I Think I Can: How Health Literacy Influences Self-Efficacy Among College Students

Background and Purpose: Previous research suggests that for some students college is a time of high stress, serious mental health challenges, and high-risk substance use habits. Students with these challenges have higher rates of depression and anxiety, lower grades, and higher rates of suicide ideation, attempts, and completions. Self-efficacy (one's belief in their abilities) and health literacy (one’s ability to read, understand, and apply health information) are two factors that promote wellbeing and positive health behaviors among college students. Previous research has focused on the relationship between health literacy and self-efficacy with diverse adult populations, mainly in health care settings, such as pregnant women, individuals with diabetes, and individuals with mental health needs. Yet little research has been conducted among college students. The purpose of this study was thus to determine the relationship between self-efficacy and health literacy among college students throughout the United States.

Method: Data were collected using quota sampling from 410 undergraduate students. Health literacy was measured using the All Aspects of Health Literacy Scale, which measures functional health literacy (one’s ability to access and read health information), communicative health literacy (one’s ability to extract and understand health information from different sources), and critical health literacy (one’s ability to apply health information). Self-efficacy was measured using the brief General Self-Efficacy Scale. Control variables included age, gender, race, parent’s yearly income, previous mental health diagnosis, and previous diagnosis of a chronic health condition. Three linear regression models were used to identify how functional, communicative, and critical health literacy uniquely predicted self-efficacy.

Results: Self-efficacy was positively predicted by functional (b = 2.77; d = 0.26; p < 0.001), communicative (b = 2.94; d = 0.27; p < 0.01), and critical health literacy (b = 1.51; d = 0.14; p < 0.05). Previous mental health diagnosis was also a significant predictor in all three models, having a negative relationship with self-efficacy, and parent’s yearly income was statistically significant in the critical health literacy model. Previous diagnosis of a chronic health condition was not statistically significant in any of the three models.

Conclusions and Implications: Our findings suggest a positive relationship between self-efficacy and health literacy in the college student population in the United States. Self-efficacy is developed as one successfully accomplishes and perseveres through challenging goals and tasks. As college is a time when many students must navigate the healthcare system on their own for the first time, successfully doing so (i.e., health literacy) could promote one’s self-efficacy in other areas. However, the majority of students enter college without having had sufficient health education. Colleges and universities could attempt to fill this gap by providing easily accessible health literacy resources and education. As our results suggest, health literacy education may also lead to higher self-efficacy, which may result in lower rates of depression and anxiety, higher grades, academic achievement, and life satisfaction, and an overall healthier and happier student body.