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Cited by 17Health Literacy and Information AccessibilityDigital literacy in educationSocial Media in Health Education

Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India

Open access
Ishikawa, Hirono, Miyawaki, Rina, Kato, Mio, Muilenburg, Jessica Legge, Tomar, Yuki Azaad, Kawamura, Yoko·2025·SSM - Population Health
DOI 10.1016/j.ssmph.2025.101844PMC PMC12311546
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Abstract

The rapid expansion of the Internet and social media has transformed health communication, highlighting the critical importance for digital health literacy - particularly during the "infodemics" of the COVID-19 pandemic. This study examined digital health literacy and online health information-seeking behaviors among university students - the digital native generation - in Japan, the United States, and India. A cross-national comparison across these culturally and technologically diverse countries provides insights into global variations in digital health literacy. An online survey was administered to 1500 undergraduate students (500 per country) using the Digital Health Literacy Instrument (DHLI) to evaluate their ability in utilizing digital health information. DHLI scores were compared across countries, and associated factors were analyzed. The mean age of participants was 20.6 years. DHLI scores were significantly higher in the US (3.10 ± 0.38) than in India (2.94 ± 0.38) and Japan (2.89 ± 0.42). While students generally demonstrated strong operational skills, many lacked sufficient ability to critically evaluate information and contribute self-generated content, indicating the need for targeted educational support. Importantly, trust in online health information sources, rather than mere usage, was strongly associated with higher DHLI scores. These findings highlight the importance of enhancing individual skills in identifying credible sources and increasing the availability of trustworthy digital health content, particularly from public agencies and official social media platforms. Future research should explore cultural and systemic factors underlying cross-country differences to inform targeted strategies for improving digital health literacy globally.

AI snapshot

Written from the paper’s full text.

TL;DR

A cross-national online survey of 1,500 undergraduate students in Japan, the US, and India found the highest digital health literacy in the US, lowest in Japan, and intermediate in India. Trust in online health information sources, rather than mere use, was strongly associated with higher digital health literacy.

Key findings

  • DHLI-total mean was 2.98 (SD = 0.40); US students scored highest (3.10 ± 0.38), followed by India (2.94 ± 0.38) and Japan (2.89 ± 0.42), with significant country differences (p < 0.001). On the 12-item DHLI-12, means were US 3.06, India 2.89, and Japan 2.72 (p < 0.001).
  • Operational skills scored highest (3.37), while evaluating reliability (2.82) and adding self-generated content (2.85) were lower; protecting privacy did not differ significantly by country (3.04, p = 0.506).
  • Trust in each information source was associated with higher DHLI scores. In multiple regression, trust in both news websites and social media had B = 0.293 (p < 0.001), and trust in news websites only had B = 0.136 (p < 0.001); use of online sources per se was not significantly associated overall.
  • Country-stratified analyses showed US (B = 0.279) and India (B = 0.104) students had higher DHLI than Japan; male gender and higher subjective social status were positively associated overall, and social media use was positively associated with DHLI only in the US while tending negative in India.

Methods

  • Online survey of 1,500 undergraduate students (500 each from Japan, the US, and India), recruited from Ipsos survey panels between September 9 and 15, 2022; health-related majors were excluded.
  • Digital health literacy was measured with the Digital Health Literacy Instrument (DHLI), including seven subscales; analyses used DHLI-total and a 12-item DHLI-12 based on four subscales (Cronbach’s α = 0.88). Use of and trust in health/medical news sources and sociodemographic factors were also measured.
  • One-way ANOVA with Bonferroni comparisons, t-tests, and multiple regression analyses stratified by country were conducted using STATA 18.0; p < 0.05 was significant.

Limitations

  • Stated by the authors: participants came from a commercial survey panel, excluding those uninterested in such surveys; 500 per country may not be generalizable; online questionnaires require basic digital literacy; DHLI is self-report and may reflect perceptions rather than objective ability; and the cross-sectional design limits causal inference.
  • Evident from the text: the 12-item DHLI-12 was used because navigation and protecting privacy subscales had low reliability (Cronbach’s α = 0.55 and 0.57, respectively); participants identifying as “other” gender were treated as missing in the final regression; and country differences may be shaped by differing tertiary enrollment rates (about 65% Japan, 79% US, 33% India) and availability of official health information, as discussed by the authors.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.ssmph.2025.101844

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

28 of 37 cited sources checked · 19 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    Previous studies during the COVID-19 pandemic reported that a significant proportion of university students faced difficulties with assessing the reliability of online health-related information.

