Health Sciences Program Student Theses, Dissertations and Capstones

Document Type


Degree Name

Doctor of Philosophy (PhD) in Health Science

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.


College of Health Care Sciences – Health Science Department

First Advisor

Gesulla Cavanaugh

Second Advisor

Raymond Ownby

Third Advisor

Joshua Caballero

Publication Date / Copyright Date



Nova Southeastern University


Health literacy is related to a variety of health outcomes, including diseases, quality of life, and even death. Few studies have investigated the relation of e-health literacy to outcomes or the mechanism by which they may be related. The purpose of this study was to evaluate the relation of e-health literacy to patients' attitudes toward health care providers, trust in physicians, and medication adherence as well as theextent to which these relations were mediated by locus of control. Data were collected on participants 40 years and older having at least one chronic health condition from the Fostering Literacy for Good HealthToday and the Spanish-related project named Vive Desarollando Amplia Salud at Nova Southeastern University. Participants included 335 persons (mean age 57.5 years; 42 Whites and 293 Nonwhites; 161 men, 164 women, 9 transgender, 1 participant self-described as Other; and a sample mean education of 11.9 years). After controlling for age, education, gender, and race, the health literacy scale score was significantly related to Attitudes Towards Health Care Providers and trust in physicians, but not to medication adherence. The Electronic Health Literacy Scale score was significantly related to locus of control. Analysis of indirect effects showed that the relations between e-health literacy and Attitudes Towards Health Care Providers, trust in physicians, and medication adherence were mediated by internal locus of control. These findings have implications for research aimed at improving patient-provider communications through programs and policies that increase patients' efficacy in using the internet to access health information.


Other Medicine and Health Sciences


Attitudes towards providers, Electronic health literacy, Locus of control, Medication adherence, Trust in physicians