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Resumo A literacia em saúde (LS) é hoje uma importante ferramenta na promoção da saúde e prevenção da doença. O presente estudo, exploratório e correlacional, tem como objetivos: caracterizar os estudantes do ensino superior (ES) relativamente aos seus níveis de LS e de LS digital (e-LS); explorar suas relações com a utilização de redes sociais e comportamentos de saúde; explorar possíveis preditores de LS e e-LS. Participaram no estudo 125 estudantes de diversos cursos, que responderam a instrumentos de autorrelato. Os resultados mostraram níveis de LS em geral acima dos encontrados na população portuguesa, mas abaixo dos níveis de LS nas faixas etárias em que se inserem esses estudantes. Do total de participantes, 42,9% apresentam valores inadequados ou problemáticos, o que constitui uma oportunidade estratégica para a promoção da LS no contexto do ES. O nível de escolaridade da mãe e o próprio sofrer de uma doença crônica revelaram-se preditores significativos da e-LS. As tecnologias digitais podem ser utilizadas como um adequado meio de promoção da saúde dos estudantes do ES, sendo fundamental a identificação de outros preditores de LS e e-LS. As universidades devem incluir a LS nos seus currículos, num conceito alargado de promoção da saúde no ES.

Abstract Health literacy (HL) is today an important tool in health promotion and disease prevention. This exploratory and correlational study aims to: characterize Higher Education (HE) students in terms of their HL and digital HS (e-HL) levels; explore their relationships with the use of social networks and health behaviors; and explore possible predictors of HL and e-HL. The study included 125 students from different courses, who responded to self-report instruments (e.g., Health Literacy Survey 16; eHealth Literacy Scale). The results showed HL levels in general above those found in the Portuguese population, but below the HL levels in the age groups in which HE students belong. Of the total number of participants, 42.9% have inadequate or problematic values, which constitutes a strategic opportunity for the promotion of HL in the context of HE. The mother's level of education and the fact that the student suffers from a chronic disease proved to be significant predictors of e-HL. Digital technologies can be used as an adequate means of promoting the health of HE students, and it is essential to identify other predictors of HL and e-HL.

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Digital health literacy influences decision-making in health. There are no validated instruments to evaluate the digital literacy about COVID-19 in Spanish-speaking countries. This study aimed to validate the Digital Health Literacy Instrument (DHLI) about COVID-19 adapted to Spanish (COVID-DHLI-Spanish) in university students and to describe its most important results. A cross-sectional study was developed with 2318 university students from Spain, Puerto Rico, and Ecuador. Internal consistency was measured with Cronbach's alpha and principal component analysis. Construct validity was analyzed using Spearman's correlations and the Kruskal−Wallis test. The internal consistency of the questionnaire was good for the global scale (Cronbach's alpha 0.69, 95% CI 0.67) as well as for its dimensions. A total of 51.1% (n = 946) of students had sufficient digital literacy, 40.1% (n = 742) had problematic digital literacy, and 8.8% (n = 162) had inadequate digital literacy. The DHLI was directly and significantly correlated with age, subjective social perception, sense of coherence, and well-being (p < 0.001). The average digital literacy was higher in men than in women, in students older than 22 years, and in those with greater satisfaction with online information (p < 0.001). The COVID-DHLI-Spanish is useful for measuring the digital literacy about COVID-19 in Spanish-speaking countries. This study suggests gaps by gender and socioeconomic perception.

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Background: The COVID-19 pandemic has generated an avalanche of information, which, if not properly addressed, generates uncertainty and limits healthy decision-making. On the other hand, the pandemic has exacerbated mental health problems among young people and adolescents, causing a worsening of their wellbeing. Previous studies have found that digital health literacy has a positive impact on people's attitudes toward the disease. This study aimed to analyze the association between digital health literacy on COVID-19 with subjective wellbeing in university students. Methods: A cross-sectional study was developed in 917 students from Ecuador. Subjective wellbeing was measured with the World Health Organization WellBeing Scale. Digital health literacy was assessed using the Spanish-translated version of the Digital Health Literacy Instrument adapted to the context of the COVID-19 pandemic. Bivariate and multivariate linear regressions were performed. Results: Digital health literacy and subjective wellbeing proofed to be significantly higher among males and among students with higher social status. The association between digital health literacy and subjective wellbeing was significant; for each increase of one point in the digital health literacy scale, an average increase of 9.64 points could be observed on the subjective wellbeing scale (IC 95% 5.61 - 13.67, p-value <0.001). This correlation persisted after adjust by demographic and socioeconomic variables. Conclusion: Improving digital health literacy in health would improve the subjective wellbeing of university students. It is suggested strengthen the digital health literacy through public and university policies that promote access, search skills and discernment of digital information. Socioeconomic and gender inequalities related to digital health literacy need to be further investigated.

