We aim to evaluate the associations between digital health literacy (DHL) related to COVID-19 and online information-seeking behavior among university students. Methods: A total of 3.084 students (75.7% women), with an average age of 24.2 (SD = 7.5) participated in this cross-sectional study, most of whom (36.5%) were from social sciences and pursued a bachelor’s degree (50.7%). Data on COVID-19-related DHL and online information-seeking behavior were collected using an online questionnaire. Logistic regression models were performed. Results: As the pandemic progressed, participants showed a lower chance of achieving a sufficient DHL (OR = 0.7; 95% CI = 0.6; 0.9). Using search engines more often (e.g., Google) (OR = 0.7; 95% CI = 0.5; 0.9), Wikipedia (OR = 0.7; 95% CI = 0.6; 0.9) and social media (e.g., Facebook) (OR = 0.7; 95% CI = 0.6; 0.9) decreased the likelihood of achieving sufficient DHL related to COVID-19. More frequent use of websites of public bodies (OR = 1.7; 95% CI = 1.1; 2.5) increased the odds of reporting sufficient DHL. Conclusion: DHL is associated with university students’ online information-seeking behavior in the time of COVID-19. From a community and public health perspective, programs aiming at improving DHL should be highlighted.

Background: Health literacy is an important skill to deal with information and positively influences individual and community health. Information concerning health is available from a plethora of online resources. The concept of digital health literacy has gained prominence with the pandemic. The absence of valid tools to analyse digital literacy levels are scant. This study aims to translate, adapt and validate the Portuguese version of the Digital Health Literacy Instrument (DHLI) as used in the global COVID-HL Network. Methods: Participants were mostly students from social sciences, psychology, education and health sciences. The Portuguese version of the DHLI contained five dimensions each consisting of three items. An online survey with university students (n = 1815, 75.1% female, average age: 24.15 years) was administered to test the validity of the Portuguese version of the DHLI. Data were analysed using exploratory and confirmatory factor analysis. Pearson correlations were also studied.Results: Two items revealed symmetry and kurtosis problems. We chose to eliminate them from the analysis. Different exploratory factor analysis attempts were made, obtaining two possible models to be tested in the confirmatory factor analysis: a three-factor model and a four-factor model. A four-factor structure of the instrument (information searching, adding self-generated content, evaluating reliability, determining relevance) was supported by confirmatory factor analysis and had good internal consistency. Conclusions:The Portuguese version of the Digital Health Literacy Instrument met adequate psychometric criteria. Therefore, it can be confidently used in Portuguese students' assessment of digital health literacy. Representative studies are needed to shed light on different target groups and their COVID-19-related DHLI.

Health literacy is a determinant factor for population health. It is important both for the prevention of health problems and the better management of those problems and unexpected situations that happen. Low health literacy has been consistently associated with poor health outcomes. This study aimed to develop a health literacy indicator for Angola and to analyze pertinent demographic characteristics related to it. Data were obtained from the first Angola Demographic and Health Survey conducted in 2015/16; we included 10 questions related to the American National Academy of Medicine definition of health literacy. Using factor analysis, we extracted one i indicator corresponding to four dimensions of health literacy. The indicator was dichotomized, and we used Logistic Regression to estimate factors associated with health literacy level: we obtained data from 19,785 adolescents and adults, aged 15–49 years. The internal consistency of the i indicator was reliable (Cronbach’s α  =  0.83). Adjusting for other variables, males with complete secondary education or above and living in urban areas were more likely to have a high level of health literacy. There were substantial differences between the 18 regions. This is the first study evaluating health literacy in Angola using the American National Academy of Medicine definition and a Demographic and Health survey. Our study shows unfavorable results for women, individuals living in rural areas and those less educated.

Background Despite its relevance, health literacy and its impact on health-seeking behaviour and health outcomes tends to be poorly understood, and usually not assessed or integrated with health policies, especially in African countries.Objective To map existing evidence on the health literacy of adolescents and adults in African countries and provide an overview of the instruments used.Methods We conducted a scoping review and applied the Population, Concept, and Context (PCC) framework recommended by Joanna Briggs Institute. Population - adolescents and adults; Concept - health literacy and health literacy scales; Context - African countries. We searched PubMed, Scopus, Taylor and Francis Online, and Web of Science for articles published in Portuguese, French, or English, between January 2000 to January 2020, using a composite search term, combining search terms with Boolean operators. Qualitative synthesis of results.Results Eighteen studies were included, and 12 health literacy instruments were identified: 7 were generic, 3 assessed health literacy regarding HIV, hypertension, and maternal care and 2 derived from Demographic Health Surveys. Health literacy levels tended to be poor and vary across countries, contexts, and groups.Conclusion Research on health literacy in Africa is limited and several authors have tried to adapt health literacy tools to local context and languages. Certain constraints like poor ability to understand questionnaire response items, and low levels of health literacy outcomes for both adolescents and adults are more marked in rural contexts and hard-to-reach populations. Our study confirmed that there is a lack of health literacy measurement instruments adapted to African contexts.

We aimed to evaluate the associations between information searching about public health and social measures (PHSM) and university students’ digital health literacy (DHL) related to the new coronavirus (SARS-CoV-2) and COVID-19. Methods: This cross-sectional study included 3,084 Portuguese university students (75.7% females), with an average age of 24.2 (SD = 7.5). Sociodemographic data, DHL questionnaire and online information concerning PHSM were gathered. Cox proportional hazards models were performed. Results: Students who searched for personal protective measures achieved in shorter time sufficient “evaluating reliability” (HR = 1.4; 95% CI = 1.1; 1.7) and “determining relevance” (HR = 1.5; 95% CI = 1.2; 1.8). Searching for surveillance and response measures was associated with sufficient “determining relevance” (HR = 1.4; 95% CI = 1.1; 1.9). Finally, those students who searched for environmental, economic and psychosocial measures achieved in shorter time “determining relevance” (HR = 1.2; 95% CI = 1.0; 1.4). Conclusions: Searching for PHSM was significantly associated with an increased likelihood of achieving sufficient DHL subscales in a shorter time. Further studies are needed, including developing strategies to increase the availability of high-quality information concerning public health and social measures and to improve (digital) health literacy.