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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Mar 2, 2025
Date Accepted: May 27, 2025

The final, peer-reviewed published version of this preprint can be found here:

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

Liao W, Ma C, Liu X, Sun Z

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

J Med Internet Res 2025;27:e73242

DOI: 10.2196/73242

PMID: 40591934

PMCID: 12264443

The Chain Mediation Role of Self-efficacy, Health Literacy, and Physical Exercise Between Internet Use and Older Adults Health: Cross-Sectional Questionnaire Study

  • Weizhen Liao; 
  • Chengyu Ma; 
  • Xiqiao Liu; 
  • Ziwei Sun

ABSTRACT

Background:

With the widespread use of the internet, the number of elderly internet users is rapidly increasing. Internet use may affect the health of older adults. It is important to explore the relationship between internet use and older adults’ health.

Objective:

This study aims to explore the relationship between internet use and self-rated health among Chinese older adults, while also analyzing the mediating roles of self-efficacy, health literacy, and physical exercise. Additionally, it will explore the moderating effect of education level in this context.

Methods:

Utilizing the 2021 PBICR dataset, this study selected a study population of 1,147 older adults aged 60 and above. Through the integrated application of methods such as multiple linear regression and Bootstrap testing, this study constructed a moderated chained mediation model to investigate the mediation pathways and marginal effects of internet use on the health of older adults.

Results:

Internet use significantly boosts the self-rated health of older adults(B=4.109,P<.01), with this enhancement manifesting through three mediating factors: self-efficacy, health literacy, and physical exercise (P-values were less than 0.001). These factors can operate independently or form a continuous chain of mediation. Additionally, education level moderates the relationship between internet use and both self-efficacy(B=1.834,P<.01)and physical exercise(B=0.174,P<.05), suggesting that among older adults with higher education levels, the beneficial effect of internet use on self-rated health is more pronounced.

Conclusions:

This study explains how internet use impacts the self-rated health of older adults through self-efficacy, health literacy, and physical exercise, enriching research on the intermediary pathways of internet use affecting older adults’ health. It provides a useful reference for actively responding to the aging of the population.


 Citation

Please cite as:

Liao W, Ma C, Liu X, Sun Z

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

J Med Internet Res 2025;27:e73242

DOI: 10.2196/73242

PMID: 40591934

PMCID: 12264443

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