JMIR Publications

ABSTRACT

Background:

In the digital age, adolescents increasingly rely on online sources for health-related information. Electronic health (eHealth) literacy—defined as the ability to find, evaluate, and apply online health information—plays a crucial role in health outcomes. However, limited research exists on eHealth literacy among Japanese high school students, particularly on its association with menstrual health and psychological well-being.

Objective:

This study aimed to assess the eHealth literacy of Japanese female high school students and examine its association with premenstrual symptoms, psychological distress, loneliness, and self-esteem.

Methods:

A cross-sectional web-based survey was conducted in December 2024 among 1,607 female students from two public high schools in Sendai, Japan. A total of 909 students with regular menstrual cycles completed all survey items. The survey included the eHealth Literacy Scale (eHEALS), Premenstrual Symptoms Questionnaire, Kessler Psychological Distress Scale (K6), Revised UCLA Loneliness Scale, Rosenberg Self-Esteem Scale, and a numerical rating scale for menstrual pain. Statistical analyses, including Student’s t-test, chi-square test, correlation analyses, and logistic regression analyses, were used to examine the relationships between eHealth literacy and various health outcomes.

Results:

The mean eHEALS score was 22.8 (standard deviation, 7.3), with 32.1% of participants classified as having high eHealth literacy (eHEALS ≥26). Students with higher eHealth literacy reported significantly lower levels of loneliness and higher self-esteem. The severity of premenstrual symptoms, particularly feeling overwhelmed, was significantly lower in the high eHealth literacy group. Additionally, interpersonal difficulties related to premenstrual symptoms were less prevalent among students with high eHealth literacy. Pearson’s correlation analysis indicated negative associations between the eHEALS score and psychological distress (K6) and loneliness, whereas a positive association was observed with self-esteem. Logistic regression analysis identified high self-esteem as a significant predictor of high eHealth literacy.

Conclusions:

This study highlights the importance of eHealth literacy in adolescent healthcare. Higher eHealth literacy is linked to lower levels of loneliness, higher self-esteem, and reduced premenstrual symptom severity, particularly feeling overwhelmed. Although the cross-sectional design limits causal conclusions, these findings suggest that enhancing eHealth literacy can benefit the mental and reproductive health of adolescents. Future studies should explore educational interventions and their long-term effects on well-being. Clinical Trial: None