Internet For Health Information Research Articles

노인의 인터넷건강정보추구와 건강문해력이 건강증진행위에 미치는 영향

Objectives This study aimed to identify internet health information seeking behavior, health literacy and factors associated with health promotion behaviors in older adults. Methods Participants included 147 elderly people in community. Data were collected from July 20 to August 19, 2023 using self-reported questionnaires. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, multiple regression. Results There are significant relationships between internet health information seeking behavior and health literacy( r=.40, p<.001), health promotion behavior and health literacy(r=.23, p=.005). In regression analysis, female gender(β=.324, p<.001) and health literacy(β=.241, p=.002) were significant factors affecting health promotion behavior. The regression model was significant(F=13.48, p<.001) and the explanatory power of the model was 14.6%. Conclusions Tailored intervention programs which improve health literacy and adapt to information technology need to be developed for the elderly.

Quality evaluation of internet resources related to breast surgery in major search engines in Korea

Background With the increasing number of internet users, search engines have become a widely used source of health-related information. However, evaluating the quality of medical information obtained through search engines can be challenging. This study aimed to evaluate the quality of search results related to breast implants obtained from major domestic websites in Korea using systematic evaluation standards.Methods Two main primary search terms (“gaseum” [breast] implant and “yubang” [breast] implant), along with 15 adjunct search terms, were combined and searched in Google, Naver, and Daum. The top 20 websites were evaluated and classified according to their type and provider. They were scored using the Korean Medical Association’s Internet Health Information Certification Standards. The proportion of significant websites, their categorical distribution, and the quality of information scores were then compared.Results Google yielded the highest number of appropriate results, with statistical significance. Blogs (36.4%) and news (34.8%) were the most common types of search results, while healthcare provider groups (49.5%) constituted the most common provider subgroup. Only 1.9% of the search results were from public organizations. Google had a significantly higher average quality score (14.04) than Naver (13.22), and Daum (12.45) (P<0.05).Conclusions Although almost half of the search results were provided by medical personnel, their average quality score (13.16) was below the overall average (13.36) and far below the 21 points of the journal/abstract category. The findings highlight the need for healthcare providers to provide high-quality medical information, and for users to develop high-level digital health literacy.

IJCM_417A: Internet health information seeking and its effect on patient-doctor relationship and satisfaction among patients attending a tertiary care hospital in Mangalore

Background: The doctor-patient relationship is a fundamental and essential component of healthcare that plays a critical role in patient outcomes, trust, and overall quality of care. Internet-based health information has been found to have both positive and negative effects on patients. Objectives: To assess the internet health-seeking behaviour among patients, and its effect on the doctor-patient relationship Methodology: In this facility-based cross-sectional study, 110 patients were assessed regarding their internet health-seeking behaviour and its effect on the doctor-patient relationship. Patient-Doctor Depth-of-Relationship Scale and Patient Satisfaction Questionnaire – Short form (PSQ-18) was used to assess the relationship. A comparison of patient satisfaction scores and doctor-patient relationship scores among those who use the internet for seeking health-related information with those who do not was done by independent t-test and P < 0.05 will be considered to be a statistically significant difference. Results: Sixty-seven-point three per cent use the internet for health-related information. Most of the patients felt satisfied with their medical care but there was still some scope of improvement in the domains of communication and the time devoted by the doctor to the patient. The overall level of patient satisfaction was above average. Our study also showed that 77.2% of the study participants had a good relationship with their doctor. Conclusion: In our study, we found that the internet using study participants were found to have an above average satisfaction with their doctors.

Exploring online health information seeking and sharing among older adults: a mini-review about acceptance, potentials, and barriers.

Online health information seeking (OHIS) is understood by health care, health promotion, and disease prevention experts as a resource for healthy aging. It is particularly relevant for older adults since this population can benefit significantly from the accessibility and convenience of online health platforms and health information. Nevertheless, empirical findings regarding the acceptance, potentials, and barriers of OHIS among older adults are limited. This mini-review aims to explore the level of acceptance of OHIS, including passive reading of information and active interactions with peers, among the older population. Furthermore, it examines the potentials and barriers associated with such practices. The findings ultimately emphasize the evolving landscape of internet health information exploration among older adults and the potential advantages and challenges that may arise, especially in the context of active interactions with peers.

