E-Health Literacy and General Health Behaviors Among Adolescents: A Transtheoretical Model Approach

Objective: This study aimed to investigate the association between high school students’ eHealth literacy levels and their general health behaviors within the framework of the Transtheoretical Model.Methods: Employing a cross-sectional design, the study was conducted across three high schools during the 2024–2025 academic year. The study included 557 high school students. Data were collected using a Sociodemographic Data Form, the eHealth Literacy Scale for Adolescents, and the TTM-based General Health Behaviors Survey. All statistical procedures, including descriptive analyses, t-tests, ANOVA, and multiple linear regression, were carried out using IBM SPSS Statistics software.Results: The study sample consisted of 557 students, of whom 38.4% were 15 years old and 62.7% were female. eHealth literacy differed significantly by age, gender, perceived mental health, self-rated digital competencies, and daily internet/social media use (p < .05). In multiple linear regression, higher age, better perceived mental health, higher levels of digital competencies (computer and internet skills), and longer daily internet use duration predicted higher eHealth literacy (R² = .13, F (7,549) =11.46, p < .001). In addition, being in more advanced stages of high-fiber food consumption and smoking cessation was associated with higher eHealth literacy, consistent with TTM-based behavior change processes.Conclusion: The results suggest that eHealth literacy is a multidimensional concept influencing health behaviors beyond mere digital access. The Transtheoretical Model proved useful in explaining eHealth literacy. School-based programs especially for disadvantaged students should be tailored to individual needs and promote access to reliable digital health information.