eHealth literacy in the general population: a cross-sectional study in China

Abstract Background eHealth literacy (eHL) is positively associated with health-related behaviors and outcomes. Previous eHL studies primarily collected data from online users and seldom focused on the general population in low- and middle-income countries (LMIC). Additionally, knowledge about facto...

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Main Authors: Chao Sun, Eline Meijer, Niels H. Chavannes, Huohuo Dai, Xiao Li, Yue Wang, Liangqiuhe Wu, Qing Zhang, Marise J. Kasteleyn
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21389-0
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author Chao Sun
Eline Meijer
Niels H. Chavannes
Huohuo Dai
Xiao Li
Yue Wang
Liangqiuhe Wu
Qing Zhang
Marise J. Kasteleyn
author_facet Chao Sun
Eline Meijer
Niels H. Chavannes
Huohuo Dai
Xiao Li
Yue Wang
Liangqiuhe Wu
Qing Zhang
Marise J. Kasteleyn
author_sort Chao Sun
collection DOAJ
description Abstract Background eHealth literacy (eHL) is positively associated with health-related behaviors and outcomes. Previous eHL studies primarily collected data from online users and seldom focused on the general population in low- and middle-income countries (LMIC). Additionally, knowledge about factors that affect eHL is limited. Chronic lung disease (CLD) has brought a large burden in LMIC, making it a relevant example for studying eHL. This study aims to explore eHL and its associated factors within the general population of China, encompassing sociodemographic characteristics, CLD knowledge, digital access, eHealth use and attitudes towards eHealth. Method Data were collected from November 2023 to January 2024 via online and hard-copy questionnaires among the general population in China. Descriptive analyses were performed to explore eHL, CLD knowledge, digital access, and attitudes towards eHealth at different sociodemographic levels. Univariable and multivariable regression analyses were performed to identify factors associated with eHL. Results 439 valid questionnaires were collected. Participants demonstrated a mean eHL of 24.7 ± 8.2 and CLD knowledge of 5.9 ± 3.7, obtained a score of 6.9 ± 1.8 in attitudes towards eHealth. A notable percentage of participants (45/439, 10.3%) reported no digital access, especially those aged 66+, the unemployed, retired, those with a primary school or below degree and earning ≤ 1500 RMB monthly. Multivariable hierarchical regression analysis showed higher eHL was uniquely associated with younger age (b=-0.10, P < .001), higher educational level (b = 2.02, P < .001), higher income (b = 1.10, P < .001), having digital access (b = 6.35, P < .001), more frequent eHealth use (b = 1.14, P < .001), and more positive attitudes towards eHealth (b = 0.47, P = .003). Conclusion Our sample from the general population in China had a relatively low eHL and CLD knowledge level, but held a positive attitudes towards eHealth. A digital divide was noticed between the elderly, low socioeconomic population and other groups. Younger age, higher educational and income level, having digital access, more frequent eHealth use and more positive attitudes towards eHealth were significantly associated with higher eHL. Efforts at both individual and systematic levels should be made to improve eHL, and promote CLD knowledge and digital access, especially in disadvantaged populations. Moreover, there is a pressing need to develop and refine national and international standards for eHL.
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spelling doaj-art-d180907f43a1492fa0958705d40499d92025-01-19T12:41:42ZengBMCBMC Public Health1471-24582025-01-0125111410.1186/s12889-025-21389-0eHealth literacy in the general population: a cross-sectional study in ChinaChao Sun0Eline Meijer1Niels H. Chavannes2Huohuo Dai3Xiao Li4Yue Wang5Liangqiuhe Wu6Qing Zhang7Marise J. Kasteleyn8Department of Public Health and Primary Care, Leiden University Medical CentreDepartment of Public Health and Primary Care, Leiden University Medical CentreDepartment of Public Health and Primary Care, Leiden University Medical CentreDepartment of Public Health and Primary Care, Leiden University Medical CentreSchool of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversityDepartment of Public Health and Primary Care, Leiden University Medical CentreAbstract Background eHealth literacy (eHL) is positively associated with health-related behaviors and outcomes. Previous eHL studies primarily collected data from online users and seldom focused on the general population in low- and middle-income countries (LMIC). Additionally, knowledge about factors that affect eHL is limited. Chronic lung disease (CLD) has brought a large burden in LMIC, making it a relevant example for studying eHL. This study aims to explore eHL and its associated factors within the general population of China, encompassing sociodemographic characteristics, CLD knowledge, digital access, eHealth use and attitudes towards eHealth. Method Data were collected from November 2023 to January 2024 via online and hard-copy questionnaires among the general population in China. Descriptive analyses were performed to explore eHL, CLD knowledge, digital access, and attitudes towards eHealth at different sociodemographic levels. Univariable and multivariable regression analyses were performed to identify factors associated with eHL. Results 439 valid questionnaires were collected. Participants demonstrated a mean eHL of 24.7 ± 8.2 and CLD knowledge of 5.9 ± 3.7, obtained a score of 6.9 ± 1.8 in attitudes towards eHealth. A notable percentage of participants (45/439, 10.3%) reported no digital access, especially those aged 66+, the unemployed, retired, those with a primary school or below degree and earning ≤ 1500 RMB monthly. Multivariable hierarchical regression analysis showed higher eHL was uniquely associated with younger age (b=-0.10, P < .001), higher educational level (b = 2.02, P < .001), higher income (b = 1.10, P < .001), having digital access (b = 6.35, P < .001), more frequent eHealth use (b = 1.14, P < .001), and more positive attitudes towards eHealth (b = 0.47, P = .003). Conclusion Our sample from the general population in China had a relatively low eHL and CLD knowledge level, but held a positive attitudes towards eHealth. A digital divide was noticed between the elderly, low socioeconomic population and other groups. Younger age, higher educational and income level, having digital access, more frequent eHealth use and more positive attitudes towards eHealth were significantly associated with higher eHL. Efforts at both individual and systematic levels should be made to improve eHL, and promote CLD knowledge and digital access, especially in disadvantaged populations. Moreover, there is a pressing need to develop and refine national and international standards for eHL.https://doi.org/10.1186/s12889-025-21389-0eHealth literacyGeneral populationChronic lung diseaseDigital accessDigital divideKnowledge
spellingShingle Chao Sun
Eline Meijer
Niels H. Chavannes
Huohuo Dai
Xiao Li
Yue Wang
Liangqiuhe Wu
Qing Zhang
Marise J. Kasteleyn
eHealth literacy in the general population: a cross-sectional study in China
BMC Public Health
eHealth literacy
General population
Chronic lung disease
Digital access
Digital divide
Knowledge
title eHealth literacy in the general population: a cross-sectional study in China
title_full eHealth literacy in the general population: a cross-sectional study in China
title_fullStr eHealth literacy in the general population: a cross-sectional study in China
title_full_unstemmed eHealth literacy in the general population: a cross-sectional study in China
title_short eHealth literacy in the general population: a cross-sectional study in China
title_sort ehealth literacy in the general population a cross sectional study in china
topic eHealth literacy
General population
Chronic lung disease
Digital access
Digital divide
Knowledge
url https://doi.org/10.1186/s12889-025-21389-0
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