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Social Participation and Digital Health Literacy Among Older Adults in the Community: The Mediating Roles of

Haichao Wang¹, Li Yang¹, Danqing Hu¹

¹School of Nursing, Qingdao University, Qingdao, Shandong Province, China.

Journal of the American Medical Directors Association

|February 6, 2026

Abstract

Objectives:

This study aimed to explore how self-efficacy and technophobia mediate the relationship between social participation and digital health literacy among older adults living in the community.

Design:

We conducted a cross-sectional survey.

Setting And Participants:

We recruited 665 older adults in Qingdao, China, from September 2024 to February 2025.

Methods:

Data were collected on sociodemographic characteristics, social participation, self-efficacy, technophobia, and digital health literacy. The SPSS PROCESS macro was used to investigate the mediating role of self-efficacy and technophobia between social participation and digital health literacy.

Results:

There were positive correlations among social participation, self-efficacy, and digital health literacy (r = 0.429-0.646, P<.001), whereas technophobia was significantly and negatively correlated with these variables (r = -0.525 to -0.273, P<.001). In the mediation model, social participation was positively associated with digital health literacy (β = 0.284, P<.001). This association was accounted for by both the independent mediating roles of self-efficacy and technophobia, as well as their sequential roles as serial mediators.

Conclusions And Implications:

Social participation is associated with digital health literacy through the pathways of self-efficacy and technophobia. By fostering engagement opportunities, supportive environments, and positive role models, communities and families may help create conditions that are conducive to higher self-efficacy and lower technophobia among older adults, both of which are associated with higher levels of digital health literacy and a greater ability to benefit from opportunities in the digital age.

Keywords:

Social participation digital health literacy older adults self-efficacy technophobia

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