Health information literacy mediates the relationship between active information seeking and HPV-related knowledge among female undergraduates: the moderating role of information channel characteristics.
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BACKGROUND: Cervical cancer remains a significant global public health challenge. Although human papillomavirus (HPV) vaccination effectively reduces incidence, coverage among Chinese female undergraduates remains suboptimal. Adequate HPV-related knowledge (HK) is essential for promoting vaccination uptake; however, the mechanism by which HPV-related active information seeking behavior (AISB) translates into accurate HK through health information literacy (HIL) remains underexplored. This study examines the mediating effect of HIL in the AISB-HK relationship and the moderating roles of primary information access channel type (CT) and channel trust preference (CTR), providing empirical evidence for targeted university-based HPV health education. METHODS: A cross-sectional survey was conducted from May to June 2024 among 519 female undergraduates at a comprehensive university in China. Participants completed a structured questionnaire assessing demographic characteristics, AISB, HIL, HK, CT, and CTR. Mediation and moderated mediation analyses were performed using the PROCESS macro (Model 4 and Model 14), controlling for demographic covariates. RESULTS: HIL partially accounted for the association between AISB and HK (indirect effect = 0.056, 95% CI [0.019, 0.093]). Both CT and CTR significantly moderated the HIL-HK pathway. The HIL-HK association was significant only among participants relying on non-professional channels (B = 0.112, p < 0.001; professional channels: B = 0.018, p = 0.521; index of moderated mediation = -0.075, 95% CI [-0.142, -0.011]). For CTR, the association was significant in both groups but approximately four times stronger among participants trusting non-professional channels (B = 0.210, p < 0.001) than among those trusting professional channels (B = 0.049, p = 0.019; index of moderated mediation = -0.128, 95% CI [-0.235, -0.046]). CONCLUSION: HIL was a significant intermediate link in the association between AISB and HK, and information channel characteristics were associated with the strength of this association. Targeted interventions aimed at enhancing HIL and optimizing health communication channels may help improve HK among college students and advance cervical cancer prevention.