    “However, previous studies during the COVID-19 pandemic reported that a significant proportion of university students faced difficulties with assessing the reliability of online health-related information (Dadaczynski et al., 2021; Frings et al., 2022).”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites Dadaczynski et al., 2021 source
    • cites Frings et al., 2022 source
  • Findingcitation

    The mean score for the "protecting privacy" subscale (3.04) was somewhat lower than those reported in previous studies conducted with the general population (3.58, 3.31, and 3.52).

    “However, the mean score for this subscale (3.04) was somewhat lower than those reported in previous studies conducted with the general population (3.58, 3.31, and 3.52 in previous studies) (Mitsutake et al., 2024; Miyawaki et al., 2024; van der Vaart & Drossaert, 2017).”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites Mitsutake et al., 2024 source

      Table 2 in the Results reports a mean privacy-protection score of 3.42 for this study’s participants, which is higher than the citing paper’s 3.04. It does not support attributing any of the stated comparison scores (3.58, 3.31, or 3.52) to Mitsutake et al.; the other cited studies cannot be judged from this source. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites Miyawaki et al., 2024 source
    • cites van der Vaart & Drossaert, 2017 source
  • Findingcitation

    Japanese students' DHLI scores were generally lower than those reported in previous studies with the Japanese general population.

    “Given that the DHLI scores for Japanese students were generally lower than those reported in previous studies with the Japanese general population (Mitsutake et al., 2024; Miyawaki et al., 2024), educational programs to improve students' ability to utilize health information online might be essential in the university curriculum.”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Mitsutake et al., 2024 source
    • cites Miyawaki et al., 2024 source
  • Premisecitation

    The readability of online health information is often far above the recommended readability level.

    “However, the readability of online health information is often far above the recommended readability level (Daraz et al., 2018; Valizadeh-Haghi et al., 2021).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Daraz et al., 2018 source
    • cites Valizadeh-Haghi et al., 2021 source
  • Premisecitation

    Individual health literacy skills are influenced by culture and society, the educational system, and the health system.

    “Individual health literacy skills are influenced by culture and society, the educational system, and the health system (Parker & Ratzan, 2010).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Parker & Ratzan, 2010 source
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 11
  • The quote only partly states this claim. 1

  • May combine two claims.

    Study design and conductcitation

    Digital health literacy was measured with the DHLI, which was originally developed in English and has been translated and validated in Japanese.

    “Digital health literacy was measured with Digital Health Literacy Instrument (DHLI) which was originally developed in English (van der Vaart & Drossaert, 2017) and has been translated and validated in Japanese (Miyawaki et al., 2024).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites van der Vaart & Drossaert, 2017 source

      The Methods section (Development of the Digital Health Literacy Instrument; page unavailable) says the authors formulated the DHLI items in Dutch and then translated the instrument into English. This contradicts the claim attached to this citation that it was originally developed in English. The Japanese translation is attributed to a different citation and is not assessed here. (LLM, conf=0.92)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites Miyawaki et al., 2024 source

  • Classified as probably not a substantial claim.

    Premisecitation

    Previous studies suggested that those with higher digital health literacy were more likely to use reliable information sources such as websites of public institutions.

    “Previous studies suggested that those with higher digital health literacy were more likely to use reliable information sources such as websites of public institutions (Bak et al., 2022; Htay et al., 2022; Mitsutake et al., 2024; Vrdelja et al., 2021).”
    Quote in the paperSubstantial claim3 of 3 sources checked
    • cites Bak et al., 2022 source

      The Results (§3.1; page unavailable) report that students with sufficient digital health literacy used social media less, although the difference was practically negligible. They also report that public-body websites were commonly used, but do not show that students with higher literacy were more likely to use those websites or other reliable sources. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites Htay et al., 2022 source
    • cites Mitsutake et al., 2024 source

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Participants majoring in health-related fields were excluded because pursuing health-related careers would affect health literacy and health information-seeking behaviors.

