Association of digital health literacy and information-seeking behaviors among physicians during COVID-19 in Ethiopia: A cross-sectional study.

Background: Universal access to health information is a requirement for all global health strategies in the era of pandemics. Getting health information from the internet is a great concern for the quality of patient healthcare. This study aimed to determine the association between digital health literacy and information-seeking behavior among physicians during COVID-19. Methods: An institutional-based cross-sectional study was conducted from December to February 2021 with a total sample size of 423. A pretest was performed among physicians before the actual data collection. After the data collection, the data were checked, cleaned, and exported into STATA v. 14. Descriptive statistics, binary logistic regression, and multivariable logistic regression analysis were applied. Then a 95% CI and a p-value of less than 0.05 were used to declare statistical significance. Results: The study revealed that 53.81% of physicians had high digital health literacy and 52.46% had high information-seeking behaviors. Health information-seeking behaviors were determined by digital health literacy, which was 2.25 times more likely than those who had low digital health literacy (AOR = 2.25, 95% CI: [1.11-4.57]). Health-related websites (67.5%) were the most common sources of health information, and 63.30% of physicians find digital health literacy easy or very easy to learn. However, 206 (50.92%) find it difficult or very difficult to decide if the information is reliable, verified, and up-to-date. Internet access (AOR = 1.90, 95% CI: [1.16-3.12]), frequency of searching for information (AOR = 5.35, 95% CI: [2.01-14.29]). All were discovered to be significantly associated with physicians' health information-seeking behaviors. Conclusions: Digital health literacy is a key to seeking health information online for appropriate decision-making. Increasing internet access, and providing ICT training, and integrate it into the health information revolution agendas, helping to disseminate health information and provide timely, reliable, and relevant news and genuine information needed for their work.

Digital health literacy and online informationseeking behavior of Lebanese university students in the time of the COVID-19 pandemic and infodemic

This cross-sectional study evaluated digital health literacy (DHL) and web-based information-seeking behavior of Lebanese university students. A total of 602 students (60.1% female), 21.5 years (±4.1), participated in May-August 2020 in an online survey. We found that 76.2% used the Internet, in the past month, for COVID-19-related information. Those with a chronic health impairment more often had limited DHL for adding self-generated content (OR=0.448;95 % CI=0.185, 1.085) and for determining relevance (OR=0.276;95 %CI=0.114-0.670). Students in graduate studies had higher odds of having sufficient DHL for adding self-generated content (OR=2.328;95 % CI=1.104, 4.909) and evaluating reliability (OR=2.318;95 % CI=1.149, 4.679). Users of official sources of information had higher odds (OR=1.665;95 % CI=1.065, 2.605) of having sufficient DHL for adding self-generated content. Regular users of social media had lower odds (OR=0.576;95 % CI=0.358, 0.928) of having sufficient DHL for evaluating reliability. Self-efficacy, in this case one's potential to accomplish a search for reliable health information and adopt it in daily life, could improve with DHL. As such, health education needs to strengthen DHL competencies in university students, particularly among undergraduates, those relying on social media, and those with an existing health impairment © Copyright 2023 Author(s). This is an open access article distributed under the terms of the Creative Commons CC-BY 4.0 License (https://creativecommons.org/licenses/by/4.0/)

Assessing Internet Surfing Behaviours and Digital Health Literacy among University Students in Ghana during the COVID-19 Pandemic

This study assessed the internet surfing behaviours and digital health literacy (DHL) among university students in Ghana during the COVID-19 pandemic. The research was guided by three major objectives: (1) examine the online information searching behaviours of university students during the COVID-19 pandemic, (2) investigate the thematic areas university students searched during COVID-19, and (3) examine the DHL level of university students. The study conveniently sampled 1014 university students to solicit their responses through questionnaire administration. Using frequency and percent counts, multiple response analysis, as well as mean and standard deviation, the study revealed that the predominant platforms university students used were search engines (n = 954, 94.1%), social media (n = 950, 93.7%), and WhatsApp (n = 950, 93.7%). Predominant themes among the thematic areas university students searched during COVID-19 were symptoms of COVID-19 (n = 701, 81.7%), COVID-19 vaccines (n = 689, 80.3%), and transmission routes of the coronavirus (n = 664, 77.4%). Further, other results showed that students enrolled in health-related programmes showed significantly higher levels of DHL compared to those in non-health-related programmes. The findings suggest the need to implement health education measures to strengthen students' health literacy capacities and their DHL ability. This finding requires governments and health authorities to implement evidence-informed health communication strategies to provide valid and reliable health information concerning the COVID-19 pandemic and support individuals to make health-promoting decisions. [ FROM AUTHOR] Copyright of COVID is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Evaluating computing students' digital skills and health literacy: A case from Bulgaria.

