JMIR Publications

ABSTRACT

Background:

Chronic diseases are the leading causes of death and disability. With the growing patient population and climbing healthcare expenditures, researchers and policymakers are seeking new approaches to improve the accessibility of health information on chronic diseases while lowering the costs. Online health information sources can play a substantial role in effective patient education and health communication. However, some contradictory evidence also suggests that patients with chronic conditions may not necessarily seek online health information.

Objective:

The aim of this study was to investigate the effects of perceived risk and perceived benefits on patients’ OHIS behavior with chronic conditions empirically. On the basis of HBM theory, we examined the influencing factors of perceived risk by two antecedents, namely perceived susceptibility and perceived severity. Meanwhile, drawing on social support theory, we explored the impact of informational support and emotional support on the perceived benefits of chronic patients in OHCs. In addition, this paper focused on the critical health literacy to explore how it moderates the effects of perceived risk and perceived benefits on OHIS behavior.

Methods:

To validate our hypotheses, we proposed a research model by integrating the above theories and developing corresponding measurement instruments. By employing the survey method, we collected data from online chronic disease communities and groups on social media. The eligible participants are consumers with at least one chronic condition and those who had the experience of seeking health information online. A total of 390 valid questionnaires were collected, and partial least square was performed to analyze the data.

Results:

Perceived risk (t=3.989, P<.001) and perceived benefits (t=3.632, P<.001) significantly affected chronic patients’ OHIS behaviors. Perceived susceptibility (t=7.743, P<.001) and perceived severity (t=8.852, P<.001) were found to influence the perceived risk of chronic diseases significantly, whereas informational support (t=5.761, P<.001) and emotional support (t=5.748, P<.001) also impacted the perceived benefits of online sources for patients with chronic conditions. In addition, our moderation analysis showed that critical health literacy negatively moderated the effect of perceived risk on OHIS behavior, however, the moderating effect of critical health literacy on perceived benefits and OHIS behavior was not significant.

Conclusions:

The integrated model proposed and tested in this study shows that the HBM, when combined with the social support theory, is able to predict OHIS behavior of patients with chronic diseases. Results of this study provided the insight and an understanding that health beliefs and social support have positive impacts on OHIS behaviors of patients with chronic diseases. In particular, perceived risk and perceived benefits can positively influence OHIS behavior. Among them, perceived susceptibility and perceived severity can effectively predict perceived risk, and informational support and emotional support can effectively predict perceived benefit. Our study also demonstrated the important moderating role of critical health literacy on OHIS behavior. In particular, critical health literacy negatively moderated the effect of perceived risk on OHIS behavior.