Digital Health Adoption, eHealth Literacy, and Trust in AI Among Generation Z University Students in Sri Lanka: An Empirical Study
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Background
Digital health technologies—spanning mobile applications, telemedicine, and AI-driven platforms—are rapidly reshaping healthcare delivery globally. Although Generation Z university students are classified as digital natives, empirical data evaluating their eHealth literacy, technology acceptance, and specific trust barriers in developing South Asian nations like Sri Lanka remain scarce.
Objective
This study evaluated eHealth literacy, technology acceptance, online health information-seeking behaviors, and adoption barriers among Gen Z undergraduates in Sri Lanka, focusing on the interplay between eHealth literacy, AI trust, and digital care preferences.
Methods
A cross-sectional survey (N = 172) was conducted among Sri Lankan university undergraduates utilizing adapted, validated instruments: the eHealth Literacy Scale (eHEALS) and the Technology Acceptance Model (TAM). Statistical analysis included scale reliability validation (Cronbach’s alpha), descriptive profiling, Chi-Square (χ 2 ) contingency tests, Pearson correlations, and Multiple Linear OLS Regression models.
Results
Participants demonstrated high overall eHealth literacy (Mean = 3.84 ± 0.58) and strong endorsement of digital health utility (Mean = 3.99 ± 0.59). Online health searches were reported by 86.6% of respondents. AI tools (e.g., ChatGPT, Gemini) emerged as the second most frequent source for health queries (57.6%), surpassing YouTube (44.2%) and social media (26.2%), with medical students showing significantly higher AI utilization (χ 2 = 8.70, p = .003). In multiple regression analysis, digital platform preference over physical clinic visits (R 2 = .352, p < .001) was significantly predicted by Perceived Ease of Use (β = 0.371, p = .001) and Trust in AI Recommendations (β = 0.370, p < .001), whereas face-to-face consultation preference (76.7%) and personal data privacy risks (50.0%) remained predominant adoption barriers.
Conclusion
Gen Z students in Sri Lanka exhibit high digital health readiness and substantial reliance on AI-driven information seeking. However, institutional deployment must address privacy concerns and integrate hybrid clinical workflows to bridge the gap between high perceived utility and physical consultation preferences.
Author Summary
Why was this study done?
Generation Z university students are often called “digital natives,” but we know very little about how young adults in lower-middle-income countries like Sri Lanka actually use digital health apps, online platforms, and AI tools for their personal health.
What did the researchers do and find?
We surveyed 172 university students across Sri Lanka using standardized measures of digital health literacy and technology acceptance. We found that 86.6% search for health information online. Surprisingly, conversational AI tools (such as ChatGPT and Gemini) have become the second most popular source for health queries (57.6%), surpassing YouTube, social media, and official government health websites. While students recognize the potential of digital health tools, 76.7% still prefer seeing a doctor face-to-face, primarily due to concerns about personal data privacy and a lack of awareness about local digital services.
What do these findings mean?
Young adults are eager to use digital health tools and interactive AI, but high technology access alone does not translate to full adoption of online medical care. To build trust, healthcare systems in Sri Lanka must create easy-to-use, privacy-protected platforms that combine automated digital convenience with professional medical oversight.
