JMIR Publications

ABSTRACT

Background:

Non-pharmacological management plays a key role in enhancing the quality of life for individuals with chronic obstructive pulmonary disease (COPD), asthma, or both. However, disparities in their physical, mental, and health empowerment outcomes have not been fully explored, particularly in relation to the moderating effect of eHealth literacy.

Objective:

This study aims to assess these disparities and examine how eHealth literacy moderates them, to guide the development of tailored non-pharmacological strategies.

Methods:

We analyzed two national Chinese surveys of individuals with self-reported asthma, COPD, or both, assessing five physical, four mental, and three health empowerment outcomes. Multiple regression with Holm-Bonferroni corrections revealed health disparities and moderation effect of eHealth literacy.

Results:

The study included 1,044 participants (254 with asthma, 696 with COPD, and 95 with both; mean age = 48.61±19.70 years; 51.3% male). Linear regression showed that individuals with both COPD and asthma had lower health-related quality of life and higher anxiety and depression compared to those with either condition alone. This group also showed higher nicotine dependence than asthma-only and lower resilience than COPD-only groups (all adjusted p < 0.05). eHealth literacy significantly moderated the effect of disease group on all outcomes except physical activity (all adjusted p for interaction < 0.05). Nine disease pairs showed disparities in both eHealth literacy groups, four only in high literacy, and eight only in low literacy (all p < 0.05).

Conclusions:

Individuals with both COPD and asthma have poorer outcomes. eHealth literacy can reduce most disparities but may worsen mental health disparities. Low eHealth literacy is associated with more disparities than high literacy. Interventions should tailor eHealth literacy tools to specific conditions, while also enhance overall eHealth literacy and integrate mental health support.