{
  "abstract": "Population ageing has made smart eldercare technology a central instrument of healthy ageing policy in China, yet accepting a device does not by itself guarantee health benefits for older adults. This study examined whether eHealth literacy statistically mediates the association between technology acceptance and health-related quality of life (HRQoL) among community-dwelling older adults, and whether the strength of this pathway differs between urban and rural residents. A cross-sectional survey was administered between June and September 2025 in Xi’an, China, using stratified sampling across urban districts and rural counties; 612 older adults aged 60 and above were approached and 552 valid questionnaires were retained (304 urban, 248 rural; valid response rate 90.2%). Acceptance of smart eldercare technology was measured with a 16-item instrument based on the unified theory of acceptance and use of technology, eHealth literacy with the 8-item eHEALS, and HRQoL with the EQ-5D-5L descriptive system and the EQ visual analogue scale (EQ-VAS); depressive symptoms were assessed with the 15-item Geriatric Depression Scale. Measurement models fitted the data well (χ2(242) = 267.92, CFI = 0.996, RMSEA = 0.014, SRMR = 0.024) and all scales showed satisfactory reliability (α = 0.786 to 0.934). Conditional process analysis showed that acceptance predicted eHealth literacy (b = 0.358, p < 0.001), that acceptance interacted with residence (b = 0.194, p = 0.009), and that eHealth literacy predicted EQ-VAS scores after adjustment (b = 3.520, p < 0.001). The indirect effect of acceptance on EQ-VAS through eHealth literacy was significant in both groups but larger among urban [1.942, 95% CI (1.184, 2.764)] than rural residents [1.259, 95% CI (0.729, 1.858)], and the index of moderated mediation was significant [0.683, 95% CI (0.185, 1.283)]. Parallel analyses with depressive symptoms as the outcome confirmed the pattern; after excluding never-users of smart devices the first-stage interaction was attenuated (p = 0.059), while eHealth literacy continued to predict EQ-VAS. The findings position eHealth literacy as a plausible pathway linking technology acceptance to quality of life and indicate that urban environments amplify this association, supporting digitally inclusive smart eldercare deployment for rural older adults.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "Original Research",
  "arxiv": null,
  "author_total": 1,
  "authors": [
    {
      "name": "Jiani Wei"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6p5dt3hrd0h76.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1988110",
  "fulltext_url": null,
  "id": "6p5dt3hrd0h76",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1988110",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "feed-journal",
      "medicine/epidemiology-public-health"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-04",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/6p5dt3hrd0h76.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T06:20:43Z",
      "native_id": "10.3389/fpubh.2026.1988110",
      "source": "feed-frontiers",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1988110"
    },
    {
      "first_seen": "2026-11-04T12:21:48Z",
      "native_id": "10.3389/fpubh.2026.1988110",
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      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1988110/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "feed-journal:medicine/epidemiology-public-health",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Technology acceptance, eHealth literacy, and health-related quality of life among community-dwelling older adults in urban and rural Xi’an, China: a moderated mediation study of smart eldercare technology",
  "title_text": "Technology acceptance, eHealth literacy, and health-related quality of life among community-dwelling older adults in urban and rural Xi’an, China: a moderated mediation study of smart eldercare technology",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T00:21:28Z",
  "url": "https://research.draconitic.com/paper/6p5dt3hrd0h76",
  "venue": "Frontiers in Public Health",
  "versions": []
}