Digital health literacy and its association with anxiety among students in Pakistan

Background The public health importance of digital health literacy has significantly increased during COVID-19 pandemic all over the world. Health literacy enables individuals in informed and timely decision making. Anxiety particularly during difficult situations may hinders the decision making ability of individuals. The aim of this study was to assess the digital health literacy seeking and its association with anxiety level among university students during the wake of COVID-19 pandemic in Pakistan. Methods This study was conducted as a member of COVID digital Health literacy network between 49 countries through an online-based cross-sectional survey. Data were collected with 1747 students from randomly selected four public sector universities in Punjab province of Pakistan. Digital health literacy instrument was used to assess students' skills in digital health information seeking regarding COVID-19. Sense of coherence (SOC) was evaluated through 9-item scale and anxiety was assessed using 9-items Dark Future Scale. Simple bivariate and multivariate linear regression was performed to assess the association of key characteristics with DHL and anxiety level among students. Results The study found that about 54% of the students had high DHL and 51.9% had low or no anxiety. The results of multivariate analysis show that gender (p value=0.005), sense of coherence (p value<0.001) and importance of information (p value<0.001) were significantly associated with DHL. Additionally, Age (p < 0.001), subject group of study (p = 0.03), university of study (p < 0.000) and financial satisfaction (p < 0.001) were significantly associated with anxiety among students. However, there was no significant relationship of DHL, SOC, and wellbeing with anxiety. Conclusions Concerted and focused interventions are needed to address anxiety related issues among university students. Key messages Future research should focus on health literacy environment and its relationship with the broader social, economic, and psychosocial contexts of anxiety among students. Concerted and focused interventions are needed to address anxiety related issues among university students.