Digital health literacy and online information seeking in times of COVID-19. A cross-sectional survey among university students in Germany.

BACKGROUND Digital communication technologies play an important role in governments' and public health authorities' health communication strategies during the COVID-19 pandemic. The internet and social media have become important sources of health-related information on the coronavirus and on protective behaviours. In addition, the COVID-19 infodemic spreads faster than the coronavirus itself, which interferes with governmental health-related communication efforts. This puts national public health containment strategies in jeopardy. Therefore, digital health literacy is a key competence to navigate coronavirus-related information and service environments. OBJECTIVE This study aimed to investigate university students' digital health literacy and online information seeking behaviours during the early stages of the coronavirus pandemic in Germany. METHODS A cross-sectional study among N=14,916 university students aged ≥18 from 130 universities across all sixteen federal states of Germany was conducted using an online survey. Along with sociodemographic characteristics (sex, age, subjective social status) measures included five subscales from the Digital Health Literacy Instrument (DHLI), which was adapted to the specific coronavirus context. Online information seeking behaviour was investigated by examining the online sources used by university students and the topics that students search for in connection with the coronavirus. Data were analysed using univariate and bivariate analyses. RESULTS Across digital health literacy dimensions, the greatest difficulties could be found for assessing the reliability of health-related information (42.3%) and the ability to determine whether the information was written with commercial interest (38.9%). Moreover, respondents also indicated that they most frequently have problems finding the information they are looking for (30.4%). When stratified according to sociodemographic characteristics, significant differences were found with female university students reporting a lower DHLI for the dimensions of 'information searching' and of 'evaluating reliability'. Search engines, news portals and public bodies' websites were most often used by the respondents as sources to search for information on COVID-19 and related issues. Female students were found to use social media and health portals more frequently, while male students used Wikipedia and other online encyclopaedias as well as YouTube more often. The use of social media was associated with a low ability to critically evaluate information, while opposite differences were observed for the use of public websites. CONCLUSIONS Although digital health literacy is, in summary, well developed in university students, a significant proportion of students still face difficulties with certain abilities to deal with information. There is need to strengthen the digital health literacy capacities of university students using tailored interventions. Improving the quality of health-related information on the internet is also key. CLINICALTRIAL