The influence of older adults' digital health literacy on health information protection behavior: a moderated mediation model

Abstract

Objective: This study aimed to explore the influencing mechanism of digital health literacy on health information protection behavior among older adults, clarify the mediating role of Internet privacy concerns and the moderating role of family support.

Methods: Convenience sampling was used to select older adults aged 60 years and above with experience in accessing digital health information as respondents, and data were collected through questionnaires. The Digital Health Literacy Scale, Internet Privacy Concerns Scale, Health Information Protection Behavior Scale, and Family Support Scale were used for measurement. SPSS 27.0 and the Process Macro (Models 4 and 14) were employed to conduct descriptive statistics, correlation analysis, and moderated mediating effect tests.

Results: Scores of digital health literacy, health information protection behavior, Internet privacy concerns, and family support among older adults all reached moderate to above-moderate levels. All variables showed a significant positive correlation (all p < 0.01). The tests of mediating effect confirmed that Internet privacy concerns played a partial mediating role between digital health literacy and health information protection behavior, accounting for 38.42% of the total effect. Tests of moderating effect showed that family support positively moderated the relationship between Internet privacy concerns and health information protection behavior. Moreover, the mediating effect of Internet privacy concerns gradually strengthened as the level of family support increased.

Conclusion: This study confirms that older adults' digital health literacy not only directly affects their health information protection behavior, but also exerts an indirect impact through Internet privacy concerns. Meanwhile, family support significantly strengthens the positive effect of Internet privacy concerns on this behavior. The "ability-cognition-behavior" multidimensional driving mechanism identified in this study provides empirical evidence for improving the digital health information protection capacity of older adults. Based on this, we can targetedly promote the integration of digital health literacy and privacy protection education, and build a linked support system of family guidance and community services. This helps older adults translate privacy concerns into practical health information protection actions.

Keywords: digital health literacy; family support; health information protection behavior; internet privacy concerns; moderated mediation; older adults.