Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Mar 08, 2023)
Date Submitted: Aug 12, 2022
Warning: This is an author submission that is not peer-reviewed or edited.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.
Relationships Among eHealth Literacy, Health Literacy and Physical Activity of Chinese College Students: A Prospective Path Analysis
ABSTRACT
Background:
Although eHealth literacy (EHL) was raised on the ground of health literacy (HL), few empirical studies were found to examine the association between them. The relationship between these two literacies still remains uncertain. Exploration on the relationship can contribute to demonstrate the differences between EHL and HL, and help deeper understand both of the concepts. In addition, recent studies have explored HL issues in daily life, linking HL closely to lifestyle behaviors. As one component of lifestyle behaviors, physical activity (PA) has been identified as an important health outcome of HL, yet few studies about HL or EHL in conjunction with PA has been conducted. Research on explaining the underlying mechanism for EHL or HL impacting PA is warranted.
Objective:
This study aimed to explore the relationships among health literacy, eHealth literacy and physical activity.
Methods:
An integrated social-cognitive model based on the social cognitive theory (SCT) and the theory of planned behavior (TPB) was proposed. A prospective design was applied in data collection section. A total of 280 Chinese college students (56%female, age=21.2 ± 1.35 years) completed both the baseline survey (T1) and the 1.5-month-later follow-up (T2). Correlation analyses and path analysis were performed to test the proposed model and assess the associations among EHL, HL and PA.
Results:
Self-perceived EHL was found to significantly associate with self-perceived HL (β=0.22, p＜0.01), but had no relationship with HL actual performance. Significant mediation effects of self-efficacy (β=0.39, p＜0.001) and social support (β=0.06, p＜0.05) were found on the relations from self-perceived EHL to PA intention. Self-efficacy was also found to negatively mediate the relation between self-perceived HL and PA intention (β=-0.1, p＜0.01). Additionally, stronger PA intention successfully predicted more PA participation one and a half month later (β=0.22, p＜0.001).
Conclusions:
A model based on the theory of planned behavior was proposed and tested in the current study to explore the relationships among eHealth literacy, health literacy and physical activity. The findings specifically highlighted that self-efficacy and social support played different roles in relationships from HL to PA and from EHL to PA, suggested a new underlying mechanism for constructing EHL and HL interventions in future studies.
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