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Higher eHealth literacy is associated with more favorable health behaviors in meta-analysis of observational studiesBetter digital health literacy leads to better personal health habits

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Key Takeaway
Note that higher eHealth literacy is associated with better health behaviors, but evidence is of low certainty.

This meta-analysis synthesizes data from observational studies to evaluate the link between eHealth literacy and health behaviors, including decision-making, promotion, and management. The analysis utilized three distinct synthesis methods to determine the strength of this association.

A correlation-based synthesis showed a positive association (pooled r=0.43; 95% CI 0.36-0.51), while a grouped OR synthesis also indicated that higher eHealth literacy was associated with more favorable behaviors (pooled OR 2.12; 95% CI 1.47-3.05). However, the continuous OR synthesis yielded a positive but not statistically significant result (pooled OR 1.07; 95% CI 0.89-1.30).

The authors note several limitations, including a predominantly cross-sectional evidence base and high heterogeneity (I2=80.50% for correlation and I2=97.98% for continuous OR). Certainty of evidence was low for the grouped OR synthesis and very low for both the correlation and continuous OR syntheses. Because these findings are based on observational data, the associations should be viewed as contextual rather than causal or uniform.

For clinical practice, the authors suggest that interventions to improve eHealth literacy should be paired with trustworthy digital services, clinician support, and specific conditions tailored to target behaviors.

Navigating the internet for medical advice can feel overwhelming. When people have high eHealth literacy, it means they have the skills to find, understand, and use online information to manage their health. This study looked at how these digital skills connect to real-life actions like making better decisions and managing personal health.

Researchers found that people with higher digital literacy were more likely to engage in favorable health behaviors. Specifically, one way of measuring the data showed a strong link between knowing how to use online tools and taking positive steps for one's health. However, other ways of looking at the same data were less clear, showing only a slight trend without reaching a high level of statistical certainty.

It is important to note that these findings are based on observational data, which means we cannot say for certain that better skills cause better habits directly. The evidence also had some inconsistencies across different studies. To be most effective, experts suggest that improving digital skills works best when paired with trustworthy online services and support from a doctor.

What this means for you:
Stronger digital health literacy is linked to better health decisions and management behaviors.

Common questions

What does eHealth literacy mean for my daily life?

eHealth literacy is your ability to find and use information from the internet to manage your health. This study found that people with higher skills in this area were more likely to engage in favorable health behaviors, such as making better decisions about their care or managing their health more effectively.

Is there a clear link between online skills and health habits?

The study found a positive association between digital literacy and healthy behaviors. While some data showed a very strong link, other types of analysis were less certain. Because the evidence is based on observational studies, these results show a connection rather than a direct cause.

How can I best improve my health using online tools?

The research suggests that improving your digital literacy works best when you use trustworthy online services and have support from a healthcare professional. Combining these tools with expert guidance helps ensure the information you find leads to better management of your health.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
BACKGROUND: Since COVID-19, health information seeking, service navigation, and routine care have become increasingly digitally mediated. It remains unclear whether the association between eHealth literacy and health behaviors is consistent across behavioral domains, populations, and analytic frameworks. OBJECTIVE: This systematic review and meta-analysis synthesized COVID-19 and post-COVID-19 evidence on the association between eHealth literacy and health behaviors and examined variation across study contexts. METHODS: We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020-compliant, PROSPERO-registered review (CRD420251009048). PubMed, Embase, Web of Science Core Collection, CINAHL Ultimate, and Scopus were searched from January 1, 2020, through March 27, 2026. Eligible observational studies assessed eHealth literacy and reported analyzable associations with health behavior outcomes collected in 2020 or later. Health behaviors were classified as health decision-making, health-promoting, or health management behaviors. Correlation coefficients, grouped odds ratios (ORs), and continuous ORs were synthesized separately using random-effects models with Knapp-Hartung adjustment. Certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. RESULTS: In total, 19 studies were included: 10 contributed correlation coefficients, 6 grouped ORs, and 3 continuous ORs. In the correlation-based synthesis, higher eHealth literacy was associated with more favorable health behaviors (pooled r=0.43, 95% CI 0.36-0.51; 95% prediction interval 0.22-0.61), with substantial heterogeneity (I2=80.50%). In the grouped OR synthesis, higher eHealth literacy was also associated with more favorable health behaviors (pooled OR 2.12, 95% CI 1.47-3.05; 95% prediction interval 1.11-4.06), with moderate heterogeneity (I2=46.33%). In the continuous OR synthesis, all 3 studies showed positive associations, but the pooled effect was not statistically significant (pooled OR 1.07, 95% CI 0.89-1.30; 95% prediction interval 0.84-1.37), with very high heterogeneity (I2=97.98%). Subgroup analyses showed a significant difference only by geriatric status in the grouped OR synthesis. Certainty was low for the grouped OR synthesis and very low for the other 2 syntheses. CONCLUSIONS: Higher eHealth literacy was generally associated with more favorable health behaviors in the correlation-based and grouped OR syntheses, whereas evidence from the continuous OR synthesis was inconclusive. Given the predominantly cross-sectional evidence base, heterogeneity, risk-of-bias concerns, and low to very low certainty, the association should be interpreted as contextual and associative rather than causal or uniform. This review is innovative in synthesizing COVID-19 and post-COVID-19 evidence, applying a functional classification of health behaviors, and analyzing distinct effect measures separately. Unlike previous reviews that summarized the association more broadly, it avoids a single mixed pooled effect and provides a cautious, context-specific interpretation. In practice, interventions should pair eHealth literacy improvement with trustworthy digital services, clinician support, and behavior-specific conditions that help translate digital information into sustained health-related action.
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