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Association between social capital, eHealth literacy, and digital health literacy among undergraduate students in China: a multigroup analysis based on gender differences.

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Title: Association between social capital, eHealth literacy, and digital health literacy among undergraduate students in China: a multigroup analysis based on gender differences.
Authors: Fu Y; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Lv D; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Chen R; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Feng K; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Li B; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Li Q; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Qin Z; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Yan S; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Cheng M; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Sun Z; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Huang Y; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Wang J; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Li S; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China., Kong F; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.
Source: Frontiers in public health [Front Public Health] 2026 May 25; Vol. 14, pp. 1839874. Date of Electronic Publication: 2026 May 25 (Print Publication: 2026).
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Frontiers Editorial Office Country of Publication: Switzerland NLM ID: 101616579 Publication Model: eCollection Cited Medium: Internet ISSN: 2296-2565 (Electronic) Linking ISSN: 22962565 NLM ISO Abbreviation: Front Public Health Subsets: MEDLINE
Imprint Name(s): Original Publication: Lausanne : Frontiers Editorial Office
MeSH Terms: Health Literacy*/statistics & numerical data , Students*/statistics & numerical data , Students*/psychology , Social Capital*, Adolescent ; Adult ; Female ; Humans ; Male ; Young Adult ; China ; Digital Health ; Sex Factors ; Surveys and Questionnaires ; Universities ; Information Literacy
Abstract: Purpose: The primary objective of this study was to explore gender differences in the relationships among social capital, eHealth literacy (EHL), and digital health literacy (DHL) among undergraduate students in China, and to support the implementation of the Healthy China and Digital China strategies.
Methods: This study collected 1,151 questionnaires from Chinese undergraduate students through snowball sampling via an online platform. DHL was assessed using the Digital Health Literacy Assessment, EHL was assessed using the eHealth Literacy Scale, and social capital was evaluated using the Chinese Simplified Social Capital Scale. SPSS was used to conduct descriptive statistics, chi-square tests, and independent-sample t-tests. AMOS was used to perform structural equation modeling (SEM) to examine gender differences in the relationships among social capital, DHL, and EHL.
Results: The mean DHL score among undergraduate students was 36.27 ± 7.321 (males: 36.65 ± 7.958; females: 36.08 ± 6.975). Social capital showed a positive correlation with DHL, with a stronger standardized direct effect among males (0.107) than females (0.047), although the gender difference was not statistically significant. EHL was positively associated with DHL, with a stronger effect among males (0.847) than females (0.806). Social capital was positively associated with EHL, with a greater direct effect in males (0.410) than females (0.230). The SEM fitness indices were similar between males and females.
Conclusion: DHL among undergraduate students was comparatively high, with males scoring slightly higher than females. Social capital was positively associated with DHL, with a stronger effect observed among males. EHL was positively associated with DHL in both genders, again with a stronger effect among males. Social capital was positively associated with EHL among both males and females, with a greater effect observed among males. These findings provide implications for strategies aimed at enhancing DHL among undergraduate students in China.
(Copyright © 2026 Fu, Lv, Chen, Feng, Li, Li, Qin, Yan, Cheng, Sun, Huang, Wang, Li and Kong.)
Competing Interests: The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Contributed Indexing: Keywords: digital health literacy; eHealth literacy; gender difference; social capital; undergraduate students
Entry Date(s): Date Created: 20260610 Date Completed: 20260612 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC13243295
DOI: 10.3389/fpubh.2026.1839874
PMID: 42267284
Database: MEDLINE
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  Data: Association between social capital, eHealth literacy, and digital health literacy among undergraduate students in China: a multigroup analysis based on gender differences.
– Name: Author
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  Data: <searchLink fieldCode="AU" term="%22Fu+Y%22">Fu Y</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Lv+D%22">Lv D</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Chen+R%22">Chen R</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Feng+K%22">Feng K</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Li+B%22">Li B</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Li+Q%22">Li Q</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Qin+Z%22">Qin Z</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Yan+S%22">Yan S</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Cheng+M%22">Cheng M</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Sun+Z%22">Sun Z</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Huang+Y%22">Huang Y</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Wang+J%22">Wang J</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Li+S%22">Li S</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.<br /><searchLink fieldCode="AU" term="%22Kong+F%22">Kong F</searchLink>; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, China.; Institute of Health and Elderly Care, Shandong University, Jinan, China.
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  Data: <searchLink fieldCode="JN" term="%22101616579%22">Frontiers in public health</searchLink> [Front Public Health] 2026 May 25; Vol. 14, pp. 1839874. <i>Date of Electronic Publication: </i>2026 May 25 (<i>Print Publication: </i>2026).
