BACKGROUND: Digital communication technologies play an important role in governments' and public health authorities' health communication strategies during the COVID-19 pandemic . The internet and social media have become important sources of health-related information on the coronavirus and on protective behaviours . In addition, the COVID-19 infodemic spreads faster than the coronavirus itself, which interferes with governmental health-related communication efforts . This puts national public health containment strategies in jeopardy . Therefore, digital health literacy is a key competence to navigate coronavirus-related information and service environments .
OBJECTIVE: This study aimed to investigate university students' digital health literacy and online information seeking behaviours during the early stages of the coronavirus pandemic in Germany .
METHODS: A cross-sectional study among N=14,916 university students aged & #8805; 18 from 130 universities across all sixteen federal states of Germany was conducted using an online survey . Along with sociodemographic characteristics (sex, age, subjective social status) measures included five subscales from the Digital Health Literacy Instrument (DHLI), which was adapted to the specific coronavirus context . Online information seeking behaviour was investigated by examining the online sources used by university students and the topics that students search for in connection with the coronavirus . Data were analysed using univariate and bivariate analyses .
RESULTS: Across digital health literacy dimensions, the greatest difficulties could be found for assessing the reliability of health-related information (42.3 %) and the ability to determine whether the information was written with commercial interest (38.9 %). Moreover, respondents also indicated that they most frequently have problems finding the information they are looking for (30.4 %). When stratified according to sociodemographic characteristics, significant differences were found with female university students reporting a lower DHLI for the dimensions of 'information searching' and of 'evaluating reliability' . Search engines, news portals and public bodies' websites were most often used by the respondents as sources to search for information on COVID-19 and related issues . Female students were found to use social media and health portals more frequently, while male students used Wikipedia and other online encyclopaedias as well as YouTube more often . The use of social media was associated with a low ability to critically evaluate information, while opposite differences were observed for the use of public websites .
CONCLUSIONS: Although digital health literacy is, in summary, well developed in university students, a significant proportion of students still face difficulties with certain abilities to deal with information . There is need to strengthen the digital health literacy capacities of university students using tailored interventions . Improving the quality of health-related information on the internet is also key.