The association of digital health literacy with healthy lifestyle behaviors: a cross-sectional study

Kevser Şevik Kaçmaz; Etem Hızaler; Fatih Denizli; Zühal Kınış; Sümeyye Yücebaş; Kader Alyanak

The association of digital health literacy with healthy lifestyle behaviors: a cross-sectional study

Abstract

Aims: This study primarily examined the association between digital health literacy and healthy lifestyle behaviors among adults. As a secondary exploratory aim, we also examined differences in DHLS and HLBS scores across selected sociodemographic characteristics. Methods: This study was designed as a cross-sectional study. The Healthy Lifestyle Behavior Scale (HLBS) and Digital Health Literacy Scale (DHLS) were administered to the participants. We used Pearson’s correlation, simple and multivariable linear regression analyses, independent-samples/Welch t-tests, and one-way/Welch ANOVA, as appropriate. Results: A total of 352 participants had a mean age of 27.90±8.33 years. There was a weak correlation between the HLBS and DHLS scores (r=0.221, p<0.001). In the unadjusted regression analysis, higher DHLS scores were associated with higher HLBS scores (B=0.356, β=0.221, p<0.001), although DHLS explained only 4.9% of the variance in HLBS scores (R²=0.049). The association remained statistically significant after adjustment for age, gender, marital status, educational level, and economic status (B=0.330, β=0.205, p<0.001). The adjusted model explained 12.7% of the variance in HLBS scores (R²=0.127). Additionally, there were significant sociodemographic differences for DHLS according to gender and for HLBS according to economic status, marital status, and exercise habit. Conclusion: Digital health literacy was positively but modestly associated with healthy lifestyle behaviors, and this association remained statistically significant after adjustment for selected sociodemographic characteristics. However, digital health literacy alone explained only a small proportion of the variance in healthy lifestyle behaviors, indicating limited explanatory value when considered in isolation. The secondary exploratory analyses also suggested that selected sociodemographic characteristics were associated with differences in digital health literacy or healthy lifestyle behaviors. These findings should not be interpreted as evidence of causal or clinically important relationships. Longitudinal studies using more representative samples are needed to clarify the temporal nature of these associations and to determine whether changes in digital health literacy are accompanied by meaningful changes in healthy lifestyle behaviors.

Keywords

Supporting Institution

None applicapable.

Ethical Statement

Before the research started, ethical approval was acquired. In compliance with the Declaration of Helsinki, each participant gave written informed consent after being informed of the purpose and methods of the study.

References

Yu J, Meng S. Impacts of the internet on health inequality and healthcare access: a cross-country study. Front Public Health. 2022;10:935608. doi:10.3389/fpubh.2022.935608
Tarhan N, Tutgun-Ünal A, Ekinci Y. Yeni kuşak hastalığı siberkondri: yeni medya çağında kuşakların siberkondri düzeyleri ile sağlık okuryazarlığı ilişkisi. OPUS Int J Soc Res. 2021;17(37):4253-4297. doi:10.26466/opus.855959
Ji H, Dong J, Pan W, Yu Y. Associations between digital literacy, health literacy, and digital health behaviors among rural residents: evidence from Zhejiang, China. Int J Equity Health. 2024;23(1):68. doi:10.1186/s12939-024-02150-2
Fatehi F, Samadbeik M, Kazemi A. What is digital health? Review of definitions. Stud Health Technol Inform. 2020;275:67-71. doi:10.3233/SHTI200696
Arias López MDP, Ong BA, Borrat Frigola X, et al. Digital literacy as a new determinant of health: a scoping review. PLOS Digit Health. 2023; 2(10):e0000279. doi:10.1371/journal.pdig.0000279
Krahn GL, Robinson A, Murray AJ, Havercamp SM; Nisonger RRTC on Health and Function. It's time to reconsider how we define health: perspective from disability and chronic condition. Disabil Health J. 2021;14(4):101129. doi:10.1016/j.dhjo.2021.101129
Celikel BE, Sezer SY, Togacar S. Examination of healthy lifestyle behaviors in adult individuals over 60 years of age. Int Online J Educ Sci. 2023;15(4):813-823.
Wang J, Wang Y, Guo Z, et al. Influence of lifestyle on suboptimal health: insights from a national cross-sectional survey in China. J Glob Health. 2023;13:04151. doi:10.7189/jogh.13.04151

