ArticleFrontiers in public health2026
Critical and interactive digital health literacy and health information adoption among college students: a cross-sectional serial mediation study from a health communication perspective.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Digital media have transformed how college students access, evaluate, and use health information. Although digital health literacy has been linked with risk perception, preventive behavior, self-care, and information seeking, less is known about its association with health information adoption as a downstream stage of digital health communication and the statistical pathways that may account for this association. Objective: This study examined the cross-sectional association between critical and interactive digital health literacy and self-reported health information adoption among college students and estimated the specific indirect associations through health risk perception and exercise self-efficacy, separately and sequentially. Methods: This cross-sectional study used a structured online questionnaire administered in three batches to college students from 12 institutions in Shandong Province, China, between September and November 2025. An independent pilot sample ( Results: Among the 3,148 participants, the mean scores were 30.83 (SD 8.24) for health information adoption, 29.21 (SD 6.25) for critical and interactive digital health literacy, 26.43 (SD 5.86) for health risk perception, and 32.35 (SD 8.17) for exercise self-efficacy. Digital health literacy was positively correlated with health information adoption ( Conclusions: Critical and interactive digital health literacy was positively associated with self-reported health information adoption among college students. Health risk perception and exercise self-efficacy provided separate and serial statistical indirect routes, but the direct association was the largest component and the serial route was comparatively small. Because the data were cross-sectional and self-reported, these estimates should be interpreted as statistical decompositions of associations rather than evidence of temporal or causal mediation.
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