The impact of internet health information seeking on COVID-19 vaccination behavior in China

BackgroundAmid the COVID-19 pandemic, the significance of vaccination has been emphatically underscored. As the foremost and pivotal measure for preventing COVID-19 transmission, the COVID-19 pneumonia vaccine plays an instrumental role in the global response to this infectious respiratory disease. However, COVID-19 vaccination coverage remains challenging in low- and middle-income countries and regions. Studies have found that frequent seeking to health information is also associated with healthier behaviors, but these studies have not yet focused on the impact of Internet health information seeking on individual vaccination and the mechanism of this effect.MethodsData were obtained from the Chinese General Social Survey (CGSS) conducted in 2021, which included 7,218 individual samples. This study used COVID-19 vaccination as indicators for the health of interest, the key independent variable is Internet health information seeking. This study tried to analyze the impact of Internet health information seeking on COVID-19 vaccination using an OLS model and PSM method.ResultsThe results show that Internet health information seeking has a significant positive impact on COVID-19 vaccination. This result passed a series of robustness tests. The mechanism analysis indicated that compared to non-Internet health information seeking individuals, Internet health information seeking individuals could know the superior advantages of vaccination and the potential for immunization through this method. And individuals who use Internet to seeking health information are more likely to acknowledge the constructive impact of online information on health behavior. This helps to explain why Internet health information seeking individuals have a higher rate of COVID-19 vaccination.ConclusionsThis study delves into the influence of Internet health information seeking on individual COVID-19 vaccination within the digital era. The outcomes underscore that Internet-mediated seeking vaccine information holds the potential to bolster individuals’ comprehension of vaccination benefits and foster increased acceptance of such information.

Electronic Health Literacy Among Baby Boomers: A Typology.

Forecasts suggest that older adults will place unprecedented demands on future health care systems. Electronic health (eHealth) resources can potentially mitigate some pressures, but to be effective patients need to be able to use them. The negative relationship between eHealth literacy and age usually results in older adults classified as one homogenous mass, which misses the opportunity to tailor interventions. This research examines similarities and differences within the baby boom cohort among a sample that uses the internet for health information. We used an electronic survey with random samples of baby boomers (N = 996) from the United States, the United Kingdom, and New Zealand. Four distinct subgroups, or segments, emerged. While not different from a socioeconomic perspective, these four groups have very different levels of eHealth literacy and corresponding health behaviors. Therefore, we contribute a more complex picture than is usually presented in eHealth studies. Resulting insights offer a useful starting point for providers wishing to better tailor health products, services, and communications to this large cohort of future older individuals. [HLRP: Health Literacy Research and Practice. 2024;8(1):e3-e11.].

The impact of internet health information usage habits on older adults' e-health literacy.

As the demand and supply sides of popular health services increasingly rely on the Internet, mastering e-health literacy should become an essential skill for older adults. The aim of this article is to analyse the effects of Internet health information usage habits on older adults' e- health literacy and to investigate the influencing mechanisms. Using a combination of random sampling and convenient sampling, data were collected through questionnaire surveys. Data from 776 older adults was analysed using correlation and hierarchical regression to analyse. The mean scores for all aspects of older adults' habits of using health information on the Internet and electronic health literacy were relatively high. There was no statistically significant difference in the predictive power of the three aspects of electronic health literacy among older adults with different genders, health statuses, education levels and ages (p > 0.05). The four factors of older adults' habits of using Internet health information can increase the explanatory power of application ability, judgment ability and decision-making ability in Model 2 by 53.7%, 46.2% and 57%, respectively, with statistical significance (p < 0.001). The better the habits of older adults in using health information on the Internet, the higher their level of electronic health literacy. Families, communities and social groups should help older adults use online health resources to improve their e-health literacy. Older adults can use WeChat or other interpersonal information platforms to share online health information with each other.