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Frontiers+Editorial+Office%22">Frontiers Editorial Office </searchLink><i>Country of Publication: </i>Switzerland <i>NLM ID: </i>101616579 <i>Publication Model: </i>eCollection <i>Cited Medium: </i>Internet <i>ISSN: </i>2296-2565 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2222962565%22">22962565 </searchLink><i>NLM ISO Abbreviation: </i>Front Public Health <i>Subsets: </i>MEDLINE
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  Data: <searchLink fieldCode="MM" term="%22Health+Literacy%22">Health Literacy*</searchLink>/<searchLink fieldCode="MM" term="%22Health+Literacy+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> <br /><searchLink fieldCode="MM" term="%22Students%22">Students*</searchLink>/<searchLink fieldCode="MM" term="%22Students+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> <br /><searchLink fieldCode="MM" term="%22Students%22">Students*</searchLink>/<searchLink fieldCode="MM" term="%22Students+psychology%22">psychology</searchLink> <br /><searchLink fieldCode="MM" term="%22Social+Capital%22">Social Capital*</searchLink><br /><searchLink fieldCode="MH" term="%22Adolescent%22">Adolescent</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Young+Adult%22">Young Adult</searchLink> ; <searchLink fieldCode="MH" term="%22China%22">China</searchLink> ; <searchLink fieldCode="MH" term="%22Digital+Health%22">Digital Health</searchLink> ; <searchLink fieldCode="MH" term="%22Sex+Factors%22">Sex Factors</searchLink> ; <searchLink fieldCode="MH" term="%22Surveys+and+Questionnaires%22">Surveys and Questionnaires</searchLink> ; <searchLink fieldCode="MH" term="%22Universities%22">Universities</searchLink> ; <searchLink fieldCode="MH" term="%22Information+Literacy%22">Information Literacy</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: The primary objective of this study was to explore gender differences in the relationships among social capital, eHealth literacy (EHL), and digital health literacy (DHL) among undergraduate students in China, and to support the implementation of the Healthy China and Digital China strategies.<br />Methods: This study collected 1,151 questionnaires from Chinese undergraduate students through snowball sampling via an online platform. DHL was assessed using the Digital Health Literacy Assessment, EHL was assessed using the eHealth Literacy Scale, and social capital was evaluated using the Chinese Simplified Social Capital Scale. SPSS was used to conduct descriptive statistics, chi-square tests, and independent-sample t-tests. AMOS was used to perform structural equation modeling (SEM) to examine gender differences in the relationships among social capital, DHL, and EHL.<br />Results: The mean DHL score among undergraduate students was 36.27 ± 7.321 (males: 36.65 ± 7.958; females: 36.08 ± 6.975). Social capital showed a positive correlation with DHL, with a stronger standardized direct effect among males (0.107) than females (0.047), although the gender difference was not statistically significant. EHL was positively associated with DHL, with a stronger effect among males (0.847) than females (0.806). Social capital was positively associated with EHL, with a greater direct effect in males (0.410) than females (0.230). The SEM fitness indices were similar between males and females.<br />Conclusion: DHL among undergraduate students was comparatively high, with males scoring slightly higher than females. Social capital was positively associated with DHL, with a stronger effect observed among males. EHL was positively associated with DHL in both genders, again with a stronger effect among males. Social capital was positively associated with EHL among both males and females, with a greater effect observed among males. These findings provide implications for strategies aimed at enhancing DHL among undergraduate students in China.<br /> (Copyright © 2026 Fu, Lv, Chen, Feng, Li, Li, Qin, Yan, Cheng, Sun, Huang, Wang, Li and Kong.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
– Name: Ref
  Label: References
  Group: RefInfo
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  Data: <i>Keywords: </i>digital health literacy; eHealth literacy; gender difference; social capital; undergraduate students
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  Data: <i>Date Created: </i>20260610 <i>Date Completed: </i>20260612 <i>Latest Revision: </i>20260813
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        Value: 10.3389/fpubh.2026.1839874
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        Text: English
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    Subjects:
      – SubjectFull: Adolescent
        Type: general
      – SubjectFull: Adult
        Type: general
      – SubjectFull: Female
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      – SubjectFull: Humans
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      – SubjectFull: Male
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      – SubjectFull: Young Adult
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      – SubjectFull: China
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      – SubjectFull: Surveys and Questionnaires
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      – SubjectFull: Health Literacy statistics & numerical data
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      – SubjectFull: Students statistics & numerical data
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      – SubjectFull: Students psychology
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      – SubjectFull: Social Capital
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    Titles:
      – TitleFull: Association between social capital, eHealth literacy, and digital health literacy among undergraduate students in China: a multigroup analysis based on gender differences.
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              Text: 2026 May 25
              Type: published
              Y: 2026
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            – TitleFull: Frontiers in public health
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