The Chain Mediation Role of Self-Efficacy, Health Literacy, and Physical Exercise in the Relationship Between Internet Use and Older Adults’ Health: Cross-Sectional Questionnaire Study
Abstract
Background With the widespread use of the internet, the number of older internet users is rapidly increasing. However, the role of individual factors such as self-efficacy, health literacy, and physical exercise in the chain of influence between internet use and the health of older adults is unclear. Objective On the basis of the media effects theory and the health belief model, we aimed to explore the relationship between internet use and self-rated health among Chinese older adults. We also analyzed the mediating roles of self-efficacy, health literacy, and physical exercise and examined how these mediating effects varied by sex, residence, and per capita monthly household income groups. In addition, we investigated the moderating effect of education level. Methods We included 1147 participants aged ≥60 years from the 2021 Psychology and Behavior Investigation of Chinese Residents project in this study. Using a combination of multiple linear regression and bootstrap testing, we constructed a chain mediation model and a moderated chain mediation model to examine how internet use affects older adults’ health through self-efficacy, health literacy, and physical exercise. In addition, we explored the marginal effects of education level within each mediation pathway. Results Internet use significantly improved the self-rated health of older adults (B=2.183; P<.001), and this improvement was exclusively mediated by self-efficacy (B=0.502; P<.001), health literacy (B=5.415;…
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