JMIR Publications

ABSTRACT

Background:

eHealth literacy is essential for post-secondary students; however, few studies have systematically reviewed its levels and related outcomes within this population.

Objective:

This study aims to systematically review the existing literature on eHealth literacy levels and their associated outcomes among post-secondary students.

Methods:

The PubMed, Web of Science, CINAHL, EMBASE, Cochrane Library, APA PsycInfo, APA PsycArticles, China National Knowledge Infrastructure(CNKI), Wanfang Data, Base, and Opengrey databases were systematically searched for studies published up from 2006 to 1st July 2024, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were eligible if they were quantitative research paper, assessed eHealth Literacy, described the relationship between eHealth Literacy and other outcomes, included post-secondary students. The risk of bias was assessed using the modified Appraisal Tool for Cross-Sectional Studies (AXIS).

Results:

A total of 89 cross-sectional studies were included from 45,168 eHealth literacy–related publications, with 68 rated as high quality and 21 as moderate quality. Various assessment tools were used across studies, with the eHealth Literacy Scale (eHEALS) being the most commonly employed (56/89, 62.9%). Reported eHealth literacy scores ranged from 23.6 ± 6.8 to 31.4 ± 4.4 (total scores), and from 3.42 ± 0.61 to 4.10 ± 0.56 (mean item scores). Associated outcomes were grouped into cognitive, emotional, and behavioral domains. eHealth literacy was positively associated with cognitive outcomes including health knowledge, self-efficacy, disease prevention behaviors, and health attitudes. Emotionally, it was linked to higher psychosocial well-being and more positive emotions, and lower negative emotions; however, its associations with overall well-being, depression, and COVID-19 fear were inconclusive. Behaviorally, eHealth literacy was associated with greater use of electronic information, disease prevention practices, volunteerism, and clinical decision-making. Its relationships with healthcare utilization, social media engagement, and healthy living were more complex and context-dependent.

Conclusions:

eHealth literacy among post-secondary students ranges from moderate-low to moderate-high, with variations due to inconsistent assessment tools. It shows positive associations with cognitive, emotional, and behavioral outcomes, though links to healthy living, digital and health service engagement, and certain psychosocial aspects remain complex. Future research should standardize measurement and explore its mechanisms across disciplines and cultures to guide effective health promotion.