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Background: Routine care for prevention and health promotion has reduced significantly due to the Covid-19 pandemic and mandatory social isolation measures. In this context, it is necessary to identify and describe Massive Open Online Courses (MOOCs) that provide opportunities for health education, promotion, and prevention aimed at the general population. The study is a systematic review of MOOCs on health education, health promotion, and prevention for the general population in a pandemic context. Methods: We developed a search for MOOC courses aimed at the general population on health education, health promotion, and prevention in different available MOOC platforms. We executed a descriptive analysis of the main characteristics of the selected MOOCs. Results: There were 117 MOOCs chosen on health education, promotion, and prevention for the general population. Coursera (40.3%) was the platform that offered the highest quantity of MOOCs; more than half of the MOOCs were in English (52.9%). The median (interquartile range) duration of the selected MOOCs was 11 (6-15) hours. The predominant themes were "Health promotion" (43%) and "Food and nutrition" (31%), and the origin was mainly from Europe (37.8%). Conclusions: MOOC offerings in health education are diverse, predominantly in English, of European origin, and in health promotion issues. This study opens an opportunity to multiply initiatives in different territories, considering other languages and topics more akin to each territorial reality, allowing it to be a more equitable learning opportunity in times of pandemic and compulsory social isolation.

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OBJECTIVE: To assess the role of trust when adolescents search for and appraise online health information. STUDY DESIGN: A systematic search of online databases (MEDLINE, EMBASE, PsycINFO, and ERIC) was performed. Google Scholar and reference lists for included studies were manually searched for additional articles. Studies were included if they examined the role of trust when adolescents (in the 13- to 18-year-old age range) searched for and/or appraised online health information. Findings were synthesized using thematic analysis. RESULTS: There were 22 studies that met the inclusion criteria. Four key themes were identified: adolescents generally distrust the Internet but use it anyway (subthemes were why adolescents distrust online health information; why adolescents still use online health information), adolescents use heuristics to appraise the trustworthiness of online health information (subthemes were different heuristics used by different adolescents, range of heuristics used by adolescents), adolescents trust websites more than social media or social networking sites, and adolescents' level of trust in online health information guides their actions and responses. CONCLUSIONS: Adolescents often distrust health information from the Internet, but continue to use it. Adolescents are aware of the need to evaluate the trustworthiness of online health information; however, their approaches vary in sophistication. As the reach and content of the Internet expands, it is important to equip adolescents with effective eHealth literacy to assess the trustworthiness of online health information.

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OBJECTIVE: To conduct a systematic review of the evidence concerning whether and how adolescents search for online health information and the extent to which they appraise the credibility of information they retrieve. STUDY DESIGN: A systematic search of online databases (MEDLINE, EMBASE, PsycINFO, ERIC) was performed. Reference lists of included papers were searched manually for additional articles. Included were studies on whether and how adolescents searched for and appraised online health information, where adolescent participants were aged 13-18 years. Thematic analysis was used to synthesize the findings. RESULTS: Thirty-four studies met the inclusion criteria. In line with the research questions, 2 key concepts were identified within the papers: whether and how adolescents search for online health information, and the extent to which adolescents appraise online health information. Four themes were identified regarding whether and how adolescents search for online health information: use of search engines, difficulties in selecting appropriate search strings, barriers to searching, and absence of searching. Four themes emerged concerning the extent to which adolescents appraise the credibility of online health information: evaluation based on Web site name and reputation, evaluation based on first impression of Web site, evaluation of Web site content, and absence of a sophisticated appraisal strategy. CONCLUSIONS: Adolescents are aware of the varying quality of online health information. Strategies used by individuals for searching and appraising online health information differ in their sophistication. It is important to develop resources to enhance search and appraisal skills and to collaborate with adolescents to ensure that such resources are appropriate for them.

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