Relationship Between Coronavirus-Related eHealth Literacy and COVID-19 Knowledge, Attitudes, and Practices among US Adults: Web-Based Survey Study

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 health information available on the internet. Objective The goals of this study were 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 a web-based survey of a representative sample of 1074 US adults. We adapted the 8-item eHealth Literacy Scale to develop the Coronavirus-Related eHealth Literacy Scale (CoV-eHEALS) to measure COVID-19−related knowledge, conspiracy beliefs, and adherence to protective behaviors (eg, wearing facial masks and social distancing). Our analyses identified sociodemographic associations with the participants’ CoV-eHEALS scores and an association between the CoV-eHEALS measure and COVID-19 KAPs. Results The internal consistency of the adapted CoV-eHEALS measure was high (Cronbach α=.92). The mean score for the CoV-eHEALS was 29.0 (SD 6.1). A total of 29% (306/1074) of the survey participants were classified as having low coronavirus-related eHealth literacy (CoV-eHEALS score <26). Independent associations were found between CoV-eHEALS scores and ethnicity (standardized β=–.083, P=.016 for Black participants) and education level (standardized β=–.151, P=.001 for participants with high-school education or lower). Controlling for demographic characteristics, CoV-eHEALS scores demonstrated positive independent associations with knowledge (standardized β=.168, P<.001) and adherence to protective behaviors (standardized β=.241, P<.001) and a negative association with conspiracy beliefs (standardized β=–.082, P=.009). Conclusions This study provides an estimate of coronavirus-related eHealth literacy among US adults. Our findings suggest that a substantial proportion of US adults have low coronavirus-related eHealth literacy and are thus at a 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 health information about COVID-19 available on the internet, assisting or simplifying web-based search for information about COVID-19, and training to improve general or coronavirus-specific search skills.

The Impact of Health Literacy on Knowledge and Attitudes towards Preventive Strategies against COVID-19: A Cross-Sectional Study

“…Our study shows a tendency for better knowledge to appear in those who have better literacy and a significant association between health literacy and attitudes. This is in concordance with a recent study in the USA population that found that adults with low coronavirus-related eHealth literacy are at a higher risk of having less protective COVID-19-related knowledge, attitudes, and practices [ 28 ]. During the pandemic, an enormous amount of information has been running continuously through the media, internet, social networks, and many other sources.…”

eHealth Literacy, Awareness of Pandemic Infectious Diseases, and Healthy Lifestyle in Middle School Students

“…Adolescents who used mobile fitness applications showed increased exercise time and intention to maintain physical fitness compared to those who did not use the applications [11]. Additionally, US adults with high eHealth literacy maintained reasonable judgments about false superstitions, obtained accurate knowledge, and practiced infection prevention behaviors as compared to those with low eHealth literacy [6].…”

“…According to the 2020 Survey on the Internet Usage in South Korea, 63.6% of health and medical information was obtained online after the COVID-19 outbreak, which represented the largest increase compared to before the COVID-19 outbreak (46.3%) among all internet search categories [5]. Furthermore, as information and messages delivered through the Internet directly and indirectly affect the thoughts and behaviors of the Internet users [4,6], the ability to use reliable and correct health information from the Internet is important for health-related behaviors and lifestyles during the pandemic [2,6].…”

“…This ability plays an important role in the prevention and self-management of diseases and satisfaction of one's need for health care [8,9]. Low eHealth literacy leads to difficulties in forming proper judgments of health-related knowledge acquired online, which subsequently causes health imbalances due to gaps and distortions in information [10], and undesirable health consequences [6]. eHealth literacy also plays a positive role in improving health knowledge and attitudes [8].…”

Potential Effects of Digital Inequality on Treatment Seeking for Opioid Use Disorder

“…Digital health or ehealth literacy adds a technological component to the health literacy construct, which includes a person's ability to seek and find, in addition to comprehend and appraise, information using electronic sources and the application of that knowledge to address health issues (Norman & Skinner, 2006). Studies examining the effects of digital health literacy have found that higher digital health literacy translated to better knowledge and protective health behaviors (An et al, 2021) and online health-seeking behaviors (Wong & Cheung, 2019).…”