A Meta-Analysis of the Relationship Between eHealth Literacy and Health-Promoting Behaviors Among Nursing Students

The increasing integration of digital technologies into healthcare has made eHealth literacy an essential competency for nursing students.This meta-analysis rigorously examined how eHealth literacy is associated with health-promoting behaviors in nursing students, drawing insights from cumulative evidence.A comprehensive search was conducted across four databases (RISS, KISS, DBpia, and PubMed), covering studies published between 2019 and 2024.A total of nine studies, involving 2,604 nursing students, met the inclusion criteria.These studies utilized validated instruments such as the eHEALS (eHealth Literacy Scale, range: 8-40) for measuring eHealth literacy and the HPLP-II (Health-Promoting Lifestyle Profile II, range: 52-208) for assessing health-promoting behaviors.A random-effects model was applied to estimate the pooled effect size, which yielded r = 0.334 (95% CI: 0.327-0.341),reflecting a moderately strong association between eHealth literacy and health-promoting behaviors.Researchers observed moderate heterogeneity (I = 37.5%), indicating some variability among the studies.Subgroup analyses showed that senior students, studies conducted in South Korea, and the use of the full version of eHEALS all exhibited a stronger relationship.The reliability of the results was supported through sensitivity analyses, while the Funnel Plot revealed no evidence of significant publication bias.These results underscore the importance of integrating eHealth literacy training into undergraduate nursing education.By enhancing digital health competencies, nursing students can better manage their health, make informed decisions, and prepare for technology-integrated clinical practice.