The association and intervention effect between eHealth literacy and lifestyle behaviors among Chinese university students

Tian, Hua; Chen, Jie

doi:10.1590/1980-220X-REEUSP-2022-0147en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 56 • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2022-0147en copy

The association and intervention effect between eHealth literacy and lifestyle behaviors among Chinese university students

A associação e o efeito da intervenção entre a alfabetização em saúde e os comportamentos de estilo de vida entre estudantes universitários chineses

Asociación y efecto de la intervención entre la alfabetización en salud y los comportamientos de estilo de vida de estudiantes universitarios chinos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

Our aim was to evaluate the association between eHealth literacy and lifestyle behaviors to intervene among Chinese university students.

Method:

The Chinese eHealth Literacy Scale (C-eHEALS) questionnaire was used to investigate the eHealth literacy level and association with lifestyle behaviors among Chinese university students. Independent sample t-test and Pearson’s correlation coefficient were used by statistical software SPSS v20.

Results:

In the first round, 5,151 university students participated in the study, including 71.46% female and 28.54% male, aged 18–22 (93.13%).The average eHealth literacy score was 26.81 ± 5.83. Four lifestyle behaviors (e.g., exercise, smoking, drinking and sleeping) were all significantly correlated with eHealth literacy scores and demonstrated significant differences. In the second investigation (N = 2,939), the average eHealth literacy score was 31.64 ± 6.44, a notable improvement compared with the first investigation.

Conclusion:

Those in the group with high eHealth literacy scores have a healthier lifestyle than those in the low-score group. Training in eHealth-related resources is a positive measure to improve university students’ eHealth literacy.

DESCRIPTORS
Health Literac; Healthy Lifestyl; Student; China

Characteristics	C-eHEALS (Mean ± SD)	P value
Sex
Male (1,410)	28.23 ± 6.46	< 0.001
Female (3,741)	26.28 ± 5.48
Age
18–22 (4,797)	26.81 ± 5.86	.061
Other (354)	26.94 ± 6.02
Only Child
Yes (524)	27.88 ± 6.39	.016
No (4,627)	26.69 ± 5.75
Origin
Town (1,135)	27.79 ± 6.27	< 0.001
Countryside (4,016)	26.53 ± 5.66
Parental education level
Low (3,953)	26.55 ± 5.68	< 0.001
High (1,198)	27.68 ± 6.20
Major
Liberal arts (3,146)	26.60 ± 5.68	= .001
Science (2,005)	27.15 ± 6.04
Grade
1 (2,018)	26.82 ± 5.93	.991
> 1 (3,133)	26.81 ± 5.76
Number of Internet devices
1(2,042)	26.55 ± 5.72	.004
> 1(3,109)	26.98 ± 5.89

Lifestyle behaviors	Frequency	Sample (%)	C-eHEALSlow (n%)	C-eHEALShigh (n%)	P value
Total	5,151.00	100	57.08	42.92	<0.001
Exercise
None	577.00	11.20	13.13	8.37	<0.001
1–2 days/month	890.00	17.28	19.08	14.88	<0.001
1–2 days/week	2,322.00	45.08	44.66	45.23	<0.001
≥ 3 days/week	1,362.00	26.44	22.93	31.12	<0.001
Breakfast
None	394.00	7.65	8.71	6.24	<0.001
1–2 days/week	691.00	13.41	14.29	12.26	<0.001
3–4 days/week	944.00	18.33	18.33	18.32	<0.001
5–6 days/week	907.00	17.61	18.20	16.82	<0.001
Everyday	2,215.00	43.00	40.48	46.36	<0.001
Smoking					<0.001
None	4,941.00	95.92	96.33	95.39	<0.001
1–2 times/week	55.00	1.07	1.19	0.90	<0.001
3–4 times/week	42.00	0.82	0.71	0.95	<0.001
Everyday	113.00	2.19	1.77	2.76	<0.001
Drinking
None	4,613.00	89.56	90.78	87.92	<0.001
1–2 days/month	430.00	8.35	7.38	9.63	<0.001
1–2 days/week	56.00	1.09	0.92	1.31	<0.001
≥ 3 times/week	52.00	1.01	0.92	1.13	<0.001
Sleeping					<0.001
≤ 6 hours/day	647.00	12.56	13.95	10.72	<0.001
7–8 hours/day	4,338.00	84.22	83.27	85.48	<0.001
≥ 9 hours/day	166.00	3.22	2.79	3.80	<0.001

