Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 20, 2020
Date Accepted: Feb 19, 2021
Date Submitted to PubMed: Mar 31, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Relationship between Coronavirus-related eHealth Literacy and COVID-19 Knowledge, Attitudes, and Practices among US Adults
ABSTRACT
Background:
During a global pandemic, it is critical that the public is able to rapidly acquire new and accurate health information. The Internet is a major source of health information. eHealth literacy is the ability of individuals to find, assess, and use online health information.
Objective:
The goals of this study are to assess coronavirus-related eHealth literacy and examine the relationship between eHealth literacy and COVID-19 related knowledge, attitudes, and practices (KAPs).
Objective:
The goals of this study are to assess coronavirus-related eHealth literacy and examine the relationship between eHealth literacy and COVID-19 related knowledge, attitudes, and practices (KAPs).
Methods:
We conducted an online survey of a representative sample of 1,074 US adults. We adapted the eight-item eHealth Literacy Scale to assess coronavirus-related eHealth literacy (CoV-eHEALS) and measured COVID-19 related knowledge, conspiracy beliefs, a protective behaviors index, and the number of trips taken from the home in the prior week. Analyses identified predictors of low CoV-eHEALS and the association between CoV-eHEALS and COVID-19 KAPs.
Results:
The internal consistency of the adapted CoV-eHEALS measure was high (alpha 0.92).The mean score for the CoV-eHEALS was 29.0 (SD 6.1). Twenty-nine percent of respondents were classified as having low CoV-eHEALS (score <26). Lower income (OR 1.43, 95% CI 1.01-2.03, for income less than $75,000) and lower educational attainment (OR 2.11, 95% CI 1.32-3.40, for high school education or less) were independent predictors of low CoV-eHEALS. Respondents with low CoV-eHEALS reported lower COVID-19 related knowledge (mean score 24.9 (SD 5.0) vs. 27.6 (SD 5.2), p<0.001), higher conspiracy beliefs (mean score 3.05 (SD 0.94) vs. 2.82 (SD 1.14), p<0.001), and routine practice of fewer protective behaviors (mean score 4.02 (SD 2.35) vs. 4.97 (SD 2.08), p<0.001) including making more trips out of the home in the prior week (mean trips 7.44 (SD 7.32) vs. 6.26 (SE 6.37), p=0.009). Adjusting for demographic factors in multivariate models (age, gender, ethnicity, income, education) had little impact on the magnitude or statistical significance of these associations.
Conclusions:
This study provides an estimate of coronavirus-related eHealth literacy among US adults. A substantial proportion of US adults can be considered as having low coronavirus-related eHealth literacy and thus at greater risk of lower and less protective COVID-19 KAPs. These findings highlight the need to assess and address eHealth literacy as part of COVID-19 control efforts. Potential strategies include improving the quality of online health information about COVID-19, assisting or simplifying online search for information about COVID-19, and training to improve general or coronavirus-specific search skills.
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