Lucini D, Luconi E, Giovanelli L, et al. Assessing lifestyle in a large cohort of undergraduate students: significance of stress, exercise and nutrition. Nutrients. 2024;16(24):4339. doi:10.3390/nu16244339
Avcı K. The impact of digital health literacy on healthy lifestyle behaviors among adults: the case of Ankara. Ankara Med J. 2025;25(1):67-79. doi:10.5505/amj.2025.02259
van der Vaart R, Drossaert C. Development of the Digital Health Literacy Instrument: measuring a broad spectrum of Health 1.0 and Health 2.0 skills. J Med Internet Res. 2017;19(1):e27. doi:10.2196/jmir.6709
Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126(5):1763-1768. doi:10.1213/ANE.0000000000002864
Mishra P, Singh U, Pandey CM, Mishra P, Pandey G. Application of Student's t-test, analysis of variance, and covariance. Ann Card Anaesth. 2019;22(4):407-411. doi:10.4103/aca.ACA_94_19
Bíró É, Vincze F, Nagy-Pénzes G, Ádány R. Investigation of the relationship of general and digital health literacy with various health-related outcomes. Front Public Health. 2023;11:1229734. doi:10.3389/fpubh.2023.1229734
Fitzpatrick PJ. Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Front Digit Health. 2023;5:1264780. doi:10.3389/fdgth.2023.1264780
Yuen E, Winter N, Savira F, et al. Digital health literacy and its association with sociodemographic characteristics, health resource use, and health outcomes: rapid review. Interact J Med Res. 2024;13:e46888. doi:10.2196/46888
Hsu W, Chiang C, Yang S. The effect of individual factors on health behaviors among college students: the mediating effects of eHealth literacy. J Med Internet Res. 2014;16(12):e287. doi:10.2196/jmir.3542
Dadaczynski K, Okan O, Messer M, et al. Digital health literacy and web-based information-seeking behaviors of university students in Germany during the COVID-19 pandemic: cross-sectional survey study. J Med Internet Res. 2021;23(1):e24097. doi:10.2196/24097
Rivadeneira MF, Miranda-Velasco MJ, Arroyo HV, Caicedo-Gallardo JD, Salvador-Pinos C. Digital health literacy related to COVID-19: validation and implementation of a questionnaire in Hispanic university students. Int J Environ Res Public Health. 2022;19(7):4092. doi:10.3390/ijerph19074092
Stellefson M, Hanik B, Chaney B, Chaney D, Tennant B, Chavarria EA. eHealth literacy among college students: a systematic review with implications for eHealth education. J Med Internet Res. 2011;13(4):e102. doi:10.2196/jmir.1703
Alam Z, Abdullahi AS, Alnuaimi SNS, et al. eHealth literacy and attitudes towards use of artificial intelligence among university students in the United Arab Emirates, a cross-sectional study. Front Digit Health. 2025;7:1574263. doi:10.3389/fdgth.2025.1574263
Zhao BY, Huang L, Cheng X, et al. Digital health literacy and associated factors among internet users from China: a cross-sectional study. BMC Public Health. 2024;24(1):908. doi:10.1186/s12889-024-18324-0
Ryan LH, Wan WH, Smith J. Spousal social support and strain: impacts on health in older couples. J Behav Med. 2014;37(6):1108-1117. doi:10.1007/s10865-014-9561-x
Yim HJ, Park HA, Kang JH, et al. Marital status and health behavior in middle-aged Korean adults. Korean J Fam Med. 2012;33(6):390-397. doi:10.4082/kjfm.2012.33.6.390
Liutsko L, Leonov S, Pashenko A, Polikanova I. Is frequency of practice of different types of physical activity associated with health and a healthy lifestyle at different ages? Eur J Investig Health Psychol Educ. 2024;14(1):256-271. doi:10.3390/ejihpe14010017
Zangger G, Mortensen SR, Tang LH, Thygesen LC, Skou ST. Association between digital health literacy and physical activity levels among individuals with and without long-term health conditions: data from a cross-sectional survey of 19,231 individuals. Digit Health. 2024; 10:20552076241233158. doi:10.1177/20552076241233158
Yao R, Zhang W, Evans R, Cao G, Rui T, Shen L. Inequities in health care services caused by the adoption of digital health technologies: scoping review. J Med Internet Res. 2022;24(3):e34144. doi:10.2196/34144
Chiu YL, Tsai CC, Liang JC. Laypeople's online health information search strategies and use for health-related problems: cross-sectional survey. J Med Internet Res. 2022;24(9):e29609. doi:10.2196/29609
Scherer LD, McPhetres J, Pennycook G, et al. Who is susceptible to online health misinformation? A test of four psychosocial hypotheses. Health Psychol. 2021;40(4):274-284. doi:10.1037/hea0000978

