TY  - JOUR
AU  - Li, Shaojie
AU  - Cui, Guanghui
AU  - Kaminga, Atipatsa Chiwanda
AU  - Cheng, Sixiang
AU  - Xu, Huilan
PY  - 2021
DA  - 2021/5/6
TI  - Associations Between Health Literacy, eHealth Literacy, and COVID-19–Related Health Behaviors Among Chinese College Students: Cross-sectional Online Study
JO  - J Med Internet Res
SP  - e25600
VL  - 23
IS  - 5
KW  - COVID-19
KW  - health literacy
KW  - eHealth literacy
KW  - COVID-19–related health behavior questionnaire
KW  - Chinese college students
AB  - 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 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). 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. 
SN  - 1438-8871
UR  - https://www.jmir.org/2021/5/e25600
UR  - https://doi.org/10.2196/25600
UR  - http://www.ncbi.nlm.nih.gov/pubmed/33822734
DO  - 10.2196/25600
ID  - info:doi/10.2196/25600
ER  -