@Article{info:doi/10.2196/25042,
author="An, Lawrence
and Bacon, Elizabeth
and Hawley, Sarah
and Yang, Penny
and Russell, Daniel
and Huffman, Scott
and Resnicow, Ken",
title="Relationship Between Coronavirus-Related eHealth Literacy and COVID-19 Knowledge, Attitudes, and Practices among US Adults: Web-Based Survey Study",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="29",
volume="23",
number="3",
pages="e25042",
keywords="internet; digital health; eHealth; eHealth literacy; coronavirus; COVID-19; knowledge; conspiracy beliefs; protective behaviors; social distancing; survey; health communication; attitude; behavior",
abstract="Background: During a global pandemic, it is critical that the public is able to rapidly acquire new and accurate health information. The internet is a major source of health information. eHealth literacy is the ability of individuals to find, assess, and use health information available on the internet. Objective: The goals of this study were to assess coronavirus-related eHealth literacy and examine the relationship between eHealth literacy and COVID-19−related knowledge, attitudes, and practices (KAPs). Methods: We conducted a web-based survey of a representative sample of 1074 US adults. We adapted the 8-item eHealth Literacy Scale to develop the Coronavirus-Related eHealth Literacy Scale (CoV-eHEALS) to measure COVID-19−related knowledge, conspiracy beliefs, and adherence to  protective behaviors (eg, wearing facial masks and social distancing). Our analyses identified sociodemographic associations with the participants' CoV-eHEALS scores and an association between the CoV-eHEALS measure and COVID-19 KAPs. Results: The internal consistency of the adapted CoV-eHEALS measure was high (Cronbach $\alpha$=.92). The mean score for the CoV-eHEALS was 29.0 (SD 6.1). A total of 29{\%} (306/1074) of the survey participants were classified as having low coronavirus-related eHealth literacy (CoV-eHEALS score <26). Independent associations were found between CoV-eHEALS scores and ethnicity (standardized $\beta$=--.083, P=.016 for Black participants) and education level (standardized $\beta$=--.151, P=.001 for participants with high-school education or lower). Controlling for demographic characteristics, CoV-eHEALS scores demonstrated positive independent associations with knowledge (standardized $\beta$=.168, P<.001) and adherence to protective behaviors (standardized $\beta$=.241, P<.001) and a negative association with conspiracy beliefs (standardized $\beta$=--.082, P=.009). Conclusions: This study provides an estimate of coronavirus-related eHealth literacy among US adults. Our findings suggest that a substantial proportion of US adults have low coronavirus-related eHealth literacy and are thus at a greater risk of lower and less-protective COVID-19 KAPs. These findings highlight the need to assess and address eHealth literacy as part of COVID-19 control efforts. Potential strategies include improving the quality of health information about COVID-19 available on the internet, assisting or simplifying web-based search for information about COVID-19, and training to improve general or coronavirus-specific search skills. ",
issn="1438-8871",
doi="10.2196/25042",
url="https://www.jmir.org/2021/3/e25042",
url="https://doi.org/10.2196/25042",
url="http://www.ncbi.nlm.nih.gov/pubmed/33626015"
}