BackgroundCollege students’ health behavior is a topic that deserves attention. Individual factors and eHealth literacy may affect an individual’s health behaviors. The integrative model of eHealth use (IMeHU) provides a parsimonious account of the connections among the digital divide, health care disparities, and the unequal distribution and use of communication technologies. However, few studies have explored the associations among individual factors, eHealth literacy, and health behaviors, and IMeHU has not been empirically investigated.ObjectiveThis study examines the associations among individual factors, eHealth literacy, and health behaviors using IMeHU.MethodsThe Health Behavior Scale is a 12-item instrument developed to measure college students’ eating, exercise, and sleep behaviors. The eHealth Literacy Scale is a 12-item instrument designed to measure college students’ functional, interactive, and critical eHealth literacy. A nationally representative sample of 525 valid college students in Taiwan was surveyed. A questionnaire was administered to collect background information about participants’ health status, degree of health concern, major, and the frequency with which they engaged in health-related discussions. This study used Amos 6.0 to conduct a confirmatory factor analysis to identify the best measurement models for the eHealth Literacy Scale and the Health Behavior Scale. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health behaviors. Additionally, causal steps approach was used to explore indirect (mediating) effects and Sobel tests were used to test the significance of the mediating effects.ResultsThe study found that perceptions of better health status (t520=2.14-6.12, P<.001-.03) and greater concern for health (t520=2.58-6.95, P<.001-.003) influenced college students’ development of 3 dimensions of eHealth literacy and adoption of healthy eating, exercise, and sleep behaviors. Moreover, eHealth literacy played an intermediary role in the association between individual factors and health behaviors (Sobel test=2.09-2.72, P<.001-.03). Specifically, higher levels of critical eHealth literacy promoted students’ health status and their practice of multiple positive health behaviors, including eating, exercise, and sleep behaviors.ConclusionsBecause this study showed that eHealth literacy mediates the association between individual factors and health behaviors, schools should aim to enhance students’ eHealth literacy and promote their health behaviors to help them achieve high levels of critical eHealth literacy. Although some of the study’s hypotheses were not supported in this study, the factors that influence health behaviors are complex and interdependent. Therefore, a follow-up study should be conducted to further explore how these factors influence one another.

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.

BackgroundGiven 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).ObjectiveThis study aimed to investigate whether individual differences and higher eHealth literacy are associated with more positive dietary behaviors and less unhealthy dietary intake.MethodsThe 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.ResultsThis 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).ConclusionsThis 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.

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.

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.