Abstract
BACKGROUND: Health-related social media is widely used for health information but has mixed effects on patient-provider relationships. The cognitive pathways through which health-related social media engagement shapes patients' perceptions of patient-centered communication (PCC) remain unclear. OBJECTIVE: Drawing on self-efficacy theory and theories of information behavior and adoption, this study examined two parallel mediators, the application of health information from social media (AHI) and online health information seeking self-efficacy (OHIS), in the association between the frequency of health-related social media engagement (HSME) and PCC among U.S. adults with chronic conditions. METHODS: This study was based on cross-sectional data from the 2022 Health Information National Trends Survey 6. The final sample included 3663 respondents who reported having at least one chronic condition and at least one hospital visit in the past year. Parallel mediation analyses were performed using Hayes' PROCESS macro (Model 4) in SPSS. RESULTS: HSME was negatively associated with PCC (β = -0.075, p < 0.001). HSME positively predicted AHI (β = 0.432, p < 0.001) and OHIS (β = 0.207, p < 0.001). AHI was negatively linked to PCC (β = -0.043, p < 0.05), whereas OHIS was positively linked to PCC (β = 0.141, p < 0.001). Significant indirect effects of HSME on PCC were found via AHI (effect = -0.019, 95% CI [-0.036, -0.002]) and via OHIS (effect = 0.029, 95% CI [0.020, 0.039]). CONCLUSION: Findings highlight that while online information-seeking confidence is positively associated with PCC, direct reliance on health information obtained from social media is negatively associated with PCC. Understanding these pathways can help improve patient-doctor relationship.