Understanding how digital health literacy affects health self-management behaviors: The mediating role of self-efficacy in college students

This study examines the impact of digital health literacy (DHL) on health self-management behaviors among college students. It determines whether self-efficacy serves as a mediator in the relationship between DHL and health self-management behaviors. A cross-sectional study was conducted among 741 college students selected from five universities in Jiangsu Province, China. Standardized scales were used to collect data on digital health literacy (eHEALS), self-efficacy (GSES), and health self-management behaviors (SRAS). Statistical analyses were conducted using SPSS 26.0, Mplus 7.4, and the PROCESS macro. The study finds that college students' DHL, self-efficacy, and health self-management were at moderate to high levels. With correlation values ranging from 0.468 to 0.624 (P < 0.01), the study found a positive relationship between DHL, self-efficacy, and health self-management. Multiple linear regression analysis showed that health self-assessment status, DHL, and self-efficacy significantly influenced health self-management (F = 123.734, P < 0.001, R² = 0.542). With an indirect impact value of 0.139 (95% bootstrap CI 0.105 to 0.177), self-efficacy plays a crucial mediating role in the relationship between DHL and health self-management. It is recommended that educational institutions cultivate DHL and self-efficacy among college students to promote effective health self-management.