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. 2025 Aug 31;13(1):992.
doi: 10.1186/s40359-025-03189-8.

The effects of self-efficacy and e-health literacy on depressive symptoms in Chinese college students: a cross-sectional survey study

Yaqin Zhong #  1 , Yanan Wang #  1 , Zhuoya Yang  1 , Wenkun Xu  1 , Bingda Yan  2 , Miaomiao Zhao  1 , Rujian Lu  3
Affiliations

The effects of self-efficacy and e-health literacy on depressive symptoms in Chinese college students: a cross-sectional survey study

Yaqin Zhong et al. BMC Psychol. .

Abstract

Background: The number of college students in need of treatment for depressive symptoms far outweighs the resources of most counseling centers due to rising health needs. It is necessary to establish prevention and intervention strategies for college students. This study aimed to explore the associations between self-efficacy, e-health literacy, and depressive symptoms to guide college students in adopting preventive measures and potential interventions for managing depressive symptoms.

Methods: This cross-sectional study randomly recruited 1500 students from two universities in Nantong City from May to December 2020. Participants' demographic characteristics, self-efficacy, e-health literacy, and depressive symptoms were collected. The mediating effect of e-Health literacy was evaluated using the bootstrap resampling technique.

Results: A total of 1388 valid questionnaires were collected. The prevalence of depressive symptoms among the sample was 50.29%. Higher self-efficacy and e-health literacy were all significantly associated with lower depressive symptoms. e-Health literacy partially mediated the association between self-efficacy and depressive symptoms, accounting for 26.6% of the total effect.

Conclusion: Improving self-efficacy and e-health literacy was associated with reducing depressive symptoms, with e-health literacy partially mediating the relationship between self-efficacy and depressive symptoms. Interventions for college students should focus on enhancing both self-efficacy and e-health literacy to help alleviate depressive symptoms.

Keywords: College students; Depressive symptoms; E-Health literacy; Self-efficacy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was received from the Institutional Review Boards at the University of Nantong. All participants gave informed consent before taking part in the study. This study was conducted following the relevant guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The mediating effect of e-health literacy on the relationship between self-efficacy and depressive symptoms. NOTE: c: total effect, c’: direct effect, ɑ:the effect of self-efficacy on e-health literacy, b: the effect of e-health literacy on depressive symptoms, * P < 0.05, ** P < 0.01, *** P < 0.001
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