Enhancing Health Literacy and Health Information Seeking Behaviour of University Students: A Review of the Current Global Landscape

Enhancing Health Literacy and Health Information Seeking Behaviour of University Students: A Review of the Current Global Landscape

Dilhani Munasinghe

Senior Assistant Librarian, Postgraduate Institute of Medicine, University of Colombo

DOI: https://dx.doi.org/10.47772/IJRISS.2025.90300284

Received: 05 March 2025; Accepted: 13 March 2025; Published: 14 April 2025

ABSTRACT

This review investigates the trends, challenges, and strategies related to health literacy (HL) and health information-seeking behaviours (HISB) among university students using research data published between 2020 and 2024. The primary objectives of the study include examining key patterns in health literacy, assessing the notable influence of technology advancements in HL and HISB,  studying the influence of educational backgrounds in HISB, and exploring strategies to enhance health literacy. The review’s overall results indicated that despite improvements in HL over time, there are still significant challenges remaining. Firstly, assessing the credibility of health information and then adjusting to quickly changing health guidelines. The accessibility of health information influences the level of HL, especially with new obstacles like misinformation and privacy concerns. Health literacy is influenced by educational backgrounds, with students in health-related sciences demonstrating superior ability to assess health information compared to their peers in other disciplines.  This indicates the importance of including comprehensive HL in every field of study. Many strategies proposed in the literature suggest incorporating health literacy education into college courses and utilizing engaging educational tools to emphasize trustworthy information from credible sources. Both students and faculty members should receive appropriate training in critical reading and evaluation. Moreover, it is essential to view HL as one of the central elements in higher-education programmes due to the important role in students’ academic and social life.  These discoveries are extremely significant for individuals who are looking to support literacy, carry out interventions, and conduct research in the field of health literacy.

Keywords: Health information credibility, Health literacy; Health information-seeking behaviours, University students

INTRODUCTION

Due to the globalization trends, there has been a greater emphasis on improving health literacy (HL) and encouraging appropriate health information-seeking behaviours (HISB) among college students. This is common in both developing nations as well as in most developed nations where access to health information can be of great benefit to students. For instance, in third-world countries, where health care may be lacking, average students’ understanding of health information may help them to reduce the chances of contracting illnesses and living a healthy life. In developed countries where there is a superflux of health information it is often confusing for the seeker. Therefore, it is important for students to have good health literacy to make informed choices about more complex systems of health care and one’s health. Without a doubt, university students are seeking health-related information not only from texts but also from electronic media and other sources. This information on HISB could be helpful to identify the best way to target interventions and educational programmes in order to match the perception and behaviour of the target population. The objective of this study is to evaluate the changing patterns in the HL and, HISB of university students at global level and explore strategies to accommodate these changes.

Significance of the Study

Health information has been growing in complexity, coming from numerous sources that vary in accuracy and reliability. The intricacy of this situation may present obstacles for people looking to make well-informed choices regarding their health. The study aims to assess how well university students can handle and comprehend the complexity of health information and whether their health literacy is progressing in line with these changes. This study can help shape public health education and intervention strategies to better address the needs of the community.

The importance of this research is emphasized by the factors shown in Figure 1:

Figure 1:  Significance of enhancing HL and HISB among university students

Source: Based on the published literature mentioned in the reference list

As shown in Figure 1 several factors contribute to the importance of enhancing health literacy and health information seeking behaviours among university students.  In recent years there have been rapid advancements in the area of digital health tools, including Web-based health portals (“webports”), mobile apps and social networks. This has revolutionized the field of health information in its distribution and application. Examining the ways in which university students engage with these technologies and how this influences their health literacy is necessary for developing effective educational strategies. Also, health content is significantly more intricate and there are multiple sources which lead to varying degrees of acumen. This complexity is proving to be difficult for the health-conscious human’s out there. It is important therefore to conduct research into how well-equipped university students are for this complexity and whether their health literacy keeps up with these advances. Additionally, public health education and intervention strategies targeting college students may be informed by the findings of this study to accommodate for behaviours associated with these distinct needs. It also provides valuable information on how students search for health information which may help to inform the development of more targeted, effective health literacy programmes. Examining literature across the world gives a wider view of health literacy patterns and behaviours, going beyond specific localities. Having a worldwide viewpoint is essential for recognizing shared obstacles and effective tactics in various areas and societies.

Problem Statement:

Many studies focus on providing themed information and health literacy, but often overlook the barriers that prevent university students from accessing or effectively using this information. This study aims to address these gaps by improving the understanding of health literacy and information-seeking behaviour among this population.

Objectives;

1. To study health literacy trends and health information seeking behaviours among university students

2. Analyze the role of technology on the health-seeking behaviour and health literacy status of university students.
3. Examine how a student’s education level and field of study impact their health information seeking behaviour.
4. Explore potential interventions and strategies to enhance health literacy and information seeking behaviours among university students in the current global context.

