient care use. Moreover, Taiwanese college students with critical eHealth literacy were more likely to make full use of health services than those with functional eHealth literacy. Finally, the educated and age-restricted sample may attenuate gender disparities in health services utilization among Taiwanese college students.
| S-EPMC6231732 | biostudies-other
Project description:BACKGROUND:Given the recognized importance of preventing poor dietary behaviors during adolescence, we need a better understanding of college students' dietary behaviors. Studies have found that individual factors and electronic health (eHealth) literacy may affect one's dietary behaviors. However, few studies have fully investigated the effect of the three levels of eHealth literacy (functional, interactive, and critical) and the interactive effect of individual factors (eg, gender, monthly expenses, and frequency of cooking) and the three levels of eHealth literacy on the four aspects of dietary behaviors (consumer health, balanced diet, regular eating habits, and unhealthy food intake). OBJECTIVE:This study aimed to investigate whether individual differences and higher eHealth literacy are associated with more positive dietary behaviors and less unhealthy dietary intake. METHODS:The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. The Dietary Behaviors Scale is a 14-item instrument developed to measure four aspects of dietary behaviors of college students. A questionnaire was administered to collect background information about participants' gender, monthly expenses, and frequency of cooking. A national sample of college students was surveyed, and 813 responses were obtained. We conducted a multiple regression analysis to examine the association among individual factors, eHealth literacy, and dietary behaviors. RESULTS:This study found that functional eHealth literacy was negatively related to unhealthy food intake (beta=-.11; P=.01), and interactive eHealth literacy was positively related to balanced diet (beta=.25; P<.001) and consumer health (beta=.15; P=.02). Moreover, critical eHealth literacy was positively related to consumer health (beta=.30; P<.001) and regular eating habits (beta=.20; P=.002). Finally, the interactive effect between gender and interactive eHealth literacy was negatively related to balanced diet (beta=-.22; P<.001). The interactive effect between monthly expenses and functional eHealth literacy was positively related to balanced diet (beta=.07; P=.03), although the interactive effect between monthly expenses and critical eHealth literacy was negatively related to balanced diet (beta=-.10; P=.047). CONCLUSIONS:This study showed that Taiwanese college students with higher functional eHealth literacy were more likely to engage in fewer unhealthy food consumption practices. Those who had higher interactive and critical eHealth literacy were more likely to engage in positive dietary behaviors than those with functional eHealth literacy. Surprisingly, females with high interactive eHealth literacy were more likely to have a poor balanced diet. In contrast, students with higher monthly expenses and higher functional eHealth literacy were more likely to have a balanced diet. However, students with higher monthly expenses and higher critical eHealth literacy were less likely to maintain a balanced diet.
| S-EPMC6904901 | biostudies-literature
Project description:BackgroundDuring the COVID-19 pandemic, the internet has significantly spread information, providing people with knowledge and advice about health protection regarding COVID-19. While a previous study demonstrated that health and eHealth literacy are related to COVID-19 prevention behaviors, few studies have focused on the relationship between health literacy, eHealth literacy, and COVID-19-related health behaviors. The latter includes not only preventative behaviors but also conventional health behaviors.ObjectiveThe objective of this study was to develop and verify a COVID-19-related health behavior questionnaire, explore its status and structure, and examine the associations between these behaviors and participants' health literacy and eHealth literacy.MethodsA snowball sampling method was adopted to recruit participants to complete anonymous cross-sectional questionnaire surveys online that assessed sociodemographic information, self-reported coronavirus knowledge, health literacy, eHealth literacy, and COVID-19-related health behaviors.ResultsOf 1873 college students who were recruited, 781 (41.7%) had adequate health literacy; the mean eHealth literacy score was 30.16 (SD 6.31). The COVID-19-related health behavior questionnaire presented a two-factor structure-COVID-19-specific precautionary behaviors and conventional health behaviors-with satisfactory fit indices and internal consistency (Cronbach α=.79). The mean score of COVID-19-related health behaviors was 53.77 (SD 8.03), and scores differed significantly (P<.05) with respect to residence, college year, academic major, family economic level, self-reported health status, having a family member or friend infected with coronavirus, and health literacy level. Linear regression analysis showed that health literacy and eHealth literacy were positively associated with COVID-19-specific precautionary behaviors (βhealth literacy=.149, βeHealth literacy=.368; P<.001) and conventional health behaviors (βhealth literacy=.219, βeHealth literacy=.277; P<.001).ConclusionsThe COVID-19-related health behavior questionnaire was a valid and reliable measure for assessing health behaviors during the pandemic. College students with higher health literacy and eHealth literacy can more actively adopt COVID-19-related health behaviors. Additionally, compared to health literacy, eHealth literacy is more closely related to COVID-19-related health behaviors. Public intervention measures based on health and eHealth literacy are required to promote COVID-19-related health behaviors during the pandemic, which may be helpful to reduce the risk of COVID-19 infection among college students.
