The mediating role of electronic health literacy: examining the relationship between self-efficacy and health-seeking behavior

Abstract

Objective: This study aimed to examine the association of self-efficacy with health-seeking behavior and to determine whether electronic health literacy mediates this relationship.Methods: Using a cross-sectional design, data were collected from 964 adults aged 18 and older residing in Konya, Türkiye. Participants completed a personal information form, the Self-Efficacy Scale, the e-health Literacy Scale, and the Health-Seeking Behavior Scale. Descriptive statistics, correlation analyses, and mediation analyses were conducted using SPSS 30.0 and PROCESS Macro (Model 4). Direct and indirect effects were assessed via bootstrapping (5,000 samples).Results: Participants had a mean age of 28.76 years, and 56% were female. Self-efficacy, e-health literacy, and health-seeking behavior were all positively and significantly correlated. Mediation analysis revealed that self-efficacy had a direct positive association with health-seeking behavior (β=0.30, p<0.001) and a significant indirect pathway through e-health literacy (B=0.02, 95% CI [0.01, 0.04], p=0.003), confirming partial mediation. Self-efficacy was also significantly associated with e-health literacy (β=0.21, p<0.001), and e-health literacy was significantly associated with health-seeking behavior (β=0.10, p=0.001). All hypotheses were statistically supported.Conclusion: The findings suggest that higher self-efficacy is associated with greater engagement in health-seeking behaviors, both directly and through the use of their digital health literacy skills. Enhancing self-efficacy and e-health literacy through targeted interventions may be associated with individuals' proactive health behaviors. These results underline the importance of integrating digital literacy content into public health education and policy frameworks.