{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:03:38Z","timestamp":1784099018909,"version":"3.55.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>eHealth literacy (eHL) has emerged as an important competency for promoting health equity. Vocational college students are often considered a digitally vulnerable population. Understanding the heterogeneity of eHL in this population and the underlying psychological mechanisms is essential for designing effective health promotion interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to identify latent profiles of eHL among vocational college students, compare differences in health-promoting lifestyle levels across profiles, and examine the mediating role of health self-efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among vocational college students from February to March 2026. The eHealth Literacy Scale, the Health Self-Efficacy Scale, and the Health-Promoting Lifestyle Profile-II were used to collect data. Latent profile analysis (LPA) was used to identify sub-groups, and bias-corrected bootstrap analyses were performed to test the mediation effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 594 vocational college students were included. The mean total eHL score was 25.21\u202f\u00b1\u202f5.26. Three distinct profiles were identified: Low Application-High Confidence (Profile 1, 15%), High Application-Low Critical Thinking (Profile 2, 52%), and High eHealth Literacy (Profile 3, 33%). For health-promoting lifestyle, students in Profiles 2 and 3 scored significantly higher than those in Profile 1 (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), while no significant difference was found between Profile 2 and Profile 3 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). Mediation analysis showed that health self-efficacy partially statistically mediated the association between eHL profile and health-promoting lifestyle when comparing Profile 1 with Profile 2 (effect\u202f=\u202f0.463, standard error [SE]\u202f=\u202f0.091, 95% confidence interval [CI] 0.345, 0.586) and Profile 1 with Profile 3 (effect\u202f=\u202f0.697, SE\u202f=\u202f0.126, 95% CI 0.464, 0.963). The proportion mediated increased from 43.62% for the transition from low to moderate eHL to 64.37% for the transition from low to high eHL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>eHL among vocational college students was heterogeneous, and health self-efficacy was statistically tested as a significant mediator in the association between eHL profiles and health-promoting lifestyle, though causal inference is limited by the cross-sectional design. These findings suggest that vocational college students should not be treated as a homogeneous population in health promotion practice. Instead, person-centered interventions should be tailored to specific eHL profiles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1864980","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:03:56Z","timestamp":1784095436000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["eHealth literacy, health self-efficacy, and health-promoting lifestyle among vocational college students: a latent profile and mediation analysis study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuanyuan","family":"Ni","sequence":"first","affiliation":[{"name":"Department of Infirmary, Wuxi University of Technology","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Li","sequence":"additional","affiliation":[{"name":"School of Medicine, Chongqing College of Humanities, Science & Technology","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Ji","sequence":"additional","affiliation":[{"name":"School of Nursing, Changzhi Medical College","place":["Changzhi, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongchao","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Infirmary, Wuxi University of Technology","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"An","sequence":"additional","affiliation":[{"name":"Department of Infirmary, Wuxi University of Technology","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongming","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Infirmary, Wuxi University of Technology","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e40622","DOI":"10.2196\/40622","article-title":"The impact of digital transformation on inpatient care: mixed methods study","volume":"9","author":"Koebe","year":"2023","journal-title":"JMIR Public Health Surveill"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"971486","DOI":"10.3389\/fpubh.2022.971486","article-title":"Digital transformation of health quality services in the healthcare industry during disruption and society 5.0 era","volume":"10","author":"Natakusumah","year":"2022","journal-title":"Front Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"100316","DOI":"10.1016\/j.lanepe.2022.100316","article-title":"The dawn of digital public health in Europe: implications for public health policy and 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