| S-EPMC8104003 | biostudies-literature
Project description:BackgroundIn 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.MethodsA 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.ResultsA 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.ConclusionsOverall, 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.
| S-EPMC8850378 | biostudies-literature
Project description:BackgroundThe increasing number of people living with one or more chronic conditions imposes a growing demand on healthcare providers. One way to handle this challenge is by re-orientating the way care is provided, empower people and increase their ability to manage their condition. This requires, amongst other factors, sufficient level of health literacy (HL) and digital competences among both patients and the healthcare providers, who serve them. The focus of this study is the level of HL, digital literacy (DL), and eHealth literacy (eHL) in nursing students in Denmark.The objective was to examine the level of these three literacies in entry- and graduate-level nursing students and examine sociodemographic characteristics and self-rated health (SRH) associations.MethodsA cross sectional study was conducted among 227 students at entry-level and 139 students at graduate-level from a nursing program. The survey consisted of the health literacy questionnaire (HLQ (nine scales)), the eHealth Literacy Assessment toolkit (eHLA (seven scales)), the eHealth Literacy Questionnaire (eHLQ (seven scales)), questions soliciting sociodemographic data, and a single item assessing the students' SRH. Pearson's chi-square test and the Mann-Whitney test were used to examine the differences in HL, DL, and eHL and between groups, and Kendall's tau-b test to examine correlations between SRH and HL, DL, and eHL.ResultsThe level of HL, DL and eHL tended to be higher among graduate-level students than in entry-level students and was satisfactory. Age, sex, country of origin, and parents' educational level and occupational background influenced students' HL levels. SRH was higher in students at the graduate level. Amongst entry-level students, SRH was positively associated to seven HLQ, four EHLA and four eHLQ, amongst graduate-level students, SRH was positively associated to seven HLQ and six eHLQ.ConclusionsEducators must be aware of how sociodemographic factors affects students' literacies and increase learning opportunities by mixing students when planning activities. Considering the higher SRH in graduate-level students, HL, DL, and eHL levels indicate that current curricula and study activities are appropriate, but there is still room for improvement.
| S-EPMC7149891 | biostudies-literature
Project description:BackgroundUnderstanding how people with diabetes seek online health information and use health applications is important to ensure these electronic tools are successfully supporting patient self-care. Furthermore, identifying the relationship between patient mobile eHealth literacy (mobile eHL) and diabetes outcomes can have far-reaching utility, for example, in the design of targeted interventions to address mobile eHL limitations. However, only limited studies have explored the impact of mobile eHL in a population with diabetes.ObjectiveThis study aims to present data about online information-seeking behavior and mobile health (mHealth) app usage, investigate the factors related to mobile eHL in Taiwanese patients with type 2 diabetes, and flesh out the relationship between eHealth literacy (eHL), mobile health literacy (mHL), and health outcomes.MethodsSubjects were recruited from January 2017 to December 2017 in the outpatient departments of 3 hospitals in Taiwan. A total of 249 Taiwanese patients with diabetes voluntarily completed a cross-sectional survey assessing sociodemographic characteristics; diabetes status; knowledge and skills of computers, the internet, and mobile apps; mobile eHL; and patient outcomes (self-care behaviors, self-rated health, HbA1c). Structural equation modeling analyses examined the model fit of mobile eHL scores and the interrelationships between latent constructs and observable variables.ResultsOf the 249 patients with diabetes, 67% (164/249) reported they had searched for online diabetes information. The participants with smartphones had owned them for an average of 6.5 years and used them for an average of 4.5 (SD 3.81) hours per day. Only 1.6% (4/249) of the patients used health apps. Some demographic factors affecting mobile eHL included age, education, and duration of type 2 diabetes. Mobile eHL was related to self-care behaviors as well as knowledge and skills of computers, the internet, and mobile technology, but only had a weak, indirect effect on self-rated health. The final model had adequate goodness-of-fit indexes: chi-square (83)=149.572, P<.001; comparative fit index (CFI)=0.925; root mean square of approximation (RMSEA)=0.057 (90% CI 004-006); chi-square/df=1.082. Mobile eHL had a weak, indirect effect on self-rated health through the variables of knowledge with skills.ConclusionsOur study reveals that although people with diabetes who rated their health conditions as moderate were confident in using mobile eHealth and technology, few adopted these tools in their daily lives. The study found that mobile eHL had a direct effect on self-care behavior as well as knowledge and skills of computers, the internet, and mobile technology, and had an indirect effect on health outcomes (glycemic control and self-rated health status). Information about this population's experiences and the role mobile eHL plays in them can spur necessary mobile eHealth patient education.