    “The screening questions were designed to include only undergraduate students and to exclude those majoring in health-related fields, such as medicine, nursing, and social work, given that pursuing health-related careers would affect health literacy and health information-seeking behaviors (Frings et al., 2022; Zhao et al., 2024).”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites Frings et al., 2022 source

      The Discussion reports that health students differed from non-health students in where they sought health information. But the study found no higher digital health literacy among health students; it describes higher health literacy as an expectation or a finding from other studies, not an effect established by its own results. The decision to exclude health-related majors belongs to the citing study, not Frings et al. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites Zhao et al., 2024 source

      The Abstract Results report higher digital health literacy scores for medical than nonmedical students, and the Discussion (Mental health and DHL) describes a difference in how students seek health information. These passages support the concern that the groups may differ, but the paper does not establish that pursuing a health-related career causes those differences. The screening decision belongs to the citing authors, not Zhao et al. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Premisecitation

    Previous international collaborative research indicated that the proportion of the population with inadequate level of health literacy varied by country.

    “Previous international collaborative research explored the differences and similarities in general health literacy of adults in European countries (Sorensen et al., 2015) and in Asian countries (Duong et al., 2017), indicating that the proportion of the population with inadequate level of health literacy varied by country.”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites Sorensen et al., 2015 source
    • cites Duong et al., 2017 source

      The Results (Table 1) report different mean general health-literacy scores across the six Asian country samples, supporting the claim of cross-country variation. The paper does not report the proportion classified as having inadequate health literacy, and the Discussion (Limitations) cautions that most samples should not be treated as nationally representative. (LLM, conf=0.83)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous research has demonstrated associations between socioeconomic status and digital health literacy.

    “Subjective social status was positively associated with DHLI scores, which was consistent with previous research that has demonstrated associations between general health literacy and socioeconomic status (Duong et al., 2017; Ishikawa et al., 2023; Sorensen et al., 2015), as well as between socioeconomic status and digital health literacy (Estrela et al., 2023; Jiang et al., 2025).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Estrela et al., 2023 source
    • cites Jiang et al., 2025 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous studies have reported mixed findings regarding the association between gender and digital health literacy.

    “While previous studies have reported mixed findings regarding the association between gender and digital health literacy (Estrela et al., 2023; Jiang et al., 2025), male students exhibited higher DHLI scores in our total sample.”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Estrela et al., 2023 source
    • cites Jiang et al., 2025 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous research has demonstrated associations between general health literacy and socioeconomic status.

    “Subjective social status was positively associated with DHLI scores, which was consistent with previous research that has demonstrated associations between general health literacy and socioeconomic status (Duong et al., 2017; Ishikawa et al., 2023; Sorensen et al., 2015), as well as between socioeconomic status and digital health literacy (Estrela et al., 2023; Jiang et al., 2025).”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites Duong et al., 2017 source
    • cites Ishikawa et al., 2023 source
    • cites Sorensen et al., 2015 source

  • May combine two claims.

    Interpretationcitation

    Trust in news websites and social media was lower in Japan partly because trustworthy online sources of health information were less available in the Japanese language due to the lack of reliable health information websites from public agencies.

    “This may be partly because trustworthy online sources of health information were less available in the Japanese language due to the lack of reliable health information websites from public agencies (Nakayama et al., 2015).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Nakayama et al., 2015 source

  • May combine two claims.

    Findingown data

    Trust in news websites, as well as trust in both news websites and social media, was positively associated with higher digital health literacy.

    “In contrast, trust in news websites, as well as trust in both news websites and social media, was positively associated with higher digital health literacy.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The differences between countries were statistically significant for the 12-item total scale and the subscales of information searching, evaluating reliability, determining relevance, and adding self-generated content.

    “The differences were statistically significant for the 12-item total scale and the subscales of information searching, evaluating reliability, determining relevance, and adding self-generated content.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The survey panel participants are representative of undergraduate students in Japan, the US, and India.
    • Rests on an assumption: The DHLI measures digital health literacy comparably across Japanese, US, and Indian university students.

  • May combine two claims.

    Findingown data

    The proportion of those who trust each information source was generally lower in Japan and higher in India.

    “The proportion of those who trust each information source was generally lower in Japan and higher in India.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The survey panel participants are representative of undergraduate students in Japan, the US, and India.

  • May combine two claims.

    Findingown data

    In Japan and the US, the proportion of those who used television was the highest (59.4% and 54.6%, respectively), while social media was used most in India (62.4%).

