Research Group
The G-Power 3.0.1 program was used to determine the sample size. α value was calculated as 0.05, medium effect size as 0.15, and Power (1-β) as 0.95. According to the result of Critical F = 19.3500000 and Actual power = 0.9505747, it was detected that at least 129 students should participate in the study. The research group consisted of 333 university students, 159 males (47.7%) and 174 females (52.3%). Of the participants, 95 were 1st-grade students (28.5%), 119 were 2nd-grade students (35.7%), 59 were 3rd-grade students (17.7%), and 60 were 4th-grade students (18.1%). While 97 participants (29.1%) in the research group stated they participated in extra-curricular sportive activities, 236 participants (70.9%) said they did not. The height average of the participants was x = 178.58/Ss = 11.103, and that of weight was x = 68.34/Ss = 16.155.
Data Collection Tools
E-Health Literacy Scale
The scale, whose validity and reliability study was conducted to determine the e-health literacy levels of individuals, consisted of a total of eight items and a single dimension [27]. The internal consistency coefficient of the scale was determined as 0.97. There were no reverse scoring items in the scale, and it was designed in a five-point Likert type. Confirmatory factor analysis (x2 = 55.261/Df = 16, CFI = 0.988, TLI = 0.980, NFI = 0.984, IFI = 0.988, RMSEA = 0.086, SRMR = 0.014) for the application of the e-health literacy scale on the current research sample shows that the scale has acceptable fit values [28].
Obesity Awareness Scale
The scale, which was developed to determine the obesity awareness levels of individuals and adapted into Turkish by Kafkas and Özen [29], consists of three sub-dimensions and a total of twenty items. Within the scope of the study, only the obesity awareness sub-dimension of the scale was included in the research. The obesity awareness sub-scale consists of nine items in total. The scale was designed as a four-point Likert type (29). Confirmatory factor analysis (x2 = 81.16/Df = 23, CFI = 0.981, TLI = 0.970, NFI = 0.973, IFI = 0.981, RMSEA = 0.087, SRMR = 0.022) for the application of the Obesity Awareness Scale on the current research sample shows that it has acceptable fit values [28].
Physical Activity Attitude Scale In Children And Adolescents: The scale, whose validity and reliability study were conducted to determine the attitudes of children and adolescents toward physical activity, consists of twelve items in total and two dimensions: positive attitude and negative attitude. The positive attitude sub-dimension comprises seven items, with an internal consistency coefficient of 0.85. The negative attitude sub-dimension includes five items, with an internal consistency coefficient of 0.80. The scale was designed as a five-point Likert type [30]. Confirmatory factor analysis (x2 = 112.467/Df = 42, CFI = 0.978, TLI = 0.971, NFI = 0.966, IFI = 0.978, RMSEA = 0.071, SRMR = 0.032) for the application of the physical activity attitude scale in children and adolescents on the current study sample shows that it has acceptable fit values [28].
Data Analysis
The Jasp 0.18.3.0 statistical program was used for data analysis. Skewness and kurtosis values were examined to assess the normality distribution of the data. Kline stated that the kurtosis and skewness values should be less than three for the data set to be normally distributed [31]. Pearson correlation analysis was applied to examine the relationship between e-health literacy, obesity awareness, and attitudes toward physical activity. In the research, the independent variable was e-health literacy, the dependent variable was obesity awareness, and the mediating variables were positive and negative attitudes toward physical activity. The bias-corrected bootstrapping 5000 method was employed to ascertain the significance of the mediating variable. For the significance of the mediation effect, it was checked that there was no zero value between the confidence intervals showing the lower and upper limits [32].
Table 1
Variables
|
1
|
2
|
3
|
4
|
Skewness
|
Kurtosis
|
X
|
SD
|
EHL
|
-
|
,730**
|
,648**
|
-,498**
|
-,756
|
-,151
|
3,843
|
,996
|
OA
|
-
|
-
|
,622**
|
-,467**
|
-,418
|
-,740
|
3,185
|
,713
|
PA+
|
-
|
-
|
-
|
-,627**
|
-1,272
|
,936
|
4,113
|
,989
|
PA-
|
-
|
-
|
-
|
-
|
1,199
|
1,108
|
1,953
|
,942
|
1 = E-Health Literacy, 2 = Obesity Awareness, 3 = Positive attitudes toward physical activity, 4 = Negative attitudes toward physical activity
The relationship between e-health literacy, obesity awareness, and positive and negative attitudes toward physical activity is given in Table 1. There was a significant positive relationship between e-health literacy and obesity awareness (r=,730, P = 001). In addition, there was a significant positive relationship between e-health literacy and positive attitudes toward physical activity (r=,648). There was a significant negative relationship between e-health literacy and negative attitudes toward physical activity (r=-,498). There was a significant positive relationship between obesity awareness and positive attitudes toward physical activity (r=,622), while there was a significant negative relationship between obesity awareness and negative attitudes toward physical activity (r=-,467) (Table 1).
