The purpose of this study was to investigate the relationship among Taiwanese high school students’ learning style, sense of presence, cognitive load, and affective and cognitive learning outcomes in an immersive virtual reality-based learning environment. This study used a teaching experiment intervention method. Seventy-seven students participated in the virtual reality-based learning environment and completed related scales and a test. This study found that although the students’ learning style does not influence learning outcomes, it may influence the subjective sense of presence and cognitive load in the learning process. Regarding the affective learning outcome, involvement/immersion, sensory fidelity, and mental effort are positive predictors. In addition, involvement/immersion, interface quality, mental load, and mental effort are negative predictors of cognitive learning outcomes. The conclusion from this study is that students with some learning style preferences must bear a greater cognitive load to achieve the same learning outcomes as other students. This study also points out that the components of sense of presence and cognitive load generate inconsistent predictive effects on affective and cognitive learning outcomes, respectively. Therefore, it is important to deeply explore the influence of sense of presence and cognitive load structure on learning in virtual environments.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Background: Given the recognized importance of preventing poor dietary behaviors during adolescence, we need a better understanding of college students’ dietary behaviors. Studies have found that individual factors and electronic health (eHealth) literacy may affect one’s dietary behaviors. However, few studies have fully investigated the effect of the three levels of eHealth literacy (functional, interactive, and critical) and the interactive effect of individual factors (eg, gender, monthly expenses, and frequency of cooking) and the three levels of eHealth literacy on the four aspects of dietary behaviors (consumer health, balanced diet, regular eating habits, and unhealthy food intake).Objective: This study aimed to investigate whether individual differences and higher eHealth literacy are associated with more positive dietary behaviors and less unhealthy dietary intake.Methods: The eHealth Literacy Scale is a 12-item instrument designed to measure college students’ functional, interactive, and critical eHealth literacy. The Dietary Behaviors Scale is a 14-item instrument developed to measure four aspects of dietary behaviors of college students. A questionnaire was administered to collect background information about participants’ gender, monthly expenses, and frequency of cooking. A national sample of college students was surveyed, and 813 responses were obtained. We conducted a multiple regression analysis to examine the association among individual factors, eHealth literacy, and dietary behaviors.Results: This study found that functional eHealth literacy was negatively related to unhealthy food intake (beta=−.11; P=.01), and interactive eHealth literacy was positively related to balanced diet (beta=.25; P<.001) and consumer health (beta=.15; P=.02). Moreover, critical eHealth literacy was positively related to consumer health (beta=.30; P<.001) and regular eating habits (beta=.20; P=.002). Finally, the interactive effect between gender and interactive eHealth literacy was negatively related to balanced diet (beta=−.22; P<.001). The interactive effect between monthly expenses and functional eHealth literacy was positively related to balanced diet (beta=.07; P=.03), although the interactive effect between monthly expenses and critical eHealth literacy was negatively related to balanced diet (beta=−.10; P=.047).Conclusions: This study showed that Taiwanese college students with higher functional eHealth literacy were more likely to engage in fewer unhealthy food consumption practices. Those who had higher interactive and critical eHealth literacy were more likely to engage in positive dietary behaviors than those with functional eHealth literacy. Surprisingly, females with high interactive eHealth literacy were more likely to have a poor balanced diet. In contrast, students with higher monthly expenses and higher functional eHealth literacy were more likely to have a balanced diet. However, students with higher monthly expenses and higher critical eHealth literacy were less likely to maintain a balanced diet.

Purpose: Knowledge, attitude, and practice (KAP) models are often used by researchers in the field of public health to explore people’s healthy behaviors. Therefore, this study mainly explored the relationships among participants’ sociodemographic status, COVID-19 knowledge, affective attitudes, and preventive behaviors. Method: This study adopted an online survey, involving a total of 136 males and 204 females, and used a cross-sectional study to investigate the relationships between variables including gender, age, COVID-19 knowledge, positive affective attitudes (emotional wellbeing, psychological wellbeing, and social wellbeing), negative affective attitudes (negative self-perception and negative perceptions of life), and preventive behaviors (hygiene habits, reducing public activities, and helping others to prevent the epidemic). Results: The majority of participants in the study were knowledgeable about COVID-19. The mean COVID-19 knowledge score was 12.86 (SD = 1.34, range: 7–15 with a full score of 15), indicating a high level of knowledge. However, the key to decide whether participants adopt COVID-19 preventive behaviors was mainly their affective attitudes, especially positive affective attitudes (β = 0.18–0.25, p< 0.01), rather than COVID-19 disease knowledge (β = −0.01–0.08, p > 0.05). In addition, the sociodemographic status of the participants revealed obvious differences in the preventive behaviors; females had better preventive behaviors than males such as cooperating with the epidemic prevention hygiene habits (t = −5.08, p< 0.01), reducing public activities (t = −3.00, p< 0.01), and helping others to prevent the epidemic (t = −1.97, p< 0.05), while the older participants were more inclined to adopt preventive behaviors including epidemic prevention hygiene habits (β = 0.18, p = 0.001, R² = 0.03), reducing public activities (β = 0.35, p< 0.001, R² = 0.13), and helping others to prevent the epidemic (β = 0.27, p< 0.001, R² = 0.07). Conclusions: Having adequate COVID-19 knowledge was not linked to higher involvement in precautionary behaviors. Attitudes toward COVID-19 may play a more critical function in prompting individuals to undertake preventive behaviors, and different positive affective attitudes had different predictive relationships with preventive behaviors.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: eHealth literacy has become an important topic in the health field and related fields. Studies have found that individuals with higher eHealth literacy are more likely to use preventive care services and to have effective interactions with their physician. In addition, previous studies have shown that there is a gender difference in the utilization of physician access and outpatient services. Nevertheless, few studies have explored the associations among gender, eHealth literacy, and various determinants of health services utilization among college students. Moreover, there is a lack of studies that focus on the three levels of eHealth literacy as predictors of health services utilization. Objective: To investigate the associations among gender, eHealth literacy, and health services utilization. Methods: The eHealth Literacy Scale is a 12-item instrument designed to measure college students’ functional, interactive, and critical eHealth literacy. The Health Services Utilization Scale is a 10-item instrument developed to measure four dimensions of health services utilization by college students. A nationally representative sample of 489 valid college students in Taiwan was surveyed. We then conducted a multiple regression analysis to examine the associations among gender, eHealth literacy, and health services utilization. Results: The study found that being female negatively predicted the purpose dimension of health services utilization (t484=-2.85, P<0.01). Moreover, critical (t484=2.98-4.23, P<0.01) and interactive eHealth literacy (t484=2.43-2.89, P<0.05) predicted 3 of the health services utilization dimensions, and functional eHealth literacy predicted only the purpose dimension (t484=-2.63, P<0.01). Conclusions: This study found that participants with high interactive and critical eHealth literacy are more likely to utilize various determinants of health services. Moreover, it found that participants with low functional or high interactive eHealth literacy might have a short time interval for visiting a doctor and that females are less likely to seek preventive, illness-related and custodial care