The main purpose of this article is to describe the importance and the challenges of digital health literacy as recognized during the COVID-19 pandemic. First, basic definitions of health literacy and digital health literacy are provided, followed by, and matched against digital competence frameworks, and health literacy skills content and scales. Based on that, a compatibility analysis is provided, against the expectations for satisfactory levels definition for the respective competences and skills. For the approbation of the approach, results received from the participation of computing students at the Sofia University St. Kliment Ohridski in the COVID-19 Health Literacy Survey are used.

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

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.

A Web Tool to Help Counter the Spread of Misinformation and Fake News: Pre-Post Study Among Medical Students to Increase Digital Health Literacy.

BACKGROUND: The COVID-19 pandemic was accompanied by the spread of uncontrolled health information and fake news, which also quickly became an infodemic. Emergency communication is a challenge for public health institutions to engage the public during disease outbreaks. Health professionals need a high level of digital health literacy (DHL) to cope with difficulties; therefore, efforts should be made to address this issue starting from undergraduate medical students. OBJECTIVE: The aim of this study was to investigate the DHL skills of Italian medical students and the effectiveness of an informatics course offered by the University of Florence (Italy). This course focuses on assessing the quality of medical information using the "dottoremaeveroche" (DMEVC) web resource offered by the Italian National Federation of Orders of Surgeons and Dentists, and on health information management. METHODS: A pre-post study was conducted at the University of Florence between November and December 2020. First-year medical students participated in a web-based survey before and after attending the informatics course. The DHL level was self-assessed using the eHealth Literacy Scale for Italy (IT-eHEALS) tool and questions about the features and quality of the resources. All responses were rated on a 5-point Likert scale. Change in the perception of skills was assessed using the Wilcoxon test. RESULTS: A total of 341 students participated in the survey at the beginning of the informatics course (women: n=211, 61.9%; mean age 19.8, SD 2.0) and 217 of them (64.2%) completed the survey at the end of the course. At the first assessment, the DHL level was moderate, with a mean total score of the IT-eHEALS of 2.9 (SD 0.9). Students felt confident about finding health-related information on the internet (mean score of 3.4, SD 1.1), whereas they doubted the usefulness of the information they received (mean score of 2.0, SD 1.0). All scores improved significantly in the second assessment. The overall mean score of the IT-eHEALS significantly increased (P<.001) to 4.2 (SD 0.6). The item with the highest score related to recognizing the quality of health information (mean score of 4.5, SD 0.7), whereas confidence in the practical application of the information received remained the lowest (mean of 3.7, SD 1.1) despite improvement. Almost all students (94.5%) valued the DMEVC as an educational tool. CONCLUSIONS: The DMEVC tool was effective in improving medical students' DHL skills. Effective tools and resources such as the DMEVC website should be used in public health communication to facilitate access to validated evidence and understanding of health recommendations.

Advancing digital health Equity: Directions for behavioral and social science research.

The field of digital health is evolving rapidly and encompasses a wide range of complex and changing technologies used to support individual and population health. The COVID-19 pandemic has augmented digital health expansion and significantly changed how digital health technologies are used. To ensure that these technologies do not create or exacerbate existing health disparities, a multi-pronged and comprehensive research approach is needed. In this commentary, we outline five recommendations for behavioral and social science researchers that are critical to promoting digital health equity. These recommendations include: (i) centering equity in research teams and theoretical approaches, (ii) focusing on issues of digital health literacy and engagement, (iii) using methods that elevate perspectives and needs of underserved populations, (iv) ensuring ethical approaches for collecting and using digital health data, and (v) developing strategies for integrating digital health tools within and across systems and settings. Taken together, these recommendations can help advance the science of digital health equity and justice.