Characteristics	C-eHEALS	Exercise	Breakfast	Smoking	Drinking	Sleeping
C-eHEALS	1
Exercise	0.119**	1
Breakfast	0.021	0.071**	1
Smoking	0.032*	0.030*	0.021	1
Drinking	0.041**	0.046**	–0.011	0.396**	1
Sleeping	0.054**	0.080**	0.007	–0.062**	–0.061**	1

Lifestyle behaviors	Frequency	Sample (%)	C-eHEALSlow (n%)	C-eHEALShigh (n%)	P value
Total	2,939.00	100	44.27	55.73	<0.001
Exercise
None	217.00	7.38	9.61	5.62	<0.001
1–2 days/month	323.00	10.99	12.91	9.46	<0.001
1–2 days/week	1,341.00	45.63	49.04	42.92	<0.001
≥ 3 days/week	1,058.00	36.00	28.44	42.00	<0.001
Breakfast
None	228.00	7.76	9.15	6.65	<0.001
1–2 days/week	353.00	12.01	12.61	11.54	<0.001
3–4 days/week	548.00	18.65	19.29	18.13	<0.001
5–6 days/week	589.00	20.04	23.29	17.46	<0.001
Everyday	1,221.00	41.54	35.66	46.21	<0.001
Smoking					<0.001
None	2,795.00	95.10	94.77	95.36	<0.001
1–2 times/week	44.00	1.50	1.61	1.40	<0.001
3–4 times/week	23.00	0.78	0.85	0.73	<0.001
Everyday	77.00	2.62	2.77	2.50	<0.001
Drinking
None	2,606.00	88.67	88.85	88.52	<0.001
1–2 days/month	263.00	8.95	8.99	8.91	<0.001
1–2days/week	31.00	1.05	1.08	1.04	<0.001
≥ 3 times/week	39.00	1.33	1.08	1.53	<0.001
Sleeping					<0.001
≤ 6 hours/day	377.00	12.83	13.84	12.03	<0.001
7–8 hours/day	2,462.00	83.77	84.01	83.58	<0.001
≥ 9 hours/day	100.00	3.40	2.15	4.40	<0.001

Characteristics	C-eHEALS		P value
Characteristics	Study 1 (N = 5,151)	Study 2 (N = 2,939)	P value
Total	26.81±5.83	31.65 ± 6.44	<0.001
Exercise
None	25.10±5.88	29.79 ± 6.44	<0.001
1–2 days/month	26.06±5.16	30.49 ± 6.40	<0.001
1–2 days/week	26.87±5.55	31.21 ± 6.41	<0.001
≥ 3 days/week	27.92 ± 6.40	32.93 ± 6.52	<0.001
Breakfast
None	25.96 ± 5.59	30.76 ± 6.44	<0.001
1–2 days/week	26.32 ± 5.53	31.01 ± 6.45	<0.001
3–4 days/week	26.77 ± 5.60	31.31 ± 6.45	<0.001
5–6 days/week	26.44 ± 5.59	30.43 ± 6.57	<0.001
Everyday	27.28 ± 6.09	32.74 ± 6.56	<0.001
Smoking			<0.001
None	26.76 ± 5.75	31.68 ± 6.44	<0.001
1–2 times/week	26.89 ± 6.48	32.16 ± 7.11	<0.001
3–4 times/week	28.52 ± 6.54	29.61 ± 7.49	<0.001
Everyday	28.34 ± 7.79	30.68 ± 7.51	<0.001
Drinking
None	26.71 ± 5.76	31.62 ± 6.44	<0.001
1–2 days/month	27.63 ± 5.79	31.89 ± 6.48	<0.001
1–2 days/week	27.71 ± 5.80	31.32 ± 7.68	<0.001
≥ 3 times/week	27.69 ± 5.83	32.08 ± 8.81	<0.001
Sleeping			<0.001
≤ 6 hours/day	26.10 ± 6.18	31.06 ± 7.07	<0.001
7–8 hours/day	26.87 ± 5.76	31.64 ± 6.41	<0.001
≥ 9 hours/day	28.10 ± 5.83	34.06 ± 6.44	<0.001

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[1] Corresponding author: Hua Tian Nanhu Road, Xinyang No. 237, 464000, China tianhua@xynu.edu.cn