    “In Japan and the US, the proportion of those who used television was the highest (59.4 % and 54.6 %, respectively), while social media was used most in India (62.4 %).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The survey panel participants are representative of undergraduate students in Japan, the US, and India.

  • The quote only partly states this claim.

    Findingown data

    Among the 1500 undergraduate students surveyed in Japan, the US, and India, the mean DHLI-total score was 2.98 (SD = 0.40).

    “The mean score of the DHLI-total was 2.98 (SD = 0.40), as displayed in Table 2.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Male students and higher subjective social status were positively associated with digital health literacy.

    “Male students and higher subjective social status were positively associated with digital health literacy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    The DHLI scores were highest in the United States, lowest in Japan, and intermediate in India.

    “The DHLI scores were highest in the US, lowest in Japan, and intermediate in India.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Television, news websites, and social media were the most commonly used sources for health and medical news, with variations across countries.

    “The study found that television, news websites, and social media were the most commonly used sources for health and medical news, with variations across countries.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Students had limited ability to critically evaluate information and contribute self-generated content.

    “While students generally demonstrated strong operational skills, their limited ability to critically evaluate information and contribute self-generated content underscores the need for targeted educational interventions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was approved by the Institutional Review Board of the University of Occupational and Environmental Health, Japan (Project number R4-023).

    “This study was approved by the Institutional Review Board of the University of Occupational and Environmental Health, Japan (Project number R4-023).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Students generally demonstrated strong operational skills but many lacked sufficient ability to critically evaluate information and contribute self-generated content.

    “While students generally demonstrated strong operational skills, many lacked sufficient ability to critically evaluate information and contribute self-generated content, indicating the need for targeted educational support.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Digital health literacy is critical for young people to utilize health information to maintain and improve their health.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Subjective social status was measured using a question about five strata, a type of assessment widely used and shown to correlate with objective indicators such as household income.

    “Subjective social status was measured using the question, “If Japanese/US/Indian society were divided into five strata, which stratum do you suppose your household would belong to?””
    • Also stated in: § Measurements · plain
      “It has also been shown to correlate with objective indicators of social status, such as household income (Sakurai et al., 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sakurai et al., 2010 source

  • May combine two claims.

    Study design and conductnone given

    Online questionnaires require at least a basic level of digital literacy, which may have biased the results.

    “Third, online questionnaires require at least a basic level of digital literacy, which may have biased the results.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    The responses represent the participants' perceptions and may differ from their objective ability.

    “The responses represent the participants' perceptions and may differ from their objective ability.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The tertiary school enrollment rate is around 65% in Japan, 79% in the United States, and 33% in India.

    “The tertiary school enrollment rate is around 65 % in Japan and 79 % in the US, whereas 33 % in India (https://data.worldbank.org/), suggesting that most university students in India are likely to come from the upper class in society.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites https://data.worldbank.org/

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Because of the cross-sectional design of the study, causality should be discussed with caution.

    “Fifth, because of the cross-sectional design of the study, causality should be discussed with caution.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    The sample size was 500 from each country, which may not be sufficient to generalize the study results.

    “Second, the sample size was 500 from each country, which may not be sufficient to generalize the study results.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Digital health literacy was measured using self-report items.

    “Fourth, digital health literacy was measured using self-report items.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Among 18-29-year-olds in the United States and Japan, internet usage is close to 100%, and among university students in India, it is 93%.

    “However, at least among 18-29-year-olds in the US and Japan, internet usage is close to 100 %, and among university students in India, it is 93 % (Eduljee et al., 2021).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Eduljee et al., 2021

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Access to online health information alone is not sufficient to improve digital health literacy; rather, the availability and accessibility of trustworthy digital health content-shaped by national health communication strategies-play a critical role and may differ across countries.

    “Our findings suggest that access to online health information alone is not sufficient to improve digital health literacy; rather, the availability and accessibility of trustworthy digital health content—shaped by national health communication strategies—play a critical role and may differ across countries.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Public agency websites and official social media can provide more evidence-based, reliable information from experts, making them more trustworthy and the recipient less concerned about the reliability of the information.
28 of 28

  • The paper relies on this without support.

    Few studies have examined digital health literacy outside the context of the COVID-19 pandemic and differences in digital health literacy across cultural backgrounds.

