Digital health literacy and its association with cyberchondria among non- medical undergraduate students in Malappuram district, Kerala

Abstract

Background: The increasing use of the internet for health information may influence health behaviour and anxiety among young adults. Digital health literacy may shape how individual access and evaluate online health information, while excessive searching may contribute to cyberchondria. This study assessed digital health literacy and cyberchondria and examined their association among non-medical undergraduate students in Malappuram district, Kerala.

Methods: A cross-sectional study was conducted among 209 students of MES Arts and Science College, Perinthalmanna, from March 2 to April 2, 2026. Participants were selected by simple random sampling. Data were collected using a questionnaire, the 8-item eHealth literacy scale (eHEALS), and the cyberchondria severity scale-12 (CSS-12). Descriptive statistics, chi-square test, multivariate logistic regression and Spearman correlation were used; p<0.05 was considered statistically significant.

Results: Participants’ mean age was 20.05±1.55 years, and 51.2% were male. The median eHEALS score was 27 (IQR 24-31); 53.1% had higher perceived digital health literacy. The median CSS-12 score was 34 (IQR 26-39), with 56.5% having low, 37.8% moderate, and 5.7% high cyberchondria. Higher perceived digital health literacy (p=0.03) and female gender (p=0.03) were significantly associated with moderate/high cyberchondria severity (p=0.005). Positive correlations were observed with compulsion (ρ=0.354, p<0.001), distress (ρ=0.136, p=0.049), excessiveness (ρ=0.235, p=0.001), and reassurance-seeking (ρ=0.220, p=0.001).

Conclusions: Higher perceived digital health literacy was associated with cyberchondria and its domains, particularly compulsion. Promoting responsible online health-information seeking may help reduce excessive searching and its psychological consequences among young adults.