The synergistic effect of internet-based health communication on health promotion: the chain-mediating effect of health literacy and health education
- 1School of Marxism, Wenzhou Polytechnic University, Wenzhou, China
Abstract
Next-generation internet technologies, represented by artificial intelligence, are reshaping the nationwide health information distribution system; this study examines the synergistic benefit effect of online health communication on health promotion. The analysis utilizes 5,333 data points from the 2023 China General Social Survey (CGSS), which employed a nationally stratified, multi-stage sampling design. Using the Hayes PROCESS Model 6 serial chain mediation model, 2,000 bias-correction Bootstrap samples were generated to conduct baseline OLS regression, mediation effect decomposition, multidimensional heterogeneity analysis, and an IPW inverse probability weighting robustness test. The baseline OLS regression reveals a significant positive overall association between online health communication and health promotion. The chain mediation model identified three indirect pathways: a single health literacy mediation pathway, a single digital health education mediation pathway, and a core serial synergistic pathway (“Online Health Communication → Health Literacy → Digital Health Education → Health Promotion”); the confidence intervals for all three pathways do not include zero. The heterogeneity analysis uncovered the distribution pattern of the digital health gap: the serial chain effect is slightly higher in urban areas than in rural areas, and slightly higher among women than among men (though the intergroup difference is not statistically significant); the strongest effect is observed among the middle-aged population aged 31–60 years, while the serial transmission chain tends to weaken among groups with lower educational attainment. Multiple robustness tests, including IPW inverse probability weighting, support the reliability of the core findings. The positive association between online health communication and residents’ health promotion can be explained through the independent and serial mediation statistical pathways involving health literacy and digital health education; this observation reveals a “progressive synergy” relationship among the three factors.
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BibTeX
@article{chen2026synergistic,
title = {{The synergistic effect of internet-based health communication on health promotion: the chain-mediating effect of health literacy and health education}},
author = {Xuezhen Chen and Ziqi Zhang},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1934669},
url = {https://doi.org/10.3389/fpubh.2026.1934669},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The synergistic effect of internet-based health communication on health promotion: the chain-mediating effect of health literacy and health education
AU - Xuezhen Chen
AU - Ziqi Zhang
PY - 2026
DA - 2026/10/12
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1934669
UR - https://doi.org/10.3389/fpubh.2026.1934669
AB - Next-generation internet technologies, represented by artificial intelligence, are reshaping the nationwide health information distribution system; this study examines the synergistic benefit effect of online health communication on health promotion. The analysis utilizes 5,333 data points from the 2023 China General Social Survey (CGSS), which employed a nationally stratified, multi-stage sampling design. Using the Hayes PROCESS Model 6 serial chain mediation model, 2,000 bias-correction Bootstrap samples were generated to conduct baseline OLS regression, mediation effect decomposition, multidimensional heterogeneity analysis, and an IPW inverse probability weighting robustness test. The baseline OLS regression reveals a significant positive overall association between online health communication and health promotion. The chain mediation model identified three indirect pathways: a single health literacy mediation pathway, a single digital health education mediation pathway, and a core serial synergistic pathway (“Online Health Communication → Health Literacy → Digital Health Education → Health Promotion”); the confidence intervals for all three pathways do not include zero. The heterogeneity analysis uncovered the distribution pattern of the digital health gap: the serial chain effect is slightly higher in urban areas than in rural areas, and slightly higher among women than among men (though the intergroup difference is not statistically significant); the strongest effect is observed among the middle-aged population aged 31–60 years, while the serial transmission chain tends to weaken among groups with lower educational attainment. Multiple robustness tests, including IPW inverse probability weighting, support the reliability of the core findings. The positive association between online health communication and residents’ health promotion can be explained through the independent and serial mediation statistical pathways involving health literacy and digital health education; this observation reveals a “progressive synergy” relationship among the three factors.
SN - 2296-2565
ER -