Jin Hengjiang, Qu Ying
School of Journalism, Chongqing University, Chongqing, China.
J Med Internet Res. 2025 Jan 6;27:e65065. doi: 10.2196/65065.
Avoiding technological innovation does not simplify life. In fact, using internet-based medical services can enhance the quality of life for older adults. In the context of an aging population and the growing integration of information technology, the demand for internet-based medical services among older adults is gaining increased attention. While scholars have highlighted the important role of intergenerational support in promoting digital inclusion for older adults, research on the relationship between intergenerational support and older adults' intentions to seek online care remains limited.
This study aims (1) to explore the association between intergenerational support, online medical information, and older adults' intention to seek medical care online, and (2) to examine the mediating role of technology perception and trust, as well as the moderating role of eHealth literacy.
A cross-sectional survey was conducted in China, collecting 958 valid responses from older adults aged 60 years and above. A vast majority of participants were between the ages of 60 and 75 years (771/958, 80.5%). Of the 958 participants, 559 (58.4%) resided in rural areas, while 399 (41.6%) lived in urban areas. The survey included questions on intergenerational support, perceived usefulness, perceived ease of use, trust, online medical information, eHealth literacy, and the intention to seek medical care online. Structural equation modeling and linear regression analysis were applied to explore the relationship between intergenerational support and the intention to seek medical care on the internet.
Intergenerational support was positively associated with perceived ease of use (β=.292, P<.001), perceived usefulness (β=.437, P<.001), trust (β=.322, P<.001), and the intention to seek medical care online (β=.354, P<.001). Online medical information also positively affected the intention to seek medical care online among older adults (β=.109, P<.001). Perceived ease of use (β=.029, 95% CI 0.009-0.054), perceived usefulness (β=.089, 95% CI 0.050-0.130), and trust (β=.063, 95% CI 0.036-0.099) partially mediated the association between intergenerational support and the intention to seek medical care online. Further analysis found that perceived ease of use, perceived usefulness, and trust played a chain mediating role between intergenerational support and the intention to seek medical care online (β=.015, 95% CI 0.008-0.027; β=.022, 95% CI 0.012-0.036). Additionally, eHealth literacy played a moderating role in the relationship between intergenerational support and perceived ease of use (β=.177, P<.001), perceived usefulness (β=.073, P<.05), trust (β=.090, P<.01), and the intention to seek medical care online (β=.124, P<.001).
An integrated model of health communication effects was constructed and validated, providing empirical support for the intention to seek medical care online and for the impact of health communication. This model also helps promote the role of technology in empowering the lives of seniors.
回避技术创新并不会简化生活。事实上,使用基于互联网的医疗服务可以提高老年人的生活质量。在人口老龄化和信息技术日益融合的背景下,老年人对基于互联网的医疗服务的需求越来越受到关注。虽然学者们强调了代际支持在促进老年人数字融入方面的重要作用,但关于代际支持与老年人寻求在线医疗意愿之间关系的研究仍然有限。
本研究旨在(1)探讨代际支持、在线医疗信息与老年人在线寻求医疗意愿之间的关联,以及(2)检验技术感知和信任的中介作用,以及电子健康素养的调节作用。
在中国进行了一项横断面调查,收集了958名60岁及以上老年人的有效回复。绝大多数参与者年龄在60至75岁之间(771/958,80.5%)。在958名参与者中,559人(58.4%)居住在农村地区,399人(41.6%)居住在城市地区。该调查包括有关代际支持、感知有用性、感知易用性、信任、在线医疗信息、电子健康素养以及在线寻求医疗意愿的问题。应用结构方程模型和线性回归分析来探讨代际支持与在线寻求医疗意愿之间的关系。
代际支持与感知易用性(β = 0.292,P <.001)、感知有用性(β = 0.437,P <.001)、信任(β = 0.322,P <.001)以及在线寻求医疗意愿(β = 0.354,P <.001)呈正相关。在线医疗信息也对老年人在线寻求医疗的意愿产生了积极影响(β = 0.109,P <.001)。感知易用性(β = 0.029,95%CI 0.009 - 0.054)、感知有用性(β = 0.089,95%CI 0.050 - 0.130)和信任(β = 0.063,95%CI 0.036 - 0.099)部分中介了代际支持与在线寻求医疗意愿之间的关联。进一步分析发现,感知易用性、感知有用性和信任在代际支持与在线寻求医疗意愿之间起链式中介作用(β = 0.015,95%CI 0.008 - 0.027;β = 0.022,95%CI 0.012 - 0.036)。此外,电子健康素养在代际支持与感知易用性(β = 0.177,P <.001)、感知有用性(β = 0.073,P <.05)、信任(β = 0.090,P <.01)以及在线寻求医疗意愿(β = 0.124,P <.001)之间的关系中起调节作用。
构建并验证了一个健康传播效果的综合模型,为在线寻求医疗意愿和健康传播的影响提供了实证支持。该模型也有助于促进技术在提升老年人生活方面的作用。