Prospective association of eHealth literacy and health literacy with physical activity among Chinese college students: a multiple mediation analysis.
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ABSTRACT: Background
The COVID-19 pandemic has decreased physical activity (PA) while increasing demand for electronic health resources. eHealth literacy (EHL) is expected to aid eHealth use and health promotion. EHL was raised on the grounds of health literacy (HL). This study explored the associations among EHL, HL, and PA in Chinese college students and identified mediating mechanisms in the EHL/HL-PA relationship.Methods
An integrated social-cognitive model was proposed. A total of 947 Chinese college students (52.8% women, age = 19.87 ± 1.68 years) completed the three-wave data collection. Path analysis was performed.Results
An adequate good-to-fit model was indicated. Perceived EHL (PEHL) was significantly associated with perceived HL (PHL) and HL performance (HLP); PHL was negatively related to HLP; PEHL was significantly associated with self-efficacy (SE) and social support (SS); PHL had a significant effect on SS but not SE; HLP significantly affected SS but not SE; SS and SE positively predicted intention (INT), which then predicted PA. SS mediated PEHL/PHL-INT links; SE mediated the PEHL-INT link; SS and INT jointly mediated PEHL/PHL/HLP-PA; SE and INT jointly mediated PEHL-PA.Conclusion
Relationships among EHL, HL, and PA were explored with multiple mediating mechanisms identified. Differential SE and SS roles in EHL/HL-PA links suggest new mechanisms to inform EHL/HL intervention development.
SUBMITTER: Liu HX
PROVIDER: S-EPMC10881736 | biostudies-literature | 2024
REPOSITORIES: biostudies-literature
Publications
Prospective association of eHealth literacy and health literacy with physical activity among Chinese college students: a multiple mediation analysis.
Liu Hua Xuan HX Chow Bik Chu BC Hassel Holger H Huang YaJun Wendy YW Liang Wei W Wang Run Bin RB
Frontiers in public health 20240208
<h4>Background</h4>The COVID-19 pandemic has decreased physical activity (PA) while increasing demand for electronic health resources. eHealth literacy (EHL) is expected to aid eHealth use and health promotion. EHL was raised on the grounds of health literacy (HL). This study explored the associations among EHL, HL, and PA in Chinese college students and identified mediating mechanisms in the EHL/HL-PA relationship.<h4>Methods</h4>An integrated social-cognitive model was proposed. A total of 947 ...[more]
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Project description:BackgroundeHealth literacy is critical for evaluating abilities in locating, accessing, and applying digital health information to enhance one's understanding, skills, and attitudes toward a healthy lifestyle. Prior research indicates that enhancing eHealth literacy can improve health behaviors such as physical activity (PA). Physical literacy (PL) refers to the ability to develop sustainable PA habits, taking into account various aspects of an individual. Notably, university students have shown a decline in PA and possess low PL levels. However, the connection between eHealth literacy and PL in this demographic has not been extensively studied, and it remains uncertain whether PA acts as a mediator between eHealth literacy and PL.ObjectiveThis study examines the extent to which PA mediates the link between eHealth literacy and PL in Chinese university students and explores gender differences in these variables.MethodsIn February 2022, a cross-sectional survey was administered to 1210 students across 3 universities in China. The instruments used were the Perceived PL Instrument, the International Physical Activity Questionnaire, and the Chinese version of the eHealth Literacy Scale. Correlations between eHealth literacy, PA, and PL were analyzed using Pearson product-moment correlation and multiple linear regression, while mediation models helped elucidate the interactions among the 3 variables.ResultsThe response rate for the study was 92.9% (1124/1210). In the mediation analysis, eHealth literacy showed a significant direct effect on PL, with a coefficient of 0.78 (β .75, SE 0.02; P<.001). Moderate to vigorous physical activity (MVPA) accounted for 2.16% of the total effect, suggesting that MVPA partially mediates the relationship between eHealth literacy and PL. Additionally, male students outperformed female students in terms of MVPA (t636=4.94; P<.001) and PL (t636=3.18; P<.001), but no significant differences were found in eHealth literacy (t636=1.23; P=.22).ConclusionsThe findings indicate that MVPA serves as a mediator in the link between eHealth literacy and PL among university students. Students with low eHealth literacy or limited PA are less likely to be physically literate. Thus, eHealth literacy plays a crucial role in enhancing PL and PA, especially when interventions targeting PL are implemented. Our results also suggest a need for targeted health education interventions aimed at improving MVPA and PL among female students, while also recognizing that eHealth literacy is comparable across genders at universities.
