Abstract
BACKGROUND: Empirical research has demonstrated that people frequently use social media for gathering and sharing online health information. Health literacy, social media use, and self-efficacy are important factors that may influence people's health behaviors online. OBJECTIVE: We aimed to examine the associations between health literacy, health-related social media use, self-efficacy, and health behavioral intentions online. METHODS: We conducted a cross-sectional survey of adults 18 years and older (n=449) to examine predictors of health-related behavioral intentions online including health literacy, social media use, and self-efficacy in China using 2 moderated mediation models. Mediation and moderation analyses were conducted. RESULTS: Self-efficacy mediated the effects of health literacy (B(indirect)=0.213, 95% CI 0.101 to 0.339) and social media use (B(indirect)=0.023, 95% CI 0.008 to 0.045) on health behavioral intentions on social media. Age moderated the effects of health literacy on self-efficacy (P=.03), while previous experience moderated the effects of social media use on self-efficacy (P<.001). CONCLUSIONS: Health literacy and health-related social media use influenced health behavioral intentions on social media via their prior effects on self-efficacy. The association between health literacy and self-efficacy was stronger among younger respondents, whereas the association between health-related social media use and self-efficacy was stronger among those who previously had positive experiences with health information on social media. Health practitioners should target self-efficacy among older populations and increase positive media experience related to health.