METHOD

Articles published between 2020 and August 2024 were considered for this study. The literature search was conducted between June and August 2024, involving an in-depth review of scholarly articles focusing on health literacy and information-seeking behaviours among university students. The search encompassed databases such as Google Scholar, PubMed, and HINARI, utilizing advanced search strategies detailed in Appendix A. Duplicate search results were identified and screened through proper keeping of search records, and using the Mendeley Reference Management software. Thematic analysis was conducted to organize, summarize, and merge essential findings from the selected studies to recognize patterns, differences, and emerging themes. Gathered publications were coded manually due to the lack of access to software like NVivo. After coding, they were categorized into themes, considering the author, publisher, and publication date of each article.

Inclusion and Exclusion Criteria:

• Inclusion Criteria:
  • Only scholarly research articles were considered for inclusion.
  • Open access and closed access
  • Year of publication 2020 – 2024 August
  • English
  • Full text
• Exclusion Criteria:
  • Insufficient data: articles lacking significant data relevant to the research objectives were excluded.
  • Non-English language: non-English articles were excluded due to potential language barriers.
  • Irrelevant study design: studies not employing suitable designs like cohort, case-control, or cross-sectional were excluded.
  • Not peer-reviewed: non-peer-reviewed articles were excluded to ensure research quality.
  • Inadequate methodology: studies with methodological flaws impacting reliability were excluded.
  • Focus on unrelated topics: articles focusing on unrelated aspects were excluded.
  • Duplicate information: articles with duplicate or overlapping data were excluded to prevent repetition.

LITERATURE REVIEW

The Institute of Medicine defines health literacy as the abilities of an individual to get, process, and use basic health information in order to make good health decisions (Nielsen-Bohlman, 2004). This involves reading skills, self-management skills and acquiring technical skills such as completing complicated health documents. The average HL among college students has been found to be better than the national average. However, despite this seemingly high level, students often lack critical practical competencies in health literacy, such as interpreting prescriptions, which could negatively impact their health outcomes (Abdoh, 2022; Bak et al., 2022). Additionally, health literacy encompasses health information-seeking behaviours (HISB), which are particularly crucial when specific health issues arise. Engaging in health-seeking behaviours such as researching symptoms or prevention strategies is vital for promoting overall health (Akakpo & Neuerer, 2024; Bastani et al., 2022). Although access to information has become more convenient through the internet, it is essential to cultivate effective e-health literacy among individuals seeking health information. This proficiency not only ensures better health outcomes but also enhances the efficient use of health services (Bonaccorsi et al., 2023; Dashti et al., 2022; Mahmoodi et al., 2022; Nu Htay et al., 2022; Sakellari et al., 2024; Seboka et al., 2022; Tian & Chen, 2023).

Accessing health information has become increasingly diverse in today’s digital age. University students, who often rely heavily on the internet, frequently use it as a primary source of health information for themselves and others. This information can be disseminated through various channels, including social media, television, books, newspapers, and healthcare providers. Factors such as personal impressions and gender significantly influence HISB, with studies indicating that women are more likely to seek confirmation of health-related queries through the internet and health services (Dadaczynski et al., 2021).While research has explored how individuals search for health-related information, there is a noticeable lack of studies examining the relationship between information-seeking behaviour and health literacy among educated populations compared to high-risk groups (Gedefaw et al., 2020; Loda et al., 2020; Nguyen et al., 2020; Nguyen et al., 2021; Rosário et al., 2020; Tangcharoensathien et al., 2020; Vaughan et al., 2020; Vrdelja et al., 2021; Zakar et al., 2021). This paper aims to fill this literature gap by investigating both HL and HISB among university students.

RESULTS AND DISCUSSION

A total of eighteen articles were collected using the method outlined earlier in detail. Table 1 presents a detailed summary of the essential attributes of the studies included in this analysis. Most of the included studies are quantitative and primarily utilized online survey questionnaires. The sample sizes of these studies vary significantly, ranging from 262  to 14,916 university students. The studies covered various regions around the world, providing a global perspective on HL and HISB in academic setting.  Table 2 provides a comprehensive overview of the studies’ characteristics, emphasizing the contributions of individual papers. It highlights key themes regarding HL and HISB among university students, emphasizing the importance of Digital Health Literacy (DHL) in the contemporary landscape.

The following discussion incorporates the findings of the respective studies depicted in Table 2,   in order to accomplish the major aims of this review: monitoring the development of health literacy trends, the impact of the new technologies, the educational level, and mechanisms for the improvement of health literacy.

Trends and Emerging Patterns in Health Literacy:

Analyzing the themes as shown in Table 2 revealed a positive trend in DHL among university students, indicating an increased ability to access and utilize online health information, which is crucial in today’s digital age (Rosário et al., 2020; Nguyen et al., 2020; Zakar et al., 2021). However, it is also noted that significant disparities persist, influenced by demographic factors such as educational background and technology access, necessitating targeted interventions to ensure equitable HL (Dadaczynski et al., 2021; Bak et al., 2022; Nguyen et al., 2020). Additionally, literature revealed that the transition to online sources underscores the need for students to develop critical navigation skills to discern reliable information, especially during health crises (Zakar et al., 2021; Bak et al., 2022; Mahmoodi et al., 2022). Further literature revealed that higher levels of DHL correlate with improved mental health outcomes, suggesting that effective HL serves as a protective factor against anxiety and uncertainty (Rosário et al., 2020; Nguyen et al., 2020).