    “However, few studies have examined digital health literacy outside the context of the COVID-19 pandemic and differences in digital health literacy across cultural backgrounds.”

  • The paper relies on this without support.

    Digital health literacy is critical for young people to utilize health information to maintain and improve their health.

    “Digital health literacy, which includes the ability to search, find, understand, and evaluate health information from electronic resources and to use the knowledge gained to solve health-related problems, is critical for young people to utilize health information to maintain and improve their health.”

  • The paper relies on this without support.

    Health literacy plays a crucial role in shaping individuals' trust in health information sources, particularly in the digital age.

    “Health literacy plays a crucial role in shaping individuals' trust in health information sources, particularly in the digital age, where vast amounts of health-related content are readily accessible online.”

  • The paper relies on this without support.

    The survey panel participants are representative of undergraduate students in Japan, the US, and India.

    “The participants were recruited from the survey panels of a global research company (https://www.ipsos.com), 500 students each from the three countries.”

  • The paper relies on this without support.

    The DHLI measures digital health literacy comparably across Japanese, US, and Indian university students.

    “Questionnaire surveys were conducted in English in the US and India and Japanese in Japan.”

  • The paper relies on this without support.

    Public agency websites and official social media can provide more evidence-based, reliable information from experts, making them more trustworthy and the recipient less concerned about the reliability of the information.

    “Public agency websites and official social media can provide more evidence-based, reliable information from experts, making them more trustworthy and the recipient less concerned about the reliability of the information.”

  • The paper relies on this without support.

    In the United States, public health agencies such as the Centers for Disease Control and Prevention actively utilize multiple platforms to disseminate timely, evidence-based information and to combat misinformation.

    “In the US, public health agencies such as the Centers for Disease Control and Prevention (CDC) actively utilize multiple platforms to disseminate timely, evidence-based information and to combat misinformation.”

  • The paper relies on this without support.

    Digital health literacy comprises both general health literacy and digital skills.

    “Digital health literacy comprises both general health literacy and digital skills.”
8 of 8

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Newspaper-use country counts do not match the total

    Minor

    The three country counts for students who used newspapers sum to 299, not the reported total of 389.

    Reported 389 · recomputed 299

  • Television-use country counts do not match the total

    Minor

    The three country counts for students who used television sum to 864, not the reported total of 764.

    Reported 764 · recomputed 864

  • Japanese students used news websites more than US students

    Minor

    The discussion says US and Indian students were more active users of each information source than Japanese students, but Table 3 reports higher news-website use in Japan than in the US (41.4% versus 38.2%).

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Eduljee, 2021, Vol. 16, 1

Cited by

Sorted by citations

Related

Authors
Ishikawa, H., Miyawaki, R., Kato, M., Muilenburg, J. L., Tomar, Y. A., & Kawamura, Y.
Affiliations
  • Teikyo University (JP)
  • Meiji University (JP)
  • Japan Institute for Health Security (JP)
  • University of Georgia (US)
  • University of Delhi (IN)
  • University of Occupational and Environmental Health Japan (JP)
Corresponding author
Ishikawa, Hirono
ORCID
Venue
SSM - Population Health
Publisher
Elsevier BV
Published
2025-09
Volume
31
Pages
101844
ISSN
2352-8273 (ISSN-L)
DOI
10.1016/j.ssmph.2025.101844
PMC
PMC12311546
OpenAlex
W4412496137
Semantic Scholar
8746753fe334173f9eab5a0a45a2b19f5d3169b5
Cited by
17
References
31
Citations by year
2026: 15 · 2025: 2
FWCI
21.45
Type
journal article
Language
en
Open access
Licence
Locations
  • SSM - Population Health (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Institutional Repositories DataBase (IRDB) (submittedVersion)
Funders
  • Public Interest Incorporated Foundation Pfizer Health Research Foundation (21-K05)
  • Japan Society for the Promotion of Science (20H03919, 25K02857)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Physical Sciences › Computer Science › Information Systems › Digital literacy in education
  • Social Sciences › Health › Social Media in Health Education
Keywords
digital health literacy, trust in health information sources, online health information seeking, university students, digital natives, cross-national comparison, COVID-19 infodemic, critical evaluation of information, social media health information, Japan, United States, India

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-11-04.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-11-04.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

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