Digital health literacy and well-being among university students: Mediating roles of fear of COVID-19, information satisfaction, and internet information search

Sheng-Chih Chen; Nhi Thi Hong Nguyen; Cheng-Yu Lin; Le Duc Huy; Chih-Feng Lai; Loan T Dang; Nguyen L T Truong; Nhi Y Hoang; Thao T P Nguyen; Tan N Phaṇ; Kevin Dadaczynski; Orkan Okan; Tuyen Van Duong

doi:10.1177/20552076231165970

Digital health literacy and well-being among university students: Mediating roles of fear of COVID-19, information satisfaction, and internet information search

Digit Health. 2023 Mar 27:9:20552076231165970. doi: 10.1177/20552076231165970. eCollection 2023 Jan-Dec.

Authors

Sheng-Chih Chen¹, Nhi Thi Hong Nguyen^{2

3}, Cheng-Yu Lin⁴, Le Duc Huy³, Chih-Feng Lai⁵, Loan T Dang^{6

7}, Nguyen L T Truong^{8

9}, Nhi Y Hoang¹⁰, Thao T P Nguyen¹¹, Tan N Phaṇ^{12

13}, Kevin Dadaczynski^{14

15}, Orkan Okan¹⁶, Tuyen Van Duong¹⁰

Affiliations

¹ Graduate Program in Digital Content and Technologies, College of Communication, National Chengchi University, Taipei, Taiwan.
² School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan.
³ Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
⁴ Department of Radio, Television & Film, Shih Hsin University, Taipei, Taiwan.
⁵ Department of Education, National Taichung University of Education, Taichung, Taiwan.
⁶ Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.
⁷ School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
⁸ Pharmacy Department, School of Medicine, Vietnam National University, Ho Chi Minh City, Binh Duong, Vietnam.
⁹ Pharmacy Department, Thong Nhat Hospital, Ho Chi Minh City, Vietnam.
¹⁰ School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
¹¹ Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
¹² Department of Tropical Diseases, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
¹³ International Health Program, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
¹⁴ Public Health Centre Fulda, Fulda University of Applied Sciences Fulda, Germany.
¹⁵ Center for Applied Health Science, Leuphana University of Lueneburg, Lueneburg, Germany.
¹⁶ Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.

Abstract

Background: Digital health literacy (DHL) enables healthy decisions, improves protective behaviors and adherence to COVID-19 measures, especially during the era of the "infodemic", and enhances psychological well-being.

Objective: We aimed to explore the mediating roles of fear of COVID-19, information satisfaction, and the importance of online information searching on the association between DHL and well-being.

Methods: A cross-sectional web-based survey was conducted among 1631 Taiwanese university students, aged 18 years and above, from June 2021 to March 2022. The collected data include sociodemographic characteristics (sex, age, social status, and financial satisfaction), the importance of online information searching, information satisfaction, fear of COVID-19, DHL, and well-being. A linear regression model was utilized to investigate factors associated with well-being, followed by a pathway analysis to assess the direct and indirect relationship between DHL and well-being.

Results: The scores of DHL and overall well-being were 3.1 ± 0.4 and 74.4 ± 19.7, respectively. Social status (B = 2.40, 95% confidence interval (CI) 1.73-3.07, p < 0.001), DHL (B 0.29, 95% CI 0.10-0.49, p < 0.001), importance of online information searching (B = 0.78, 95% CI 0.38-1.17, p < 0.001), and information satisfaction (B = 3.59, 95% CI 2.22-4.94, p < 0.001) were positively associated with well-being, whereas higher fear of COVID-19 scores (B = -0.38, 95% CI -0.55-(-0.21), p < 0.001) and female (B = -2.99, 95% CI -5.02-0.6, p = 0.004) were associated with lower well-being, when compared with lower fear scores and male, respectively. Fear of COVID-19 (B = 0.03, 95% CI 0.016-0.04, p < 0.001), importance of online information searching (B = 0.03, 95% CI 0.01-0.05, p = 0.005), and information satisfaction (B = 0.05, 95% CI 0.023-0.067, p < 0.001) were significantly mediated the relationship between DHL and well-being.

Conclusion: Higher DHL scores show direct and indirect associations with higher well-being scores. Fear, importance of online information searching, and information satisfaction significantly contributed to the association.

Keywords: COVID-19; Taiwanese students; digital health literacy; mediator; pathway analysis; well-being.