Health Literacy, Digital Health Literacy, and COVID-19 Pandemic Attitudes and Behaviors in U.S. College Students: Implications for Interventions

Abstract

The COVID-19 pandemic has been accompanied by rapidly emerging evidence, changing guidance, and misinformation, which present new challenges for health literacy (HL) and digital health literacy (DHL) skills. This study explored whether COVID-19-related information access, attitudes, and behaviors were associated with health literacy and digital health literacy among college students in the United States. Self-reported measures of health literacy, along with items on pandemic-related attitudes, behaviors, information sources, and social networks, were collected online using a managed research panel. In July 2020, 256 responses were collected, which mirrored the racial/ethnic and gender diversity of U.S. colleges. Only 49% reported adequate HL, and 57% found DHL tasks easy overall. DHL did not vary by HL level. In multivariable models, both HL and DHL were independently associated with overall compliance with basic preventive practices. Higher DHL, but not HL, was significantly associated with greater willingness to get a COVID-19 vaccine and the belief that acquiring the disease would negatively impact their life. On average, respondents discussed health with 4–5 people, which did not vary by HL or DHL measures. The usage of online information sources varied by HL and DHL. The study findings can inform future student-focused interventions, including identifying the distinct roles of HL and DHL in pandemic information access, attitudes, and behaviors.

Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review

“…The latest reference from a survey conducted during the period of active immunization process (April 2021) shows however a higher acceptance rate (of 75%) [73] . Specific populations, such as college students, reported high hesitancy [74] while another survey on people aged 14–24 years found that up to 75% of the participants would accept the future vaccine [75] . Adults (35–44 years old) representatives of social media users population, showed a surprisingly high intention to receive the vaccine with 81% of acceptance rate [76] .…”

“…Themes identified to contribute to high hesitancy were most prominently associated with certain socio-demographic variables. Such variables included income (e.g., being low-income population), age (e.g., younger patients were more hesitant, partially as they perceived being at lower risk compared to elders [ 69 , 74 , 79 , 80 , 96 , 149 ]), education (e.g., having a lower education degree [ 69 , 71 , 96 , 97 , 101 , 102 , 146 , 148 , 150 , 152 ]), area of residence (e.g., those in rural areas were more hesitant [ 69 , 101 , 149 ]), reported race and/or ethnicity (e.g., those who identified as minorities [ 38 , [69] , [70] , [71] , 75 , 77 , 78 , 103 , 149 , 151 ]). Interestingly, studies that included specific populations (such as patients with different health conditions) generally observed a lower intention to vaccinate among them compared with the general population.…”

The Impact of Health Literacy on Knowledge and Attitudes towards Preventive Strategies against COVID-19: A Cross-Sectional Study

“…However, internet is associated with lower literacy levels [ 17 ], because of the amount of fake information that is disseminated without technical review and appraisal [ 18 ]. Recent studies on digital health literacy about COVID-19 show that, although students generally achieve high levels, they are unable to make judgments about the reliability of online health information [ 19 , 20 , 21 ]. Without true information there is no real freedom to decide.…”

Low COVID-19-related practice increases the risk of poor health literacy in international students

“…This result was in line with the study among 256 students in the US showing that HL was independently associated with preventive practices about COVID-19. (30) Students with lower HL use social media more frequently and thus are at greater risk of exposure to false and misleading information, possibly becoming additional vectors in the propagation of poor information, encouragement of harmful health practices, or resistance to public health guidance. threaten public health, such as pandemics.…”