Examining the relationships between e-health literacy, cyberchondria, health anxiety, and health perception among foreign university students.

backgroundThis study aimed to understand the relationship between e-health literacy, health perception, cyberchondria, and health anxiety among foreign university students in Turkey. International students often face unique challenges such as language barriers, cultural differences, and limited familiarity with local healthcare systems, which may lead them to rely more heavily on online health information and shape their responses to health-related uncertainty and stress. Understanding these dynamics is essential from a public health perspective, as this population represents a vulnerable group whose health behaviors and digital engagement have important implications for both individual well-being and broader community health.

methodsA cross-sectional design was used in the study. The sample consisted of 352 foreign students selected through the convenience sampling method. The study data were collected from a university in the Western Black Sea Region in Turkey between June 2024 and November 2024. A serial multiple mediation analysis was applied to examine the direct and indirect effects of health perception on e-health literacy.

resultsThe findings show that health perception positively affects e-health literacy, but cyberchondria and health anxiety have important mediating roles in this relationship. Findings suggest that individuals with negative health perception are more likely to exhibit behaviors such as increased health-related information-seeking, which may be associated with elevated levels of cyberchondria and health anxiety. The serial mediating role of cyberchondria and health anxiety further exacerbates the negative impact of negative health perception on e-health literacy.

conclusionsThe study highlights the complex interplay between psychological factors and digital health behaviors among foreign students. Improving e-health literacy requires addressing health perception and mitigating anxiety-related behaviors. The findings suggest the importance of developing culturally tailored digital health literacy programs to support informed decision-making and reduce vulnerability to online health misinformation.