Associations between media use, self-efficacy, and health literacy among Chinese rural and urban elderly: A moderated mediation model

Yebo Yu; Yibo Wu; Zhen Huang; Xinying Sun

doi:10.3389/fpubh.2023.1104904

Associations between media use, self-efficacy, and health literacy among Chinese rural and urban elderly: A moderated mediation model

Front Public Health. 2023 Mar 9:11:1104904. doi: 10.3389/fpubh.2023.1104904. eCollection 2023.

Authors

Yebo Yu¹, Yibo Wu^{1

2}, Zhen Huang¹, Xinying Sun¹

Affiliations

¹ Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China.
² Health Culture Research Center of Shaanxi, Key Research Base of Philosophy and Social Sciences in Shaanxi Province, Xi'an, Shaanxi, China.

Abstract

Objectives: The influence of media use on health literacy among urban and rural elderly has been unknown in China. This study aims to examine the association between media use and health literacy and to explore the mediating role of self-efficacy and the moderating role of urban-rural residency.

Methods: Based on the cross-sectional study of the Psychology and Behavior Investigation of Chinese Residents (PBICR) in 2022, a total of 4,070 Chinese old people aged 60 years and above were included. We adopted the simplified New General Self-Efficacy Scale (NGSES) and the simplified Health Literacy Scale-Short Form (HLS-SF) to measure self-efficacy and health literacy. Media use was measured using a self-administrated questionnaire.

Results: Results showed that Chinese urban elderly had a higher frequency of media use than rural ones in the aspects of social activities, self-presentation, social action, leisure and entertainment, information acquisition, and business transactions through media (P < 0.001). Among all participants, self-presentation (B = 0.217, 95% CI: 0.040, 0.394), leisure and entertainment (B = 0.345, 95% CI: 0.189, 0.502), and information acquisition (B = 0.918, 95% CI: 0.761, 1.076) were significantly associated with health literacy. Self-efficacy partially mediated the effect of media use on health literacy (B_indirect = 0.045, 95% CI: 0.032, 0.058), accounting for 18.37% of the total effect. Urban-rural residency (B = 0.049, 95% CI: 0.024, 0.075) moderated the relationship between media use and self-efficacy significantly.

Conclusion: The urban-rural gap in health literacy requires more attention. The promotion of media use and self-efficacy may play a role in eliminating health disparities.

Limitations: As a cross-sectional study, it could not establish cause-effect relationships.

Keywords: Chinese elderly; health literacy; media use; self-efficacy; urban-rural residents.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
East Asian People
Health Literacy*
Humans
Self Efficacy*
Surveys and Questionnaires

Grants and funding

This work was supported by the Beijing Social Science Foundation (Grant Number: 21XCB007). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.