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Purpose: The aim of this study was to examine the association between eHealth literacy and health-related quality of life (HRQoL) and explore whether health-promoting behaviors mediate the association between eHealth literacy and HRQoL among Chinese older adults., Methods: An anonymous cross-sectional survey was conducted among 2300 adults aged 60 or older from Jinan, China. The eHealth Literacy Scale, Short-Form Health-Promoting Lifestyle Profile, and Short-Form Health Survey (SF-12) were used to measure eHealth literacy, health-promoting behaviors, and HRQoL. Multivariate linear regression analyses were conducted to test the association between eHealth literacy, health-promoting behaviors, and HRQoL. The mediation analyses, composed of PROCESS analysis and bootstrapping method, were preformed to test both total (c), direct (c'), and indirect effects (a*b) of eHealth literacy on HRQOL through health-promoting behaviors., Results: Regression analyses indicated that eHealth literacy (B = 0.487, p < 0.001) was significantly positively associated with health-promoting behaviors, and health-promoting behaviors (B = 0.257, p < 0.001) were associated with HRQoL. The mediation analyses indicated that eHealth literacy had a significant direct (c' = 0.183, p < 0.001) and indirect effect on older adults' HRQoL through health-promoting behaviors (a*b = 0.125, bootstrapped 95% confidence interval (CI) = 0.094-0.157). The indirect effect accounted for 40.6% of the total effect (c = 0.308, bootstrapped 95% CI 0.241-0.376) of eHealth literacy on HRQoL., Conclusions: Health-promoting behaviors mediated the association between eHealth literacy and HRQoL in Chinese older adults. The establishment of interventions focused on health-promoting behavior may be an effective way to help older adults with low eHealth literacy improve their HRQoL., (© 2021. The Author(s).)

Healthy aging is an important means of promoting the well-being of older individuals. However, no studies have examined the relationship between eHealth literacy and healthy aging or its mechanism. Therefore, this study aimed to examine the relationship between eHealth literacy and healthy aging and the mediating effect of health behaviors in older Chinese individuals. Cross-sectional study. We recruited 2144 older individuals from Jinan, Shandong Province, China. We used the eHealth Literacy Scale to assess eHealth literacy. Healthy aging was evaluated based on multimorbidity, functional limitations, mild cognitive impairment, depressive symptoms, and social isolation. Moreover, health behaviors were assessed using the Health-Promoting Lifestyle Profile. Logistic and linear regression models were used to analyze the relationships between eHealth literacy, healthy aging, and its components. Finally, a structural equation model was used to analyze the mediation. High eHealth literacy was associated with all healthy aging components (P <.05), including the absence of multimorbidity [odds ratio (OR), 1.014; 95% CI, 1.002–1.025], no functional limitation (OR, 1.035; 95% CI, 1.022–1.047), no mild cognitive impairment (OR, 1.042; 95% CI, 1.024–1.061), no depressive symptoms (OR, 1.049; 95% CI, 1.027–1.072), and no social isolation (OR, 1.033; 95% CI, 1.018–1.048). In the adjusted model, eHealth literacy (β = 0.174; 95% CI, 0.132–0.217) was positively correlated with healthy aging. Health behaviors had a partial mediating effect on the relationship between eHealth literacy and healthy aging. Higher eHealth literacy was associated with better healthy aging in older Chinese individuals, and health behaviors mediated this relationship. Improving eHealth literacy may be an effective intervention for achieving healthy aging. [ABSTRACT FROM AUTHOR]