Table 2
|
|
|
|
|
|
95% Confidence Interval
|
Factor
|
Item
|
Est.
|
Std. Error
|
z-value
|
p.
|
Lower
|
Upper
|
OA
|
OA1
|
0.613
|
0.035
|
17.340
|
< .001
|
0.543
|
0.682
|
OA2
|
0.670
|
0.036
|
18.783
|
< .001
|
0.600
|
0.740
|
OA3
|
0.668
|
0.036
|
18.777
|
< .001
|
0.598
|
0.738
|
OA4
|
0.724
|
0.035
|
20.687
|
< .001
|
0.655
|
0.792
|
OA5
|
0.688
|
0.034
|
20.151
|
< .001
|
0.621
|
0.755
|
OA6
|
0.785
|
0.040
|
19.695
|
< .001
|
0.707
|
0.863
|
OA7
|
0.767
|
0.046
|
16.732
|
< .001
|
0.677
|
0.857
|
OA8
|
0.712
|
0.035
|
20.170
|
< .001
|
0.643
|
0.782
|
OA9
|
0.792
|
0.039
|
20.391
|
< .001
|
0.716
|
0.868
|
EHL
|
EHL1
|
0.959
|
0.046
|
20.658
|
< .001
|
0.868
|
1.050
|
EHL2
|
1.030
|
0.046
|
22.593
|
< .001
|
0.941
|
1.120
|
EHL3
|
0.974
|
0.044
|
22.155
|
< .001
|
0.888
|
1.061
|
EHL4
|
1.006
|
0.046
|
21.990
|
< .001
|
0.916
|
1.095
|
EHL5
|
0.999
|
0.046
|
21.623
|
< .001
|
0.908
|
1.089
|
EHL6
|
0.937
|
0.046
|
20.276
|
< .001
|
0.847
|
1.028
|
EHL7
|
0.987
|
0.047
|
20.841
|
< .001
|
0.895
|
1.080
|
PAA+
|
ESOY8
|
0.952
|
0.053
|
17.925
|
< .001
|
0.847
|
1.056
|
PAA + 1
|
0.933
|
0.051
|
18.166
|
< .001
|
0.832
|
1.033
|
PAA + 2
|
0.954
|
0.049
|
19.349
|
< .001
|
0.858
|
1.051
|
PAA + 3
|
-0.608
|
0.062
|
-9.818
|
< .001
|
-0.729
|
-0.487
|
PAA + 4
|
-0.584
|
0.055
|
-10.648
|
< .001
|
-0.691
|
-0.476
|
PAA + 5
|
0.969
|
0.044
|
21.847
|
< .001
|
0.882
|
1.055
|
PAA + 6
|
0.955
|
0.044
|
21.753
|
< .001
|
0.869
|
1.041
|
PAA + 7
|
1.003
|
0.050
|
20.086
|
< .001
|
0.905
|
1.101
|
PAA-
|
PAA-8
|
1.063
|
0.049
|
21.807
|
< .001
|
0.967
|
1.158
|
PAA-9
|
-0.625
|
0.055
|
-11.427
|
< .001
|
-0.732
|
-0.518
|
PAA-10
|
-0.655
|
0.055
|
-11.830
|
< .001
|
-0.764
|
-0.547
|
PAA-11
|
-0.586
|
0.065
|
-8.959
|
< .001
|
-0.714
|
-0.458
|
PAA-12
|
0.903
|
0.046
|
19.649
|
< .001
|
0.813
|
0.993
|
EHL = E-Health Literacy, OA = Obesity Awareness, PAA + = Positive attitudes toward physical activity, PAA-=Negative attitudes toward physical activity
Table 2 presents the factor loadings and 95% confidence intervals of the four-factor measurement model utilized in the measurement study. The CFA results indicate that the construct validity of the four-factor measurement model holds acceptable values (χ²=1205.510/Df = 367, p = < .001, CFI = 0,922, IFI = 0,922 TLI = 0,914, RMSEA = 0.083, NFI = 0.892, SRMR = 0.060, GFI = 0,969) (Table 2).
It was detected that e-health literacy had a positive and significant effect on obesity awareness (β = 0.408, t = 11.696, p = < .001, CI=[0.340–0.477]). It was found that e-health literacy had a negative and significant effect (β=-0.462, t=-10.482, p = < .001, CI=[-0.548, -0.376]) on negative attitudes toward physical activity. E-health literacy was found to have a positive and significant effect (β = 0.643, t = 15.546, p = < .001, CI=[0.562–0.724]) on positive attitudes toward physical activity. The mediating effect of positive attitudes toward physical activity between e-health literacy and obesity awareness was found to be positive and significant (β = 0.0112, t = 4.259, p = < .001, CI=[0.060–0.163]. It was determined that the mediating effect of negative attitudes toward physical activity between e-health literacy and obesity awareness was not significant (β = 0.0162, t = 0.913, p = 0.361, CI=[-0.018-0.049]. The predictive effect of e-health literacy and attitudes toward physical activity on obesity awareness was found to be 57%. It was identified that e-health literacy explained 25% of the negative attitudes toward physical activity and 42% of the positive attitudes toward physical activity (Table 3).
EHL = E-Health Literacy, OA = Obesity Awareness, PA + = Positive attitudes toward physical activity, PA-=Negative attitudes toward physical activity