eHealth Literacy and Lifestyle Behaviours among Undergraduate Students in Nigeria: A Cross-sectional Study

Document Type : Original Article


1 Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria

2 School of Medicine, University of Nottingham, Nottingham, United Kingdom


Background and Objective: Lifestyle choices influence health and wellbeing, and accessing health information online requires skills to use effectively. This study aimed to assess eHealth literacy and its association with lifestyle behaviours among undergraduate students in Nigeria.

Materials and Methods: We employed a cross-sectional study design using questionnaires to gather responses from undergraduate students across 15 faculties at the University of Nigeria, Nsukka. The calculated sample size was 630 participants, but to account for a 50% potential loss, 1250 students across all levels were selected for the study. A random sampling technique was used to select six faculties: three health-related and three non-health-related. A structured demographic questionnaire was used to record sociodemographic information, lifestyle behaviours, internet access, and use; the e-health literacy scale (eHEALS) was used to record e-Health literacy. The data was analysed using IBM SPSS version 25.0. Descriptive (mean, frequency, percentage) and inferential statistics (Chi square) were employed, where appropriate, with statistical significance set at p < 0.05.

Results: Out of the 1250 students that participated in the study, 1233 (98.7%) had internet access, while 791 (63.5%) used the internet to assess health information regularly. A total of 648 (51.8%) and 573 (45.9%) students, respectively, exercised regularly and slept regularly. A total of 913 (73%) participants ate regular breakfast. Most of the students did not consume alcohol regularly (91.9%) and were non-smokers (95.9%). The mean eHEALS score was 27.77/40 points. Students in health-related courses had better eHealth literacy than others (p<0.05); a higher level of study led to higher eHealth literacy (p<0.01); and those who exercised once a week or more had better eHealth literacy (p<0.01).

Conclusion: Study participants demonstrated good eHealth literacy, associated with course, level of study, exercise, and sleep patterns. Future nationwide studies on the impact of eHealth literacy education are needed to prove causation and develop an intervention.


Acknowledgements: The authors thank all the students at the university who participated in the study and the various course representatives who assisted with the recruiting of study participants.

Availability of data and materials: The datasets generated and/or analysed during this study are not publicly available to protect confidentiality, but aggregated data is available from the corresponding author upon reasonable request.

Conflicts of interests: The authors declare that they have no competing interests.

Consent for publication: Not applicable

Ethical approval and consent to participate: The study obtained full ethical approval from the Faculty of Pharmaceutical Science ethical review board. Ref No: FPSRE/UNN/21/0011 (Aug 15, 2021). No identifier information was requested from the respondents. All information obtained from the respondents was treated with the utmost confidentiality. Before each participant signed the written informed consent, we made sure they read it, understood its contents, and decided they wanted to take part in the study. We confirm that all procedures followed the guidance outlined in the Declaration of Helsinki.

Funding: This study did not receive any form of funding from any agencies in the public, commercial, or not-for-profit sectors.

Author contributions: NUI, OJU and BOU-K devised the study and developed/refined the main conceptual ideas. NUI and BOU-K led the study protocol development, ethical application and gaining approvals. All authors undertook recruitment and data collection. OJU undertook the main analysis with critical input from NUI and BOU-K. OJU and BOU-K drafted the manuscript. All authors helped refine the manuscript and approved the final version.


Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit

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