The field of digital health is quickly growing and changing. Digital health technologies have the potential to increase access to health-related information and healthcare and improve wellbeing, but it is important that those technologies don't widen existing health disparities or create new ones. Behavioral and social science researchers have a key role to play in centering equity in their research teams and theoretical approaches, focusing on key barriers to access, uptake, and usage, studying digital health in ways that elevate the voices and needs of historically underserved groups, being thoughtful about how digital health data are collected and used, and making sure that digital health tools are designed to be used in real-world settings.

Digital health literacy and subjective wellbeing in the context of COVID-19: A cross-sectional study among university students in Ecuador.

Background: The COVID-19 pandemic has generated an avalanche of information, which, if not properly addressed, generates uncertainty and limits healthy decision-making. On the other hand, the pandemic has exacerbated mental health problems among young people and adolescents, causing a worsening of their wellbeing. Previous studies have found that digital health literacy has a positive impact on people's attitudes toward the disease. This study aimed to analyze the association between digital health literacy on COVID-19 with subjective wellbeing in university students. Methods: A cross-sectional study was developed in 917 students from Ecuador. Subjective wellbeing was measured with the World Health Organization WellBeing Scale. Digital health literacy was assessed using the Spanish-translated version of the Digital Health Literacy Instrument adapted to the context of the COVID-19 pandemic. Bivariate and multivariate linear regressions were performed. Results: Digital health literacy and subjective wellbeing proofed to be significantly higher among males and among students with higher social status. The association between digital health literacy and subjective wellbeing was significant; for each increase of one point in the digital health literacy scale, an average increase of 9.64 points could be observed on the subjective wellbeing scale (IC 95% 5.61 - 13.67, p-value <0.001). This correlation persisted after adjust by demographic and socioeconomic variables. Conclusion: Improving digital health literacy in health would improve the subjective wellbeing of university students. It is suggested strengthen the digital health literacy through public and university policies that promote access, search skills and discernment of digital information. Socioeconomic and gender inequalities related to digital health literacy need to be further investigated.

Digital Health Literacy and Information-Seeking in the Era of COVID-19: Gender Differences Emerged from a Florentine University Experience.

Gender appears to be a strong predictor of online health information-seeking behaviour (OHISB), which is related to Digital Health Literacy (DHL). Gender differences in OHISB have been studied in different countries with different results, but no studies have investigated gender-specific OHISB among University students during the COVID-19 pandemic. We sought to investigate any gender differences in OHISB in the period between the first and second waves of the pandemic in Italian university students. A questionnaire developed by the global COVID-HL network, including existing and adapted validated scales and self-developed scales, was administered to 2996 University students in Florence. Gender differences were tested using the χ2 test or the Mann-Whitney U test. Male students reported a higher score in DHL than females (p < 0.001). However, female students seek COVID-19 information more often on different sources (for themselves and other people), on various topics, consider various aspects of information quality to be "very important'' (p < 0.05) and are more likely to be "often dissatisfied'' or "partly satisfied'' with information (p < 0.001). Our study confirmed gender as an important dimension to explain students' OHISB differences, which could help institutions promote gender-specific education programmes and provide gender-oriented health information.

eHealth Literacy and Patient Portal Use and Attitudes: Cross-sectional Observational Study.

BACKGROUND: Throughout the COVID-19 pandemic, patient portals have become more widely used tools of patient care delivery. However, not all individuals have equivalent access or ability to use patient portals. OBJECTIVE: The aim of this study is to evaluate the relationships between eHealth literacy (eHL) and patient portal awareness, use, and attitudes among hospitalized patients. METHODS: Inpatients completed patient portal surveys; eHL was assessed (eHealth Literacy Scale). Multivariable logistic regression analyses adjusted for age, self-reported race, gender, and educational attainment were completed with significance at P<.006 (Bonferroni correction). RESULTS: Among 274 participants, most identified as Black (n=166, 61%) and female (n=140, 51%), mean age was 56.5 (SD 16.7) years, and 178 (65%) reported some college or higher educational attainment. One-quarter (n=79, 28%) had low eHL (mean 27, SD 9.5), which was associated with lower odds of portal access awareness (odds ratio 0.11, 95% CI 0.05-0.23; P<.001), having ever used portals (odds ratio 0.19, 95% CI 0.10-0.36; P<.001), less perceived usefulness of portals (odds ratio 0.20, 95% CI 0.10-0.38; P=.001), and lower likelihood of planning to use portals in the coming years (odds ratio 0.12, 95% CI 0.06-0.25; P<.001). As time through the COVID-19 pandemic passed, there was a trend toward increased perceived usefulness of patient portals (53% vs 62%, P=.08), but average eHL did not increase through time (P=.81). CONCLUSIONS: Low eHL was associated with less awareness, use, and perceived usefulness of portals. Perceived usefulness of portals likely increased through the COVID-19 pandemic, but patients' eHL did not. Interventions tailored for patients with low eHL could ensure greater equity in health care delivery through the COVID-19 pandemic.