| S-EPMC7895642 | biostudies-literature
Project description:BACKGROUND:This study aimed to investigate the associations between individual factors, electronic health (eHealth) literacy, dietary behaviors, and exercise habits in college students, as well as the moderating effect of gender on the above target behaviors. METHODS:A pen-and-paper questionnaire with a stratified sampling method was used to collect data, and at least 100 students from each stratum were determined to be used for the official sample in this study. Finally, 674 students completed the survey. RESULTS AND CONCLUSIONS:Chi-square test results demonstrated that genders had dissimilar dietary supplement use and subjective health status. Further analyses indicated females had a higher likelihood of taking dietary supplements and poorer subjective health statuses. The t-test results indicated that the functional eHealth literacy, dietary behaviors, and exercise habits of genders were different, and the mean scores showed that males had higher functional eHealth literacy, healthier dietary behaviors, and higher exercise involvement than females. Regression analyses showed that students who were male, took dietary supplements, placed the utmost importance on health, and had high critical eHealth literacy tended to possess healthy dietary behaviors. Students who were male and had good subjective health statuses tended to have higher exercise involvement. Specifically, the critical eHealth literacy changed dietary behaviors less effectively for women than for men, and the subjective health status changed exercise habits less effectively for women than for men. Therefore, when designing the diet and exercise intervention programs, gender-specific programs rather than generic programs should be given priority to develop.
| S-EPMC7143736 | biostudies-literature
Project description:BACKGROUND:Parents often use digital media to search for information related to their children's health. As the quantity and quality of digital sources meant specifically for parents expand, parents' digital health literacy is increasingly important to process the information they retrieve. One of the earliest developed and widely used instruments to assess digital health literacy is the self-reported eHealth Literacy Scale (eHEALS). However, the eHEALS has not been psychometrically validated in a sample of parents. Given the inconsistency of the eHEALS underlying factor structure across previous reports, it is particularly important for validation to occur. OBJECTIVE:This study aimed to determine the factor structure of the German eHEALS measure in a sample of parents by adopting classic and modern psychometric approaches. In particular, this study sought to identify the eHEALS validity as a unidimensional index as well as the viability for potential subscales. METHODS:A cross-sectional design was used across two purposive sampling frames: online and paper administrations. Responses were collected between January 2018 and May 2018 from 703 Swiss-German parents. In addition to determining the sampling characteristics, we conducted exploratory factor analysis of the eHEALS by considering its ordinal structure using polychoric correlations. This analysis was performed separately for online-based and paper-based responses to examine the general factor strength of the eHEALS as a unidimensional index. Furthermore, item response theory (IRT) analyses were conducted by fitting eHEALS to a bifactor model to further inspect its unidimensionality and subscale viability. RESULTS:Parents in both samples were predominantly mothers (622/703, 88.5%), highly educated (538/703, 76.9%), of Swiss nationality (489/703, 71.8%), and living with a partner (692/703, 98.4%). Factor analyses of the eHEALS indicated the presence of a strong general factor across both paper and online samples, and the Wilcoxon rank-sum test indicated that the eHEALS total sum score was not significantly different between the paper and online samples (P=.12). Finally, the IRT analyses indicated negligible multidimensionality, insufficient subscale reliability after accounting for the eHEALS general factor, and a reduced subset of items that could serve as a unidimensional index of the eHEALS across the paper and online samples. CONCLUSIONS:The German eHEALS evidenced good psychometric properties in a parent-specific study sample. Factor analyses indicated a strong general factor across purposively distinct sample frames (online and paper). IRT analyses validated the eHEALS as a unidimensional index while failing to find support for subscale usage.