The Evaluation of the Suitability, Quality, and Readability of Publicly Available Online Resources for the Self-Management of Fear of Cancer Recurrence.

Cancer survivors often rely on the internet for health information, which has varying levels of readability, suitability, and quality. There is a need for high-quality online self-management resources for cancer survivors with fear of cancer recurrence (FCR). This study evaluated the readability, suitability, and quality of publicly available online FCR self-management resources. A Google search using FCR-related keywords identified freely available FCR self-management resources for cancer survivors in English. Resource readability (reading grade level), suitability, and quality were evaluated using relevant assessment tools. Descriptive statistics and cluster analysis identified resources with higher suitability and quality scores. Mean resource (n = 23) readability score was grade 11 (SD = 1.6, Range = 9-14). The mean suitability score was 56.0% (SD = 11.4%, Range = 31.0-76.3%), indicating average suitability and the mean quality score was 53% (SD = 11.7%, Range = 27-80%), indicating fair quality. A cluster of 15 (65%) resources with higher suitability and quality scores was identified. There were no significant associations between suitability or quality scores and the type of organisation that published the resources. Online FCR self-management resources varied in readability, suitability and quality. Resources with higher quality and suitability scores relative to other resources are identified for use by healthcare professionals and cancer survivors. Resources that are more culturally appropriate, with lower reading grade levels and detailed self-management strategies are needed.

Perception and attitude of medical sciences students towards the use of online Internet information in Oman

Background: The trend of seeking medical and health information through the Internet has been continuously increasing among youth population specially college students. The aim of this study was to record the perception and attitude of medical sciences students studying in Oman towards the use of medical and health information on the internet. Methods: A cross sectional study which involved medical sciences students studying in four higher education institutions. The questionnaire was composed of 23 close-ended questions grouped into demographic and students’ perception and attitudes towards medical and health information in the internet. Results: The internet was used as source for medical literature and medical information along with other activities in 71.1% of students and PubMed and Google were used as trusted search engines. The majority of students (96.9%) tend to check the accuracy and reliability of internet medical and health information through searching for particular information in two or more websites. 72.1% of the students believe that the internet offers great potential to meet academic needs and promote learning. The statistical analysis showed a significant statistical correlation (p=0.0001) in certain aspects of the perception and attitude of the participating students towards the utilization of medical and health information on the internet. Conclusion: Although majority of students were trained on utilizing medical and health information during their university education, it seems this exposure varies between the four academic majors. Educational institutions in Oman are encouraged to design their e-health literacy program based on the individual requirements of medical sciences curricula.

Vaccination, health information seeking, and ICT use among Estonians aged 50+ during COVID-19

Abstract Background Vaccination is one of the most effective ways to protect oneself against Coronavirus. However, many people, including older adults, have refused to receive the vaccine. The study aimed to analyze relationships between vaccination intention, socioeconomic indicators, health status, choices in health behavior, health information (HI) seeking, and acceptance of ICTs for health purposes. Methods After the end of the first lockdown in 2020, a cross-sectional survey was conducted among 500 Estonians aged 50 and over. Results More than half (53.5%) of respondents were in favor of vaccination, less than a third (30.5%) were hesitant, and sixteen percent (16%) were opposed. There was a significant correlation between being male and having a higher education level with vaccination readiness. As the respondent felt the need for HI more often and searched the internet for HI more recently, the more likely they were to agree to be vaccinated (rho = .14, p &amp;lt;.05). It was found that vaccination readiness and the need for a digital health application were positively correlated (rho = .25, p .01): the more such an application was needed, the more people agreed to be vaccinated. Uninterested and hesitant respondents used fewer HI sources than those interested in vaccination. Improved health behavior choices did not increase willingness to get vaccinated (e.g., eating healthier and exercising more). Vaccination readiness was also unrelated to health status. Conclusions At least in Estonia, many upper-middle-aged and older people use the internet and smart devices to get HI during a crisis. However, why these people don't make other health-conscious choices should be investigated. Planning health campaigns and vaccinations and/or tackling new health crises should consider the differences between people aged 50 and older. Key messages • In a time of crisis, the internet broadens the range of sources of health information. • It is important for health campaigns to take into account the growing tendency of 50+ people to obtain HI from the internet.

