Online Health Information Seeking, eHealth Literacy, and Health Behaviors Among Chinese Internet Users: Cross-Sectional Survey Study

Abstract

Background: The internet has become an increasingly vital platform for health-related information, especially in upper-middle-income countries such as China. While previous research has suggested that online health information seeking (OHIS) can significantly impact individuals’ engagement in health behaviors, most research focused on patient-centered health communication. Objective: This study aims to examine how OHIS influences health behavior engagement among Chinese internet users, focusing on the role of eHealth literacy and perceived information quality in influencing relationships. Methods: An online cross-sectional survey was conducted in November 2021 among 10,000 Chinese internet users, using quota sampling based on sex, age, and urban and rural residence, in line with the 48th Statistical Report on Internet Development of China. Nonparametric tests were used to examine the differences in eHealth literacy across sociodemographic groups. Partial correlation analysis and stepwise linear regression were conducted to test the associations between key variables. Confirmatory factor analysis and structural equation modeling were conducted to test the hypotheses. Results: Our study identified significant disparities in functional and critical eHealth literacy between urban and rural residents across age groups, income levels, education backgrounds, and health conditions (all P