Electronic Health (eHealth) Literacy and Self-Care Behaviors-Results from a Survey of University Students in a Developing Country

eHealth literacy (eHL) is directly linked to disease prevention, health promotion, and improved healthcare outcomes. The objectives of this study are to assess undergraduate university students' knowledge and perceived skills of finding, appraising, and applying electronic health information to health-related problems, as well as to assess the association of eHL with physical, psychological, and emotional self-care. Methods: The measurement model, comprising four correlated factors based on the 28 valid items from two reliable and valid tests, the 'eHealth literacy scale (eHEALS)' and 'the self-care assessment tool (SCAT)', was estimated using confirmatory factor analysis (CFA) among a sample of 1557 undergraduate university students in Pakistan. Results: The mean value of the eHEALS ranges between 2.90 and 3.33, indicating that the majority of the respondents had moderate levels of eHL skills. Female respondents and respondents from urban areas have greater levels of perceived eHL skills compared with their male and rural counterparts. The CFA model fit indices show that the goodness of fit values are acceptable: x2 = 7.727, p = 0.000; RMSEA = 0.065; TLI = 0.930, CFI = 0.936, IFI = 0.936, GFI = 0.890, NFI = 0.928, RFI = 0.920, PGFI = 0.754. Conclusion: Electronic health (eHealth) literacy has a strong positive association with physical, psychological, and emotional self-care. However, perceived eHL skills among undergraduate university students are moderate, making them potentially susceptible to health risks. Implications: Our study has several practical implications. Its findings can be used to devise eHealth literacy programs for developing relevant skills among undergraduate university students based on their identified needs.