The relationship between electronic health literacy and healthy lifestyle behaviors among first-year university students in Gorgan, Iran: A cross-sectional study

The global rise in non-communicable diseases has underscored the importance of adopting healthy lifestyle behaviors, particularly among youth. In parallel, the digital transformation of health information access has made electronic health literacy a critical determinant of health outcomes. University students, as digitally connected and developmentally vulnerable individuals, represent a strategic population for health promotion interventions. This study aimed to examine the relationship between electronic health literacy and healthy lifestyle behaviors among first-year undergraduate students in selected universities in Gorgan, Iran. A cross-sectional study was conducted in 2024 involving 191 students selected through stratified random sampling. Data were collected using three validated instruments: a demographic questionnaire, the electronic health literacy scale, and the healthy lifestyle scale for university students. The mean electronic health literacy score was 26.16 (SD=5.52), and the mean healthy lifestyle behavior score was 142.96 (SD=18.67), indicating favorable levels of these two constructs among the participants. A significant positive correlation was observed between electronic health literacy and healthy lifestyle behaviors (r=0.485, P<0.001), with electronic health literacy explaining 23.5% of the variance in healthy lifestyle behavior scores. Multiple linear regression analysis identified electronic health literacy, academic discipline, and income level as significant factors associated with healthy lifestyle behaviors; students from non-medical disciplines and those with higher socioeconomic status reported healthier lifestyle behaviors. Higher electronic health literacy is associated with healthier lifestyle behaviors among university students. These findings highlight the need for targeted digital health education and institutional support to enhance health outcomes in young adults. Integrating electronic health literacy into university curricula may be a cost-effective strategy to promote lifelong wellness and reduce the burden of lifestyle-related diseases.