@Article{info:doi/10.2196/25600,
author="Li, Shaojie
and Cui, Guanghui
and Kaminga, Atipatsa Chiwanda
and Cheng, Sixiang
and Xu, Huilan",
title="Associations Between Health Literacy, eHealth Literacy, and COVID-19--Related Health Behaviors Among Chinese College Students: Cross-sectional Online Study",
journal="J Med Internet Res",
year="2021",
month="May",
day="6",
volume="23",
number="5",
pages="e25600",
keywords="COVID-19; health literacy; eHealth literacy; COVID-19--related health behavior questionnaire; Chinese college students",
abstract="Background: During 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. Objective: The 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. Methods: A 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. Results: Of 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 $\alpha$=.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 ($\beta$health literacy=.149, $\beta$eHealth literacy=.368; P<.001) and conventional health behaviors ($\beta$health literacy=.219, $\beta$eHealth literacy=.277; P<.001). Conclusions: The 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. ",
issn="1438-8871",
doi="10.2196/25600",
url="https://www.jmir.org/2021/5/e25600",
url="https://doi.org/10.2196/25600",
url="http://www.ncbi.nlm.nih.gov/pubmed/33822734"
}