Association of Digital Health Literacy with Future Anxiety as Mediated by Information Satisfaction and Fear of COVID-19: A Pathway Analysis among Taiwanese Students.

Digital Health Literacy (DHL) helps online users with navigating the infodemic and co-existing conspiracy beliefs to avoid mental distress and maintain well-being. We aimed to investigate the association between DHL and future anxiety (FA); and examine the potential mediation roles of information satisfaction and fear of COVID-19 (F-CoV). A web-based cross-sectional survey was carried out among 1631 Taiwanese university students aged 18 years and above from June 2021 to March 2022. Data collected were socio-demographic characteristics (sex, age, social status, university location), information satisfaction, F-CoV, DHL and FA (using Future Dark scale). The linear regression model was used to explore factors associated with FA. The pathway analysis was further used to evaluate the direct and indirect relationship between DHL and FA. A higher score of DHL (B = -0.21; 95% CI, -0.37, -0.06; p = 0.006), and information satisfaction (B = -0.16; 95% CI, -0.24, -0.08; p < 0.001) were associated with a lower FA score, whereas a higher F-CoV score was associated with a higher FA score (B = 0.43; 95% CI, 0.36, 0.50; p < 0.001). DHL showed the direct impact (B = -0.1; 95% CI, -0.17, -0.04; p = 0.002) and indirect impact on FA as mediated by information satisfaction (B = -0.04; 95% CI, -0.06, -0.01; p = 0.002) and F-CoV (B = -0.06, 95% CI, -0.08, -0.04; p < 0.001). Strategic approaches to promote DHL, information satisfaction, lower F-CoV are suggested to reduce FA among students.

Online health information seeking and digital health literacy among information and learning resources undergraduate students.

Background: During the COVID-19 pandemic, students have trouble coping with the available health information regarding the coronavirus in their daily lives because of misinformation. Objectives: The aim of this study was to evaluate online health information seeking and digital health literacy among information and learning resources undergraduate students at Taibah University during the COVID-19 pandemic. Methods: To investigate the primary goal, this study used a simultaneous exploratory mixed methods design. Seventeen students participated in phone interviews, and 306 were invited to complete an online survey. Analysis: The collected data was analyzed using both quantitative (SPSS) and qualitative (NVivo 10) methods. Results: Search engines, social media, and YouTube were most often used by the respondents as sources to search for COVID-19-related information. COVID-19 symptoms, restrictions, and the current spread of COVID-19 were the most searched topics by the respondents. Significant and relevant differences emerged for the digital health literacy subscales "information search" and "adding self-generated content". However, there were no significant differences in the digital health literacy subscale "determining relevance". Conclusion: Using the internet to provide health information tailored to the needs and interests of students to seek health information online and thereby improve their health literacy.

Digital Health Literacy and Covid-19 Vaccine Hesitancy among Different Levels of Education in Malaysia

Introduction: Globally, people who hesitant to receive COVID-19 vaccination were greatly influenced by their knowledge related to health. Therefore, address this knowledge gap, this research aims to evaluate the digital health literacy and vaccine hesitancy towards COVID-19 vaccine among different levels of education in Malaysia. Method(s): A total of 1546 Malaysian participated in this cross-sectional wed based survey. A standardized questionnaire was generated using Google form, and the link was shared through multiple social media platforms. Digital Health Literacy Instrument (DHLI) and WHO's vaccine hesitancy questionnaire were used to evaluate the digital health literacy and vaccine hesitancy towards COVID-19 vaccine among different levels of education in Malaysia. Result(s): Among 1546 participants, 14 participants had clear incomplete data and excluding those age less than 18 years old making a total of participants 1532. Regarding standard deviation and mean of the results, participants classified as pro-vaccine. Multiple predictors were identified that contributed to vaccine hesitancy. This included level of education which leads to various level of digital health literacy. Conclusion(s): In summary, the COVID-19 vaccine hesitancy among the people were basically due to their lack of knowledge or inability to find reliable sources on the internet that cause them to have anxiety towards the vaccination programme. Copyright © 2022, Anka Publishers. All rights reserved.

