Online health information seeking and health anxiety in the elderly: The mediating role of perceived information quality

Introduction. This study investigates the impact of online health information seeking modes, self-directed and proxy seeking on health anxiety among the elderly. Method. A total of 543 valid questionnaires were collected from elderly individuals aged sixty and above who had experienced illness in the past six months. The survey was conducted both online and offline, with data collection primarily carried out in Anhui Province, China. Participants had varied socio-demographic backgrounds and generally lower levels of digital literacy. Analysis. We employed benchmark regression and propensity score matching to address self-selection bias and estimate causal effects. Mediation analysis was conducted to explore the role of perceived information quality, while subsample regression analyses examined differences based on gender, education level, and perceived physical limitations. Results. The findings revealed that self-directed online health information seeking exacerbated health anxiety among the elderly, with information quality perception serving as a mediating factor. Conversely, proxy online health information seeking alleviated health anxiety among the elderly, but the mediating effect of information quality perception was not significant in this process. Subsample regression revealed that compared to males, female health anxiety was more susceptible to the exacerbation effect of self-directed seeking and the alleviation effect of proxy seeking. Individuals with higher education levels exhibited a weaker exacerbation effect of self-directed seeking on health anxiety and a stronger alleviation effect of proxy seeking compared to those with lower education levels. Among older adults whose physical condition significantly affected their daily activities, self-directed seeking had a stronger exacerbating effect on health anxiety, while proxy seeking provided a greater alleviating effect. Conclusions. This study underscores the risks of increased health anxiety associated with self-directed online health information seeking among older adults and highlights the potential of proxy seeking as an effective mitigating strategy.