Associations of eHealth Literacy With Health Behavior Among Adult Internet Users

Abstract

BackgroundIn the rapidly developing use of the Internet in society, eHealth literacy—having the skills to utilize health information on the Internet—has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users.ObjectiveThe aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan.MethodsThe participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses.ResultsWe analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth literacy were significantly more likely to exhibit the good health behaviors of physical exercise (adjusted odds ratio [AOR] 1.377, 95% CI 1.131-1.678) and eating a balanced diet (AOR 1.572, 95% CI 1.274-1.940) than individuals with low eHealth literacy.ConclusionsWe found that some health behaviors, including exercise and balanced nutrition, were independently associated with eHealth literacy among Japanese adult Internet users.

Electronic Health Literacy Across the Lifespan: Measurement Invariance Study (Preprint)

“…Specifically, older adults had less confidence in their awareness of online health information, skills to locate online health information, as well as their skills to evaluate and act upon online health information once it is located. This finding is consistent with previous literature stating that older adults have lower proficiency in eHealth literacy than their younger counterparts [7,[11][12][13]. However, this innovative finding provides a precise interpretation of eHEALS, specifically about which eHealth literacy skills are limited and the degree to which they are limited across age groups.…”

“…People with a low degree of eHealth literacy are less likely to trust online health information [6], and they are also less likely to actively seek out health information from the Internet [7]. As such, eHealth literacy is a central skillset that influences not only health information seeking behaviors [8][9][10], but also the likelihood of engaging in proactive health-related outcomes and experiences [7,11].…”

“…Evidence exists for the inverse correlation between age and eHealth literacy [7,[11][12][13]. Older adults generally have lower health literacy than their younger counterparts [14,15], yet this population is increasingly adopting the Internet with a high degree of confidence to access health information and supplement their healthcare [4,12].…”

Examining the Relationship between Online Social Capital and eHealth Literacy: Implications for Instagram Use for Chronic Disease Prevention among College Students

“…35 Higher frequency of online health information seeking behaviors is strongly associated with greater eHealth Literacy in the general population. 36 Moreover, adequate eHealth Literacy is important to benefit from the wealth of health information circulated on the Internet. 35 …”

Education-Based Gaps in eHealth: A Weighted Logistic Regression Approach

“…First, there tends to be a lack of statistical rigor; with the exception of a few recent studies [11,28], research on eHealth behaviors tends to focus on prevalence (ie, percentage) as opposed to association with eHealth literacy. Causal models are optimal [29,30], and research that explores significant associations with eHealth behaviors and the relationships between health literacy and eHealth behaviors is also important [11].…”