Digital Health Literacy and the Risk of Following Misinformation About Common Diseases Among University Students: A Narrative Review
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Background. University students rely heavily on the internet and social media for health information. At the same time, health misinformation about vaccines, infectious diseases and everyday conditions circulates widely online. Digital health literacy (DHL) is widely proposed as a protective skill, but the evidence linking DHL to resistance against misinformation in students has not been brought together.
Objective. To synthesise evidence on (1) the concept and measurement of DHL, (2) the scale and consequences of health misinformation, (3) the level of DHL and the misinformation-related behaviour of university students, with attention to Pakistan, and (4) interventions that may reduce students’ vulnerability.
Methods. A narrative review based on targeted searches of open-access biomedical, public health and communication sources, supplemented by reference tracing. Systematic reviews, cross-sectional studies, intervention studies and landmark conceptual papers were included. The review is not a systematic review, and no meta-analysis was attempted.
Results. Three consistent themes emerge. First, students generally report moderate to high confidence in finding health information online, but confidence in judging its quality and usefulness is lower, and most DHL research relies on self-report rather than performance tests. Second, health misinformation is common, its measured proportion on social media varies widely across studies, and its documented harms include vaccine hesitancy and delayed care; a 2019 polio vaccine rumour in Pakistan illustrates how quickly harm can follow. Third, students in several countries report meeting and passing on misinformation, and students in health fields are not immune. Educational interventions, especially those building evaluation skills and those using inoculation approaches, are promising, but the evidence base for health outcomes is thin. Direct evidence on misinformation about specific common diseases such as diabetes, hypertension, dengue or hepatitis among students is scarce.
Conclusions. Self-rated DHL should not be treated as proof that students can resist misinformation. Universities should teach and assess appraisal skills for all disciplines, and future studies should pair self-report scales with performance-based tests and disease-specific misinformation measures.
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