Psychometric validation of the Chinese digital health literacy instrument among Chinese older adults who have internet use experience.

In this digital age, the Internet has become a major source of health information, and electronic health (eHealth) literacy becomes increasingly important for older individuals to properly use the extensive eHealth resources for self-care. A valid and reliable tool for assessing older people's eHealth literacy would help healthcare workers identify those disadvantaged groups in digital health and provide relevant health education. This study aimed to evaluate the psychometric properties of the Chinese version of DHLI in assessing eHealth literacy among older adults in China. A web-based, cross-sectional study was conducted among 277 Chinese older adults from September to November 2021. Two weeks after the first completion, 62 of them answered the C-DHLI again. The reliability (e.g. internal consistency and test-retest reliability), factorial structure and validity (i.e. content validity and convergent validity) of the C-DHLI were evaluated based on the survey data. The results demonstrated good internal consistency (Cronbach's alpha: 0.94) and test-retest reliability (total intraclass correlation coefficient [ICC]: 0.94) of the C-DHLI. Principal component analysis revealed that the 18 items of C-DHLI loaded on three factors, accounting for 74.69% of the total variance; CFA supported its three-factor structure with good model fits. Convergent validity was examined by the significant associations between C-DHLI and C-eHEALS (r = 0.61), health literacy (r = 0.56), and whether having used the Internet for health information (ρ = 0.43) (ps <.001). A cut-off score of 45 was recommended for determining higher and lower literacy using the C-DHLI, with the area under curve of 0.82 (95% CI = 0.77-0.88). The C-DHLI showed good psychometric performance in assessing eHealth literacy among Chinese older adults. The findings can support healthcare professionals to effectively measure eHealth literacy among older adults and conduct tailored eHealth interventions or training.

Pregnancy-Related Information-Seeking Behavior and Information Literacy Profiles of Women at Reproductive Age

ABSTRACT The purpose of this article is to capture pregnancy-related information seeking behavior of women and its correlation with socio-economic status and with Internet health information literacy profiles. A user survey based on Wilson’s’ macro-model of information seeking behavior was designed and carried out. The survey included 289 women at reproductive age who provided valid feedback on information needs, motives for seeking pregnancy-related information online, information resources employed and Internet information literacy. Responses were collected via an anonymous questionnaire and processed using SPSS (Statistical Package for Social Sciences) version 25.0. The results demonstrate that women have increased information needs during pregnancy, that they are primarily concerned about the health of their embryos and that they tend to turn mainly to their doctors, their family and to the Web for obtaining pregnancy-related information. Internet is most used by younger women and online information is generally deemed useful. The analysis of survey responses indicated that pregnancy-related information literacy profiles are influenced by women’s educational status and age. Official online information sources should be made available in Greece, where women could find useful and trusted information about pregnancy issues.

Assessment of Electronic Health Literacy among Patients in an Urban, Academic Radiation Therapy Department

