Evaluating e-health literacy, knowledge, attitude and practice regarding COVID-19 prevention and Self-Protection among Iranian students: a cross-sectional online survey

Background The coronavirus 2019 (COVID-19) pandemic requires integrated intervention by both the governments and individuals. University students have a great role in distributing reliable information about disease prevention behaviors. The aim of this study was to identify the Knowledge, Attitude and Practice of COVID-19 Prevention and Self-Protection behaviors in students. Methods This cross-sectional online survey was conducted on Iranian university students. All students filled a questionnaire consisting of demographic characteristics, e-Health Literacy Scale (EHEALS) questionnaire and a researcher-made knowledge, attitude and practice (KAP) questionnaire. Data was analyzed using the SPSS software. Results A total of 925 students (69.9% female) participated in this study. The median age of the students was 23 years old. Majority of students (641, 69.3%) were non-medical students. The median and interquartile range (IQR) for knowledge, attitude, practice and P-EHEALS scores in Medical students were 52.00 (27.00), 4.00 (1.00), 28.00 (8.00), and 26.00 (9.00), respectively which were significantly higher than non-medical students, 28.00 (15.00), 3.00 (2.00), 20.00 (8.00), and 26.00 (9.00), respectively (p < 0.001). Practice score was a significant related to knowledge (p < 0.001), attitude (p < 0.001), having a COVID-19 infected family member (p < 0.001), older age (p < 0.001), medical field of education (p = 0.001), higher EHEALS score (p = 0.018), and female gender (p = 0.013). Knowledge, attitude and having a COVID-19 infected person in family were the strongest predictors of preventive practices. Conclusions KAP and E-Health literacy of university students, especially non-medical students, should be considered in order to improve COVID-19 preventive behaviors in the society.