| S-EPMC7101498 | biostudies-literature
Project description:BackgroundThroughout the COVID-19 pandemic, patient portals have become more widely used tools of patient care delivery. However, not all individuals have equivalent access or ability to use patient portals.ObjectiveThe aim of this study is to evaluate the relationships between eHealth literacy (eHL) and patient portal awareness, use, and attitudes among hospitalized patients.MethodsInpatients completed patient portal surveys; eHL was assessed (eHealth Literacy Scale). Multivariable logistic regression analyses adjusted for age, self-reported race, gender, and educational attainment were completed with significance at P<.006 (Bonferroni correction).ResultsAmong 274 participants, most identified as Black (n=166, 61%) and female (n=140, 51%), mean age was 56.5 (SD 16.7) years, and 178 (65%) reported some college or higher educational attainment. One-quarter (n=79, 28%) had low eHL (mean 27, SD 9.5), which was associated with lower odds of portal access awareness (odds ratio 0.11, 95% CI 0.05-0.23; P<.001), having ever used portals (odds ratio 0.19, 95% CI 0.10-0.36; P<.001), less perceived usefulness of portals (odds ratio 0.20, 95% CI 0.10-0.38; P=.001), and lower likelihood of planning to use portals in the coming years (odds ratio 0.12, 95% CI 0.06-0.25; P<.001). As time through the COVID-19 pandemic passed, there was a trend toward increased perceived usefulness of patient portals (53% vs 62%, P=.08), but average eHL did not increase through time (P=.81).ConclusionsLow eHL was associated with less awareness, use, and perceived usefulness of portals. Perceived usefulness of portals likely increased through the COVID-19 pandemic, but patients' eHL did not. Interventions tailored for patients with low eHL could ensure greater equity in health care delivery through the COVID-19 pandemic.
| S-EPMC9919456 | biostudies-literature
Project description:BackgroundeHealth literacy is gaining importance for maintaining and promoting health. Studies have found that individuals with high eHealth literacy are more likely to adopt healthy eating, exercise, and sleep behaviors. In addition, previous studies have shown that various individual factors (eg, frequency of seeking information on health issues, degree of health concern, frequency of eating organic food, and students' college major) are associated with eHealth literacy and health-promoting lifestyles. Nevertheless, few studies have explored the associations among individual factors, eHealth literacy, and health-promoting lifestyles among college students. Moreover, there is a lack of studies that focus on eHealth literacy as a predictor of psychological health behaviors.ObjectiveTo examine the associations among various individual factors, eHealth literacy, and health-promoting lifestyles.MethodsThe eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. The Health-promoting Lifestyle Scale is a 23-item instrument developed to measure college students' self-actualization, health responsibility, interpersonal support, exercise, nutrition, and stress management. A nationally representative sample of 556 valid college students in Taiwan was surveyed. A questionnaire was administered to gather the respondents' background information, including the frequency of seeking information on health issues, the frequency of eating organic food, the degree of health concern, and the students' major. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health-promoting lifestyles.ResultsThe study found that factors such as medical majors (t550=2.47-7.55, P<.05) and greater concern with health (t550=2.15-9.01, P<.05) predicted college students' 4-6 health-promoting lifestyle dimensions and the 3 dimensions of eHealth literacy. Moreover, critical eHealth literacy positively predicted all 6 health-promoting lifestyle dimensions (t547=2.66-7.28, P<.01), functional literacy positively predicted 2 dimensions (t547=2.32-2.98, P<.05), and interactive literacy predicted only the self-actualization dimension (t547=2.81, P<.01).ConclusionsThis study found that participants who majored in medical fields had greater concern with their health and frequently sought health information, exhibited better eHealth literacy, and had a positive health-promoting lifestyle. Moreover, this study showed that college students with a higher critical eHealth literacy engaged better in health-promoting activities than those with functional and interactive literacy.
| S-EPMC5263862 | biostudies-literature