The Mediating Role of e-Health Literacy in Self-efficacy and Depressive Symptoms among Chinese College Students

Background: Depressive symptoms is a relatively common mental disorder, which can lead to serious physical, psychological, and social problems. This study aimed to explore the associations between self-efficacy, e-Health literacy and depressive symptoms among Chinese college students and to evaluate the effect of e-Health literacy as a potential mediator. Methods: By using a cluster sampling method, 1500 students from two universities were recruited in Nantong City, China. Participants' demographic characteristics, self-efficacy, e-Health literacy and depressive symptoms were collected. OLS was used to explore the associations between variables and the Karlson Holm and Breen method was used to estimate the mediation effect. Results: A total of 1388 valid questionnaires were collected. The prevalence of depressive symptoms among the sample was 50.29%. Higher self-efficacy and e-Health literacy were all significantly associated with lower levels of depressive symptoms. E-health literacy partially mediated the association between self-efficacy and depressive symptoms, accounting for 26.6% of the total effect. Conclusion: Our results indicated that self-efficacy was negatively associated with depressive symptoms in college students. E-health literacy partially mediated the association between self-efficacy and depressive symptoms. Interventions for college students should include increasing self-efficacy, e-health literacy to attenuate depressive symptoms.