Infodemic Preparedness and COVID-19: Searching about Public Health and Social Measures Is Associated with Digital Health Literacy in University Students.

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.

Assessing the validity of digital health literacy instrument for secondary school students in Ghana: The polychoric factor analytic approach.

The emergence of the coronavirus pandemic resulted in the heightened need for digital health literacy among the youth of school-going age. Despite the relevance of digital health literacy among the general public (including students), it appears the measurement of digital health literacy is still a challenge among researchers. Recently, Dadackinski and colleagues adapted existing digital health literacy measures to fit the COVID-19 situation. Since this development, the instrument has been widely used with few validation studies with none in Africa and specifically, in Ghana. The purpose of the study was to assess the validity of the digital health literacy instrument (DHLI) for secondary school students in Ghana using the polychoric factor analysis. We sampled 1,392 students from secondary schools in Ghana. The digital health literacy instrument was administered to the respondents, thereof. The study confirmed the four latent structure of the DHLI. Further, sufficient validity evidence was found regarding the construct validity of the DHLI. The findings from the study support the validity of the DHLI and its utility within the Ghanaian context. With the growing need for digital health literacy among younger people globally, the DHLI provides sufficient grounds for scaling them based on their level of literacy. There is a need for the instrument to be adapted and re-validated in Ghana and among different populations to widen its reproducibility.

The COVID-19 pandemic in an interdependent world: Digital health as a tool for equity and gender empowerment

Throughout history, pandemics have paved the way for the development of public health. The current COVID-19 pandemic is no different as it is taking advantage of our flat and interconnected world, posing a threat to global health at a pace as never seen before. This chapter presents an analysis of how digital health and gender empowerment can bridge the inequity gap caused and sustained by disparities related to social determinants of health. COVID-19 has struck certain groups disproportionately;this has increased the need for availability and accessibility of health services. Our findings suggest that COVID-19 is a gender-sensitive virus relying on access to digital health means. Multiple examples and case studies are provided to illustrate the relationship between inequity, gender, and digital health. Moving forward, the pandemic has crystallized the need for paradigm shifts. In this regard, the achievement of equity in health is one of the only ways to control and ultimately eradicate COVID-19 in order to leave no one behind. © 2022 Elsevier Inc. All rights reserved.

Digital Health Literacy: Bibliometric Analysis.

BACKGROUND: Digital health is growing at a rapid pace, and digital health literacy has attracted increasing attention from the academic community. OBJECTIVE: The purposes of this study are to conduct a systematic bibliometric analysis on the field of digital health literacy and to understand the research context and trends in this field. METHODS: Methods: A total of 1955 scientific publications were collected from the Web of Science core collection. Institutional co-operation, journal co-citation, theme bursting, keyword co-occurrence, author co-operation, author co-citation, literature co-citation, and references in the field of digital health literacy were analyzed using the VOSviewer and CiteSpace knowledge mapping tools. RESULTS: The results demonstrate that the United States has the highest number of publications and citations in this field. The University of California System was first in terms of institutional contributions. The Journal of Medical Internet Research led in the number of publications, citations, and co-citations. Research areas of highly cited articles in the field of digital health literacy mainly include the definition and scale of health literacy, health literacy and health outcomes, health literacy and the digital divide, and the influencing factors of health literacy. CONCLUSIONS: We summarized research progress in the field of digital health literacy and reveal the context, trends, and trending topics of digital health literacy research through statistical analysis and network visualization. We found that digital health literacy has a significant potential to improve health outcomes, bridge the digital divide, and reduce health inequalities. Our work can serve as a fundamental reference and directional guide for future research in this field.

Digital health literacy to share COVID-19 related information and associated factors among healthcare providers worked at COVID-19 treatment centers in Amhara region, Ethiopia: A cross-sectional survey.

