An Empirical Study of eHealth Literacy and Cyberchondria Severity: Pros, Cons, and Risks of Online Health Information Seeking Behavior Among Undergraduate Students (Preprint)

BACKGROUND With the development of the Internet, healthcare websites have gained increasing importance by enabling easy access to health information, thereby influencing the attitudes and behaviors of individuals toward health issues. However, few studies have addressed public access to health information and self-diagnosis. OBJECTIVE This study investigated the background factors and status of cyberchondria severity among college students by conducting a nationwide sample survey using the Cyberchondria Severity Scale. Further, for those whose scores are higher than one standard deviation from the mean, we explored their perspective of electronic-health literacy—their recent experience in using online health information. METHODS A nationally representative sample of college students was surveyed, and 802 valid responses were obtained. The cyberchondria severity survey was conducted. Further, we recruited nine volunteers with more than one standard deviation from the mean to investigate their search behaviors. RESULTS There were significant differences in the different dimensions of cyberchondria severity (F(3, 2403) = 256.26, p < .001); post hoc comparisons showed that the perceived controllability score was the highest. Furthermore, there were significant positive correlations between perceived controllability, online physician–patient interaction, increased anxiety, and obsessive-compulsive hypochondria. This indicates that, the more the college students feel they can control their anxiety by searching for online health information and the more frequently they interact with online physicians, the higher their levels of anxiety and obsessive-compulsive hypochondria. Additionally, the perceived controllability and online physician–patient interaction showed a significant positive correlation. The degree of health concern of the individual emerged as a significant positive indicator of the three dimensions of cyberchondria severity, except for increased anxiety (t790 = 2.58–3.69, P < .001–.03). Specifically, high levels of health concern promoted perceived controllability, online physician–patient interaction, and obsessive-compulsive hypochondria of the students. The interview results showed that college students’ exposure to online health information significantly affected their mental and physical health, increasing anxiety and stress, thereby highlighting the need to improve online health literacy and provide reliable information. CONCLUSIONS This study found that there are “benefits,” “harms,” and “risks” to the recent use of online healthcare information for college students. Furthermore, “critical consciousness and electronic health literacy” were found to be vital abilities for effectively using online health information. Future research should explore how college students develop their ability from “self-awareness” to “action change,” and guide college students to develop their “critical health literacy,” which is also the key to digital health.