Details

Primary Language

English

Subjects

Digital Health

Journal Section

Research Article

Authors

Kevser Şevik Kaçmaz ^*
0000-0003-1675-0757
Türkiye

Etem Hızaler
0000-0002-6924-1051
Türkiye

Fatih Denizli
0000-0001-5039-7606
Türkiye

Zühal Kınış
0000-0003-0417-860X
Türkiye

Sümeyye Yücebaş
0009-0008-8459-8092
Türkiye

Kader Alyanak
0009-0002-5470-9165
Türkiye

Publication Date

October 25, 2026

Submission Date

July 21, 2026

Acceptance Date

October 17, 2026

Published in Issue

Year 2026 Volume: 8 Number: 6

IZ

https://izlik.org/JA49BZ66AD

Cite

RIS / Bibtex

APA

Şevik Kaçmaz, K., Hızaler, E., Denizli, F., Kınış, Z., Yücebaş, S., & Alyanak, K. (2026). The association of digital health literacy with healthy lifestyle behaviors: a cross-sectional study. Anatolian Current Medical Journal, 8(6), 1365-1372. https://izlik.org/JA49BZ66AD

AMA

1.Şevik Kaçmaz K, Hızaler E, Denizli F, Kınış Z, Yücebaş S, Alyanak K. The association of digital health literacy with healthy lifestyle behaviors: a cross-sectional study. Anatolian Curr Med J / ACMJ / acmj. 2026;8(6):1365-1372. https://izlik.org/JA49BZ66AD

Chicago

Şevik Kaçmaz, Kevser, Etem Hızaler, Fatih Denizli, Zühal Kınış, Sümeyye Yücebaş, and Kader Alyanak. 2026. “The Association of Digital Health Literacy With Healthy Lifestyle Behaviors: A Cross-Sectional Study”. Anatolian Current Medical Journal 8 (6): 1365-72. https://izlik.org/JA49BZ66AD.

EndNote

Şevik Kaçmaz K, Hızaler E, Denizli F, Kınış Z, Yücebaş S, Alyanak K (October 1, 2026) The association of digital health literacy with healthy lifestyle behaviors: a cross-sectional study. Anatolian Current Medical Journal 8 6 1365–1372.

IEEE

[1]K. Şevik Kaçmaz, E. Hızaler, F. Denizli, Z. Kınış, S. Yücebaş, and K. Alyanak, “The association of digital health literacy with healthy lifestyle behaviors: a cross-sectional study”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 6, pp. 1365–1372, Oct. 2026, [Online]. Available: https://izlik.org/JA49BZ66AD

ISNAD

Şevik Kaçmaz, Kevser - Hızaler, Etem - Denizli, Fatih - Kınış, Zühal - Yücebaş, Sümeyye - Alyanak, Kader. “The Association of Digital Health Literacy With Healthy Lifestyle Behaviors: A Cross-Sectional Study”. Anatolian Current Medical Journal 8/6 (October 1, 2026): 1365-1372. https://izlik.org/JA49BZ66AD.

JAMA

1.Şevik Kaçmaz K, Hızaler E, Denizli F, Kınış Z, Yücebaş S, Alyanak K. The association of digital health literacy with healthy lifestyle behaviors: a cross-sectional study. Anatolian Curr Med J / ACMJ / acmj. 2026;8:1365–1372.

MLA

Şevik Kaçmaz, Kevser, et al. “The Association of Digital Health Literacy With Healthy Lifestyle Behaviors: A Cross-Sectional Study”. Anatolian Current Medical Journal, vol. 8, no. 6, Oct. 2026, pp. 1365-72, https://izlik.org/JA49BZ66AD.

Vancouver

1.Kevser Şevik Kaçmaz, Etem Hızaler, Fatih Denizli, Zühal Kınış, Sümeyye Yücebaş, Kader Alyanak. The association of digital health literacy with healthy lifestyle behaviors: a cross-sectional study. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 Oct. 1;8(6):1365-72. Available from: https://izlik.org/JA49BZ66AD