With the rapid development of online technologies, people now need to have essential skills to search, evaluate, and use online health information to solve health problems, which are known as electronic health (eHealth) literacy. Past studies mostly investigated eHealth literacy as perceived skills measured by self-assessment scales. This approach raises questions of its validity. There is a lack of understanding of eHealth literacy through an objective lens. Based on self-efficacy theory, my dissertation proposed hypotheses to investigate the relationships among perceived eHealth literacy, information search behaviors and search outcomes. Two research questions were also proposed to investigate 1) the mediation effect of information search behaviors on the relationship between eHealth literacy and search outcomes; 2) eHealth literacy’s effect on information search behaviors in three search phases.

A quasi-experimental study was conducted. 17 participants each in low and high eHealth literacy groups searched information on three fact-finding tasks. Three main information search behaviors – query formulation, information evaluation, information extraction – were recorded. Search outcomes included participants’ knowledge gained and confidence change after the search. Content analysis and regression analyses were performed. The findings showed that low and high eHealth literacy groups had different search strategies on SERPs and content webpages. Furthermore, despite the fact that both groups were able to find the correct answers, high eHealth literacy participants were more confident in their answer than low eHealth literacy participants. The study did not find information search behaviors mediating the relationship between eHealth literacy and search outcomes. The search strategies also differed between the two groups in different search phases. People with high eHealth literacy spent more time on SERPs in the first phase. On the contrary, people with low eHealth literacy read more on SERPs in the last phase. One practical implication from the findings is to predict people’s eHealth literacy according to their search strategies in different search phases. The findings contribute to the literature by revealing how people with different eHealth literacy levels perform search behaviors. The results provide future research directions in developing objective measurement of eHealth literacy based on information search behaviors.