Background: Coronavirus (CoV) is a novel respiratory virus that can cause severe acute respiratory syndrome (SARS). It affects millions of people in the world and thousands of people in Ethiopia. In responding to this, digital health technologies help to reduce COVID-19 outbreaks by sharing accurate and timely COVID-19 related information. Additionally, digital solutions are used for remote consulting during the pandemic, in creating COVID-19 related awareness, for distribution of the vaccine, and so on. Therefore, this study aimed to assess digital health literacy to share COVID-19 related information and associated factors among healthcare providers who worked at COVID-19 treatment centers in the Amhara region, Northwest Ethiopia. Method: An institutional-based cross-sectional survey was conducted from April 4 to May 4, 2021. The study included 476 healthcare providers who worked at COVID-19 treatment centers in the Amhara region. A pretested, structured self-administered questionnaire was used to collect data. EpiData 4.6 and SPSS version 26 were used for data entry and analysis respectively. Bi-variable and Multivariable logistic regression analysis was used to identify factors associated with the dependent variable. A P-value of less than 0.05 was used to declare statistical significance. Result: A total of 456 respondents were participated in the study, with 95.8% response rate. Digital health literacy to share COVID-19 related information found to be 50.4% (95% CI: 46-55). Educational status [AOR = 4.37, 95% CI(2.08-9.17)], training [AOR = 3.00, 95% CI (1.80-5.00)], attitude [AOR = 1.99, 95% CI(1.18-3.36)], perceived usefulness [AOR = 2.01, 95% CI(1.22-3.32)], perceived ease of use [AOR = 2.00, 95% CI(1.25-3.21)] and smartphone access [AOR = 5.21, 95% CI(2.34-9.62)] were significantly associated with digital health literacy to sharing of COVID-19 related information at P-value less than 0.05. Conclusion: This finding indicated that approximately half of the respondents had digital health literacy to share COVID-19 related information which was inadequate. Improving respondents' educational status, computer training, smartphone access, perceived usefulness, perceived ease of use, and attitude was necessary to measure digital health literacy to sharing of COVID-19 related information.

Validation of the COVID-19 Digital Health Literacy Instrument in the Italian Language: A Cross-Sectional Study of Italian University Students.

The Coronavirus Disease 19 (COVID-19) pandemic and the associated "infodemic" have shown the importance of surveillance and promotion of health literacy, especially for young adults such as university students who use digital media to a very high degree. This study aimed to assess the validity and reliability of the Italian version of the COVID-19 adapted version of the Digital Health Literacy Instrument (DHLI). This cross-sectional study is part of the COVID-19 University Students Survey involving 3985 students from two Italian universities. First, item analysis and internal consistency were assessed. Then, Principal Component Analysis (PCA) and Confirmatory Factor Analyses (CFA) were performed comparing different models. The Italian DHLI showed good psychometric characteristics. The protecting privacy subscale was excluded, given the criticalities presented in the validation process. CFA confirmed the four-factor structure, also including a high-order factor. This result allows using the scale to measure a global level of digital health literacy and consider its levels separately for each construct component: searching the web for information, evaluating reliability, determining personal relevance, and adding self-generated content.

Digital Health Literacy Related to COVID-19: Validation and Implementation of a Questionnaire in Hispanic University Students.

Digital health literacy influences decision-making in health. There are no validated instruments to evaluate the digital literacy about COVID-19 in Spanish-speaking countries. This study aimed to validate the Digital Health Literacy Instrument (DHLI) about COVID-19 adapted to Spanish (COVID-DHLI-Spanish) in university students and to describe its most important results. A cross-sectional study was developed with 2318 university students from Spain, Puerto Rico, and Ecuador. Internal consistency was measured with Cronbach's alpha and principal component analysis. Construct validity was analyzed using Spearman's correlations and the Kruskal-Wallis test. The internal consistency of the questionnaire was good for the global scale (Cronbach's alpha 0.69, 95% CI 0.67) as well as for its dimensions. A total of 51.1% (n = 946) of students had sufficient digital literacy, 40.1% (n = 742) had problematic digital literacy, and 8.8% (n = 162) had inadequate digital literacy. The DHLI was directly and significantly correlated with age, subjective social perception, sense of coherence, and well-being (p < 0.001). The average digital literacy was higher in men than in women, in students older than 22 years, and in those with greater satisfaction with online information (p < 0.001). The COVID-DHLI-Spanish is useful for measuring the digital literacy about COVID-19 in Spanish-speaking countries. This study suggests gaps by gender and socioeconomic perception.