Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 29;23(3):e25042.
doi: 10.2196/25042.

Relationship Between Coronavirus-Related eHealth Literacy and COVID-19 Knowledge, Attitudes, and Practices among US Adults: Web-Based Survey Study

Lawrence An  1   2 , Elizabeth Bacon  1 , Sarah Hawley  1   2   3 , Penny Yang  1 , Daniel Russell  4 , Scott Huffman  4 , Ken Resnicow  1   5
Affiliations

Relationship Between Coronavirus-Related eHealth Literacy and COVID-19 Knowledge, Attitudes, and Practices among US Adults: Web-Based Survey Study

Lawrence An et al. J Med Internet Res. .

Abstract

Background: During a global pandemic, it is critical that the public is able to rapidly acquire new and accurate health information. The internet is a major source of health information. eHealth literacy is the ability of individuals to find, assess, and use health information available on the internet.

Objective: The goals of this study were to assess coronavirus-related eHealth literacy and examine the relationship between eHealth literacy and COVID-19-related knowledge, attitudes, and practices (KAPs).

Methods: We conducted a web-based survey of a representative sample of 1074 US adults. We adapted the 8-item eHealth Literacy Scale to develop the Coronavirus-Related eHealth Literacy Scale (CoV-eHEALS) to measure COVID-19-related knowledge, conspiracy beliefs, and adherence to protective behaviors (eg, wearing facial masks and social distancing). Our analyses identified sociodemographic associations with the participants' CoV-eHEALS scores and an association between the CoV-eHEALS measure and COVID-19 KAPs.

Results: The internal consistency of the adapted CoV-eHEALS measure was high (Cronbach α=.92). The mean score for the CoV-eHEALS was 29.0 (SD 6.1). A total of 29% (306/1074) of the survey participants were classified as having low coronavirus-related eHealth literacy (CoV-eHEALS score <26). Independent associations were found between CoV-eHEALS scores and ethnicity (standardized β=-.083, P=.016 for Black participants) and education level (standardized β=-.151, P=.001 for participants with high-school education or lower). Controlling for demographic characteristics, CoV-eHEALS scores demonstrated positive independent associations with knowledge (standardized β=.168, P<.001) and adherence to protective behaviors (standardized β=.241, P<.001) and a negative association with conspiracy beliefs (standardized β=-.082, P=.009).

Conclusions: This study provides an estimate of coronavirus-related eHealth literacy among US adults. Our findings suggest that a substantial proportion of US adults have low coronavirus-related eHealth literacy and are thus at a greater risk of lower and less-protective COVID-19 KAPs. These findings highlight the need to assess and address eHealth literacy as part of COVID-19 control efforts. Potential strategies include improving the quality of health information about COVID-19 available on the internet, assisting or simplifying web-based search for information about COVID-19, and training to improve general or coronavirus-specific search skills.

Keywords: COVID-19; attitude; behavior; conspiracy beliefs; coronavirus; digital health; eHealth; eHealth literacy; health communication; internet; knowledge; protective behaviors; social distancing; survey.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Number of correct knowledge items by coronavirus-related eHealth literacy.
Figure 2
Figure 2
Number of rejected conspiracy items by coronavirus-related eHealth literacy.
Figure 3
Figure 3
Number of routine protective behaviors by coronavirus-related eHealth literacy.
See this image and copyright information in PMC

References

    1. Brørs G, Norman C, Norekvål TM. Accelerated importance of eHealth literacy in the COVID-19 outbreak and beyond. Eur J Cardiovasc Nurs. 2020 Aug;19(6):458–461. doi: 10.1177/1474515120941307. https://journals.sagepub.com/doi/10.1177/1474515120941307?url_ver=Z39.88... - DOI - PMC - PubMed
    1. Chong Y, Cheng H, Chan H, Chien W, Wong S. COVID-19 pandemic, infodemic and the role of eHealth literacy. Int J Nurs Stud. 2020 Aug;108:103644. doi: 10.1016/j.ijnurstu.2020.103644. http://europepmc.org/abstract/MED/32447127 - DOI - PMC - PubMed
    1. Sentell T, Vamos S, Okan O. Interdisciplinary perspectives on health literacy research around the world: more important than ever in a time of COVID-19. Int J Environ Res Public Health. 2020 Apr 26;17(9):3010. doi: 10.3390/ijerph17093010. https://www.mdpi.com/resolver?pii=ijerph17093010 - DOI - PMC - PubMed
    1. Eysenbach G. How to fight an infodemic: the four pillars of infodemic management. J Med Internet Res. 2020 Jun 29;22(6):e21820. doi: 10.2196/21820. https://www.jmir.org/2020/6/e21820/ - DOI - PMC - PubMed
    1. Coronavirus disease (COVID-19) pandemic. World Health Organization. [2020-10-06]. https://www.who.int/emergencies/diseases/novel-coronavirus-2019.