Supplementary file 1_The impact of digital literacy on health behaviors among middle-aged and older adults: the mediating roles of proactive health awareness and social capital.docx

BackgroundWith the rapid acceleration of population aging in China, promoting healthy behaviors among middle-aged and older adults has become an urgent public health priority. Digital literacy, as a key skill in the digital era, may influence health behaviors directly or indirectly through psychological and social pathways. This study analyzes the impact of digital literacy on health behaviors among middle-aged and older adults, focusing on the mediating roles of proactive health awareness and social capital.
MethodsUsing data from the 2021 Chinese General Social Survey (CGSS), this study constructed a composite digital literacy index based on the entropy weight method. A total of 1,458 respondents aged 45 and above were included. Health behaviors were measured by dietary and exercise indicators, while proactive health awareness and social capital were modeled as mediators. Ordinary least squares regression, ordinal logistic regression, and ordered probit regression were applied to analyse the direct and indirect effects of digital literacy on health behaviors.
ResultsDigital literacy had no significant direct effect on health behaviors (β = 0.098, p > 0.05). Mediation analysis indicated significant indirect effects: higher digital literacy was associated with greater proactive health awareness (indirect effect = 0.085, p < 0.01) and with greater social capital (indirect effect = 0.049, p < 0.05), both of which were linked to healthier behaviors. A sequential pathway (digital literacy → proactive health awareness → social capital → health behavior) was also significant (indirect effect = 0.011, p < 0.01). Age-stratified analysis showed that these mediating effects were significant only among middle-aged adults (45–59 years) and not among older adults (≥60 years).
ConclusionAmong middle-aged and older Chinese adults, digital literacy appears to influence health behaviors mainly by enhancing health awareness and expanding social support. These findings imply that interventions to promote healthy aging should combine digital skills training with health education and community support networks. The observed age differences suggest that such strategies may need to be tailored to different age groups.