The COVID-19 pandemic dramatically affected health outcomes and healthcare access, especially with the abrupt transition to virtual care. Cancer patients in the New York City borough of the Bronx, a potentially marginalized community with high rates of poverty and non-English speakers, may be particularly vulnerable to healthcare disparities, given their advanced age and possible difficulty navigating telemedicine appointments due to decreased electronic health literacy (EHL). We investigated EHL levels using both subjective and objective measures and associated predictors of EHL in patients within an academic, urban radiation oncology department. We conducted a prospective IRB-approved study of patients aged ≥18 presenting for care in our department. Patients' internet access and established habits were surveyed via Health Information National Trends Survey (HINTS). Subjective EHL, self-reported comfort using the internet for health information, was assessed via the eHealth Literacy Scale (eHEALS), which calculates a score by adding participants' answers for 8 questions (each on a 1 to 5-point Likert scale). Subjective EHL was categorized as low (8-23), moderate (24-31), or good (32-40). Objective EHL was determined by the eHealth Literacy Objective Scale (eHeLiOS), which tests responses to 9 common scenarios on gathering and assessing electronic health information via multiple-choice questions. The numbers of correct answers were totaled and categorized into low (1-4), moderate (5-7), or good (8-9) EHL. Patients were enrolled between December 2020 and December 2022. 56 patients completed the subjective eHEALS assessment, while 49 completed the eHeLiOS objective test. 52% and 27% of patients identified as Black and Hispanic, respectively; 66% were male, and the median age was 67 (range 28-86). 76% reported accessing the internet regularly, of which 92% reported doing so via broadband network. The prevalence of good EHL was 10% using objective and 29% using subjective surveys. Using a proportional odds logistic model, only age was associated with EHL. For every increased year of age, there was an 11% decrease in objective (OR 0.89, p = 0.02) and 5% decrease in subjective (OR 0.95, p = 0.08) EHL odds, respectively. Gender, race/ethnicity, income, insurance, and employment status were not significantly associated with EHL. Few study patients, who represent an older and potentially marginalized population, showed good EHL levels; more perceived good EHL via subjective testing than we observed using our objective measure. These data suggest implementation of an objective EHL assessment would aid in identifying patients who may benefit from learning activities to improve EHL and support to navigate telehealth visits effectively. Further research is needed to optimize telemedicine strategies for older cancer patients with low EHL.

Identifying the Information Needs and Format Preferences for Web-Based Content Among Adults With or Parents of Children With Attention-Deficit/Hyperactivity Disorder: Three-Stage Qualitative Analysis.

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent childhood and adult behavioral disorder. Internet searches for ADHD information are rising, particularly for diagnosis and treatment. Despite effective ADHD treatments, research suggests that there are delays in seeking help for ADHD. Identifying ways to shorten delays is important for minimizing morbidity associated with ADHD. One way to shorten these delays is to improve internet health information resources. Research shows that parents of children with ADHD feel that much of the information available is technical and not tailored for their child's needs and verbal instructions given by health care providers were too pharmacologically focused with limited information about how to manage and support ADHD symptoms in daily living. A majority of parents search the internet for general and pharmacological information for ADHD and prefer web-based resources for learning about ADHD, but web-based resources may be inaccurate and of low quality. Ensuring accurate information through the internet is an important step in assisting parents and adults in making informed decisions about the diagnosis and treatment of ADHD. Although a great deal of information regarding ADHD is available on the internet, some information is not based on scientific evidence or is difficult for stakeholders to understand. Determining gaps in access to accurate ADHD information and stakeholder interest in the type of information desired is important in improving patient engagement with the health care system, but minimal research addresses these needs. This study aims to determine the information needs and formatting needs of web-based content for adults with ADHD and parents of children with ADHD in order to improve user experience and engagement. This was a 3-phase study consisting of in-depth phone interviews about experiences with ADHD and barriers searching for ADHD-related information, focus groups where participants were instructed to consider the pathways by which they made decisions using web-based resources, and observing participants interacting with a newly developed website tailored for adults with potential ADHD and caregivers of children who had or might have ADHD. Phase 1 individual interviews and phase 2 focus groups identified the needs of the ADHD stakeholders related to website content and format. Interview and focus group findings were used to develop a website. Phase 3 used think-aloud interviews to evaluate website usability to inform the tailoring of the website based on user feedback. Interviews and focus group findings revealed preferences for ADHD website information and content, website layout, and information sources. Themes included a preference for destigmatizing information about ADHD, information specific to patient demographics, and evidence-based information tailored to lay audiences. ADHD stakeholders are specifically seeking positive information about ADHD presented in a user-friendly format.

Human Papillomavirus (HPV) and HPV Vaccine Awareness among Korean American Immigrants in Alabama: Would Internet Use Improve Health Awareness?

