Digital natives: A systematic review of the digital health literacy and influencing factors among Chinese college students
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Objective: This study aimed to explore the current status of digital health literacy (DHL) among Chinese college students, and to summarize and analyze the related influencing factors. Methods: A systematic search was conducted in Web of Science, PubMed, EBSCO, Scopus, China National Knowledge Infrastructure, Wanfang Data, and VIP databases for relevant literature published between 1 January 2006 and 30 May 2024. Results: A total of 32 articles, with sample sizes ranging from 224 to 16,497 participants, were included in this review. The e-Health Literacy Scale was the most commonly used measurement for DHL among China college students. The level of DHL among Chinese college students was not high, which was associated with a variable of factors. Based on the social ecological model, the influencing factors at the individual level included age, gender, depression and anxiety status, self-rated health status, frequency of physical exercise, participation in health club activities, taking health courses, and attitude toward health; at the interpersonal level, the influencing factors included family income, parents’ education level, family structure, and only child status; at the organizational level, influencing factors included major, grade, and interpersonal relationships; at the community level, influencing factors included hukou and place of origin. Conclusions: The findings of this review provide valuable insights for the development of targeted health education interventions and policies to enhance DHL among Chinese college students. Future research should prioritize nationwide studies to further investigate the factors influencing DHL among Chinese college students and to develop more scientifically rigorous and effective measurement tools for DHL.
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Digital health literacy might be shaped by unique national characteristics, including media habits, educational approaches, healthcare systems, and digital infrastructure.
“Although online information is available across countries, digital health literacy might be shaped by unique national characteristics, including media habits, educational approaches, healthcare systems, and digital infrastructure (Jiang et al., 2025).”
From Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India (2025) · cites this paper as Jiang et al., 2025
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.”
From Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India (2025) · cites this paper as Jiang et al., 2025
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).”
From Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India (2025) · cites this paper as Jiang et al., 2025
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Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018) · BMC Medical Research Methodology · doi:10.1186/s12874-018-0611-x · Cited by 11,385 · cited 2× · see citing works
“13 Moreover, semiquantitative systematic reviews offer a visually intuitive and comprehensive presentation of the aggregated data from the included studies, enhancing the accessibility and clarity of the fi ndings.”
Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study
Son, C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020) · Journal of Medical Internet Research · doi:10.2196/21279 · Cited by 2,822 · see citing works
Htay, M. N. N., Parial, L. L., Tolabing, M. C., Dadaczynski, K., Okan, O., Leung, A. Y. M., & Su, T. T. (2022) · PLOS ONE · doi:10.1371/journal.pone.0266276 · Cited by 78 · see citing works
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Sorted by citations
Ishikawa, H., Miyawaki, R., Kato, M., Muilenburg, J. L., Tomar, Y. A., & Kawamura, Y. (2025) · SSM - Population Health · doi:10.1016/j.ssmph.2025.101844 · Cited by 17 · see citing works
- Authors
- Jiang, J., Zhou, M., Yin, Z., Cui, Y., & Liu, S.
- Affiliations
- East China Normal University (CN)
- Shanghai Urban Construction Vocational College (CN)
- Shanxi University (CN)
- Corresponding author
- Zhou, Mei
- Yin, Zhihua
- Venue
- DIGITAL HEALTH
- Publisher
- SAGE Publications
- Published
- 2025-05
- Volume
- 11
- Pages
- 20552076251346006-20552076251346006
- ISSN
- 2055-2076 (ISSN-L)
- PMC
- PMC12107012
- OpenAlex
- W4410743168
- Cited by
- 15
- References
- 3
- Citations by year
- 2026: 14 · 2025: 1
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Digital Health (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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 › Library and Information Sciences › Library Science and Information Literacy
- Keywords
- digital health literacy, university students, influencing factors, socio-ecological model, anxiety and depression, physical activity, family socioeconomic factors, household registration, health education intervention, Chinese students
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