Impact of Digital Advancements on Information-Seeking Behaviours: The widespread adoption of digital platforms has transformed how students seek health information. While technology facilitates easier access, it also presents challenges, such as the overwhelming volume of information and the prevalence of misinformation (Vrdelja et al., 2021; Bak et al., 2022). This highlights the necessity for students to develop robust digital literacy skills, enabling them to critically evaluate online resources and navigate the digital landscape effectively (Abdoh, 2022; Seboka et al., 2022).

Role of Educational Backgrounds and Disciplines

According to Table 2 students in health-related fields typically demonstrate higher health literacy compared to their peers in other disciplines (Dashti et al., 2022; Baklola et al., 2024). This disparity underscores the importance of integrating health literacy education into non-health curricula. Gender-specific differences further highlight the need for tailored educational strategies, addressing the unique challenges faced by different groups (Nguyen et al., 2020; Sakellari et al., 2024). Comprehensive health education across various academic programme can enhance overall understanding and promote better health-seeking behaviours among diverse student populations (Dashti et al., 2022; Baklola et al., 2024).

Potential Interventions and Strategies: To enhance DHL, developing targeted educational programme is essential. These programmes should equip students with the skills to evaluate online health information and promote credible sources (Bastani et al., 2022; Akakpo & Neuerer, 2024). Engaging students in interactive training sessions can facilitate practical application of health literacy skills, making the learning process more effective (Bonaccorsi et al., 2023; Seboka et al., 2022). Additionally, leveraging online platforms for health education can expand access to reliable information (Bastani et al., 2022; Akakpo & Neuerer, 2024). A comprehensive approach that integrates curriculum development, targeted interventions, and digital literacy training is essential for improving health literacy and HISB among university students (Bonaccorsi et al., 2023; Seboka et al., 2022).

According to the Table 2, addressing the intricate relationship between health literacy, technology, education, and intervention strategies is vital for empowering university students to navigate health information effectively. A comprehensive approach that considers the diversity of student experiences will be crucial in fostering a healthier and more informed population.

Table 1. Fundamental attributes of literature included in the review

Table 2: Comprehensive overview of Published Literature on Enhancing Health Literacy and Health Information-Seeking Behaviour of University Students

CONCLUSION

This review looks at how university students comprehend and pursue health information in today’s digital environment, from 2020 through 2024 August. The increase of health information and its multiple facets makes it important to have an insight into the dynamics of health literacy and information-seeking behaviours of the university students. The findings argues that university students have to be educated in a way where they digest health information and search for it when needed more effectively based on the realities of the 21^st century. By integrating technology and addressing these issues, the education providers and policy makers could assist learners in comprehending complex health information. Educating health literacy and incorporating it into the course contents are integral to equipping the students with the ability to function autonomously regarding health matters. Nevertheless, with the continuous modification in health information, more research must be undertaken in order to be able to look into the future and help the students cope with the management of their health information more efficiently.

REFERENCES

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ANNEX A

Searching Strategy in PubMed

Search: ((health literacy) AND (information seeking behaviour)) AND (university students) Filters: from 2020 – 2024 ((“health literacy”[MeSH Terms] OR (“health”[All Fields] AND “literacy”[All Fields]) OR “health literacy”[All Fields]) AND (“information seeking behaviour”[MeSH Terms] OR (“information”[All Fields] AND “seeking”[All Fields] AND “behaviour”[All Fields]) OR “information seeking behaviour”[All Fields] OR (“information”[All Fields] AND “seeking”[All Fields] AND “behaviour”[All Fields]) OR “information seeking behaviour”[All Fields]) AND ((“universiti”[All Fields] OR “universities”[MeSH Terms] OR “universities”[All Fields] OR “university”[All Fields] OR “university s”[All Fields]) AND (“student s”[All Fields] OR “students”[MeSH Terms] OR “students”[All Fields] OR “student”[All Fields] OR “students s”[All Fields]))) AND (2020:2024[pdat])

Translations health literacy: “health literacy”[MeSH Terms] OR (“health”[All Fields] AND “literacy”[All Fields]) OR “health literacy”[All Fields] information seeking behaviour: “information seeking behaviour”[MeSH Terms] OR (“information”[All Fields] AND “seeking”[All Fields] AND “behaviour”[All Fields]) OR “information seeking behaviour”[All Fields] OR (“information”[All Fields] AND “seeking”[All Fields] AND “behaviour”[All Fields]) OR “information seeking behaviour”[All Fields] university: “universiti”[All Fields] OR “universities”[MeSH Terms] OR “universities”[All Fields] OR “university”[All Fields] OR “university’s”[All Fields] students: “student’s”[All Fields] OR “students”[MeSH Terms] OR “students”[All Fields] OR “student”[All Fields] OR “student’s”[All Fields]

Google scholar and Hinari database

Health Literacy AND Information Seeking Behaviour AND University Students OR Undergraduate Students in Universities