Although the HPV vaccine is known to prevent associated cancers, studies found a low awareness among Korean Americans (KA). This study aimed to examine the HPV and HPV vaccine awareness among KA in Alabama. A cross-sectional survey was conducted with a convenience sample of 278 KA residing in Alabama to understand the levels of HPV and HPV vaccine awareness and associated factors. Those who heard of HPV were 31.7% and 29.5% for HPV vaccine. Those who were older than 50 years old and married were less likely to hear of HPV and HPV vaccine. Those who were female and had annual health check-ups were more likely to hear of both. Using the Internet for health information was positively associated with HPV vaccine awareness. HPV education tailored to sociodemographic and using the Internet might be an effective strategy in improving the HPV and HPV vaccine awareness levels.

Factors associated with health information technology use in adults recently diagnosed with cancer: NHIS 2012-2017.

e18673 Background: Electronic health information technology (HIT) usage among U.S. adults nearly doubled between 2007 and 2014. HIT utilization has been associated with improvement in health literacy, care coordination, provider access, and quality of care. Despite the positive influence of HIT, disparities regarding its usage exist. Individuals more likely to seek cancer prevention information online are younger, Non-Hispanic White, and highly educated. While individuals diagnosed with cancer are likely to research health information online, limited attention has focused on factors associated with HIT use among adults with cancer. The purpose of this study was to identify sociodemographic, behavioral, and health factors associated with HIT use among adults recently diagnosed with cancer. Methods: A cross-sectional analysis using the National Health Interview Survey (NHIS) 2012-2017 was conducted. Adults diagnosed with cancer within 12 months of taking the survey and reported a response to all five HIT variables (using the internet for health information, scheduling an appointment, using chat rooms for health information, filling a prescription online, and emailing a medical provider) were included (N = 3136). Survey-weighted proportions and 95% confidence intervals (CIs) were estimated for all categorical variables, and survey-weighted means and 95% CIs were estimated for continuous variables. Multiple logistic regression models were used to estimate factors associated with overall and individual HIT use. Results: Among U.S. adults with cancer utilizing HIT (51%), the highest usage was looking up health information online (53.37%) and the lowest usage was seen in using online chat groups to learn about health topics (3.04%). There was a higher prevalence in Non-Hispanic Whites looking up health information on the internet and scheduling an appointment; Asians filling a prescription online; and Non-Hispanic Blacks using online chat groups. For a one-unit increase in the number of non-cancer chronic conditions, the odds of using any HIT decreased by a factor of 0.15; p-value=&lt; 0.0001. After adjusting for covariates, significant factors related to any HIT use were identified in patients that were younger; female; Asian and Non-Hispanic White; and had health insurance, higher education, and higher income. Conclusions: Adults recently diagnosed with cancer are increasingly utilizing the internet to find health information but use varies across subgroups. These data could be utilized to direct future research investigating the influence of certain types of HIT interventions on access to health care.

Perceived and performed electronic health literacy of medical sciences students.

Evidence indicates that perceived skills for searching the Internet for health information may differ from actual skills in searching, finding, and appraising health information. This study investigated the perceived and performed eHealth literacy of medical sciences students, as well as the relationships between those literacies. This study enrolled 228 medical sciences students (convenience sample) in Iran. The study tools include the eHEALS literacy scale for the perceived eHealth literacy and a questionnaire designed by the authors to assess performed eHealth literacy (skills around access, understanding, appraising, applying, and generating information). Data were analysed using descriptive statistics and the Pearson correlation coefficient. In general, over 70% of students perceived their skills of access and appraisal as good/very good, correlating with their estimated performance. Students perceived they were less confident in some appraisal skills (e.g., using information from the Internet to make health decisions) than others. Performed skills in information generation were mostly poor or very good; performed application skills generally good/very good. The eHEALS score scales with actual skills (access and appraisal). Support is necessary for students in particular types of appraisal skills.

AB107. SOH23ABS_014. Acromioclavicular joint reconstruction: an analysis of the readability and quality of online patient information

Background: Currently, patients use the internet for health information relating to surgery. The aim of this study is to assess the readability and quality of online health information relating to acromioclavicular joint reconstruction. We hypothesize that the information will be of poor quality and be too difficult to read for the average patient.

