eHealth literacy and health-related quality of life: associations between eHEALS, EQ-5D-5L and health behaviours in a cross-sectional population survey

Abstract

Abstract eHealth literacy has been been seen as an influencing factor of population health, while supporting evidence is mixed. We aimed to explore the association between eHealth literacy and health-related quality of life, with focus on the mediating effect of health behaviours and subgroup differences concerning health status and sociodemographic characteristics. We conducted a cross-sectional online survey in Hungary (N=1000) recording the eHealth literacy scale (eHEALS), EQ-5D-5L, lifestyle-related risks, perception of subjective lifestyle and health information seeking activity. Data were analysed via consistent partial-least squares structural equation modelling (cPLS-SEM). eHEALS had a small indirect effect on EQ-5D-5L (standardised b =0.031, p=0.002), mediated by subjective lifestyle (i.e., one perceives his/her lifestyle as healthier than others), but no direct or indirect effect via lifestyle-related risks of health information seeking. The association between lifestyle-related risks and eHEALS score was weak and fully mediated by health information seeking in the full sample (b =-0.035, p=0.009), but there was strong direct association between the eHEALS score and fewer lifestyle risks in respondents with poor health (EQ-5D-5L < 0.67; b =-0.294, p=0.040). Our findings provide clues for provide clues for public health strategies aiming to improve eHealth literacy in the general population.