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Project description:BackgroundAlthough COVID-19 vaccines hold the potential to dramatically alter the COVID-19 pandemic, vaccine hesitancy remains a serious threat to the management and control of COVID-19 infections. Vaccination of young adults plays a crucial role in achieving herd immunity. However, the determinants of COVID-19 vaccine acceptance among the youth in China have not been fully explored. Our study aims to investigate the direct and indirect effects of perceived health literacy on COVID-19 vaccine acceptance.MethodsThis survey was conducted among Chinese college students during September and October, 2020. COVID-19 vaccine acceptance was defined as the likelihood that participants would get a COVID-19 vaccine. A mediation analysis was employed to explore the direct and indirect effects of perceived health literacy on COVID-19 vaccine acceptance.ResultsA total of 2,587 college students were included in our study. The results of the survey revealed that the majority (80.40%) of the participants expressed high COVID-19 vaccine acceptance. After controlling for demographic characteristics, the relationship between perceived health literacy and COVID-19 vaccine acceptance was mediated by positive attitudes toward general vaccination (std.β = 0.004, p = 0.037) and self-efficacy of COVID-19 vaccine (std.β = 0.053, p < 0.001).ConclusionsThe findings suggest that interventions targeting health literacy to promote COVID-19 vaccination coverage might consider placing greater emphasis on enhancing the positive attitude towards and self-efficacy of vaccines among youth.
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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.
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Project description:The present study discusses the relationship between adult attachment and trait anxiety of Chinese college students based on the "internal working models" theory. Six hundred and seventy-two valid data were collected using a self-reported questionnaire. The mediating roles of self-esteem, perceived social support, and security in the relationship between adult attachment orientations (anxiety and avoidance) and trait anxiety were investigated using the structural equation model and bootstrap methods. The results showed that: self-esteem and security play mediating roles in the relationship between attachment anxiety and trait anxiety. self-esteem, perceived social support, and security play mediating roles in the relationship between attachment avoidance and trait anxiety. In addition, there were different mediation mechanisms in the correlation between different attachment dimensions and trait anxiety. This study provided empirical data for exploring the formation and maintenance of trait anxiety in college students and had a specific significance for the early prevention and clinical intervention of anxiety-related disorders.
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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.
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Project description:BackgroundGood 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.ObjectiveThis 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.MethodsWe 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.ResultsThe 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.ConclusionsThese 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.
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Project description:BackgroundElectronic 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.ObjectiveThe objective of this study was to investigate the associations among gender, eHealth literacy, and health services utilization.MethodsWe 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.ResultsThe 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).ConclusionsThis 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.
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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
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.
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Project description:BackgroundDuring the COVID-19 pandemic, suspensions of activities and long periods of self-isolation led to a sharp increase in excessive use of mobile phones, which sparked public concern about mobile phone addiction (MPA). In recent years, more and more attention has been paid to physical exercise as a protective effect of MPA. However, more studies are needed to reveal this relationship and the exact mechanisms, based on which this study tested the mediating and moderating roles of self-control, rumination, psychological distress, and loneliness between physical exercise and MPA.MethodsIn this cross-sectional study, primary data was collected by questionnaire from 1,843 college students (19.75 ± 1.3) from five universities in Sichuan Province in Mainland China. Mobile Phone Addiction Tendency Scale (MPATS), Physical Activity Rating Scale-3 (PARS-3), Self-Control Scale (SCS), Ruminative Response Scale (RRS), Depression Anxiety Stress Scale-21 (DASS-21), and UCLA Loneliness Scale (UCLA-20) were investigated. The mediating models were examined using SPSS PROCESS macro 3.3 software, in which the mediation variables were self-control, rumination, and psychological distress, and the moderation was loneliness. Gender, major, and grade were included as control variables.ResultSelf-control, rumination, and psychological distress played a simple mediating role between physical exercise and MPA. Moreover, not only self-control and rumination but also self-control and psychological distress played the chain mediating roles between physical exercise and MPA. The chain pathways were moderated by loneliness. Specifically, the effect was more substantial among college students with higher loneliness.ConclusionThe conclusions corroborate and clarify that self-control, rumination, and psychological distress mediated the association between physical exercise and MPA, and the mediation effects were moderated via loneliness. This present study advanced our understanding of how and when college students' physical exercise was related to MPA. It also illustrates that educators and parents should pay more attention to college students' physical exercise.
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