The relationship between depression, anxiety, e-health literacy, and health-promoting behavior in nursing students during COVID-19.

The purpose of this study was to identify the correlation between depression, anxiety, e-health literacy (eHL), and health-promoting behaviors among nursing students during the coronavirus disease 2019 (COVID-19) pandemic, and to identify the factors affecting health-promoting behaviors. A cross-sectional study was conducted online, recruiting 301 nursing students recruited from 4 universities in the Chungcheng Province and Daejeon Metropolitan City in South Korea between May 28 and June 30, 2021. Data were analyzed using SPSS WIN 27.0. The general characteristics of the study participants were analyzed by frequency and percentage, and the degree of depression, anxiety, eHL, and health-promoting behaviors were calculated as averages and standard deviations. Differences in health-promoting behaviors according to general characteristics were analyzed using independent t tests and analysis of variance, and a post hoc Scheffe test was conducted. Correlations between depression, anxiety, eHL, and health-promoting behaviors were measured using Pearson correlation matrices. Stepwise multiple regression was performed to identify factors affecting health-promoting behaviors. During the COVID-19 pandemic, the average level of depression and anxiety was reported to be 3.93 (4.71) and 3.40 (4.30), respectively; 33.2% of nursing students experienced more than mild depression and 29.2% experienced anxiety. The average eHL level was 3.91 (0.56), and the average of health-promoting behaviors was 2.43 (0.45). Depression was positively correlated with anxiety (R = 0.734, P < .001) and negatively correlated with health-promoting behaviors (r = -0.198, P = .001), whereas eHL had a positive correlation with health-promoting behaviors (R = 0.347, P < .001). The factors affecting health-promoting behaviors were religion (β = -0.160, standard error [SE] = 0.048), current health status (β = -0.097, SE = 0.032), frequency of searching the Internet for health-related information in a week (β = -0.070, SE = 0.026), interest in health (β = -0.191, SE = 0.039), and critical eHL (β = 0.243, SE = 0.040); the explanatory power was 27.4%. Results demonstrate that during the COVID-19 pandemic, higher depression and anxiety among nursing students decreased health-promoting behaviors, while higher eHL increased health-promoting behaviors, and eHL was a major factor affecting health-promoting behaviors. These results contribute to the provision of basic data for the development of nursing intervention programs and educational strategies that can establish correct health-promoting behaviors by managing depression and anxiety among nursing students and improving eHL.

The association of electronic health literacy with behavioural and psychological coronary artery disease risk factors in patients after percutaneous coronary intervention: a 12-month follow-up study.

Fundamental roadblocks, such as non-use and low electronic health (eHealth) literacy, prevent the implementation of eHealth resources. The aims were to study internet usage for health information and eHealth literacy in patients after percutaneous coronary intervention (PCI). Further, we aimed to evaluate temporal changes and determine whether the use of the internet to find health information and eHealth literacy were associated with coronary artery disease (CAD) risk factors at the index admission and 12-month follow-up of the same population. This prospective longitudinal study recruited 2924 adult patients with internet access treated by PCI in two Nordic countries. Assessments were made at baseline and 12-month follow-up, including a de novo question Have you used the internet to find information about health?, the eHealth literacy scale, and assessment of clinical, behavioural, and psychological CAD risk factors. Regression analyses were used. Patients' use of the internet for health information and their eHealth literacy were moderate at baseline but significantly lower at 12-month follow-up. Non-users of the internet for health information were more often smokers and had a lower burden of anxiety symptoms. Lower eHealth literacy was associated with a higher burden of depression symptoms at baseline and lower physical activity and being a smoker at baseline and at 12-month follow-up. Non-use of the internet and lower eHealth literacy need to be considered when implementing eHealth resources, as they are associated with behavioural and psychological CAD risk factors. eHealth should therefore be designed and implemented with high-risk CAD patients in mind. ClinicalTrials.gov NCT03810612 https://clinicaltrials.gov/ct2/show/NCT03810612.