Abstract:

[Purpose/Significance] Against the backdrop of China's aging population and advancing digitalization, the digital divide has created disparities in how efficiently older adults can access health information. This has emerged as a critical barrier to their health management. Existing studies have explored factors influencing older adults' health management but rarely focused on the digital divide within this group or deeply integrated individual traits, environmental factors, and health behaviors. Grounded in the Triadic Reciprocal Determinism Theory, this study investigates how exposure to online health information affects older adults' health management behaviors and uncovers how the digital divide manifests in this process. Its innovation lies in addressing gaps in previous research by systematically examining the heterogeneous impacts of online health information exposure on health management across different subgroups (e.g., urban vs. rural residents, those with varying digital skills). This enriches the theoretical system of older adults' health information behavior and health management, while offering practical guidance for tackling the key issue of enhancing older adults' health management and bridging the digital divide amid aging and digitalization. [Method/Process] Guided by the Triadic Reciprocal Determinism Theory, the study formulates hypotheses through literature review. It utilizes cross-sectional data from the 2020 Chinese Longitudinal Aging Social Survey (CLASS), with a valid sample of 3 118 adults aged 60 and above. Health management is influenced by older adults' attitudes toward handling minor illnesses and the frequency of their physical exercise. Online health information exposure is measured by three indicators: the convenience of accessing online health services, engagement in online health management, and ownership of smartwatches or bracelets. Control variables include gender, age, education, and household registration type. Multiple regression models are constructed to test hypotheses, supplemented by robustness tests (adding control variables and replacing dependent variables), heterogeneity analysis (stratified by smartphone proficiency), and mediating effect analysis (comparing urban and rural groups) to ensure result reliability. [Results/Conclusions] Key findings reveal that the convenience of accessing health services via the Internet and engagement in online health management both positively boost older adults' initiative to seek medical care when dealing with minor illnesses. Smart Wearable devices exert a "double-edged sword" effect: they have a negative impact on medical-seeking behavior for minor illnesses yet correlate positively with more frequent physical exercise. Older adults proficient in smartphone use show greater activity in health management. Significant urban-rural differences exist in reliance on social network information-rural older adults are more likely to enhance their health management initiative through family and friend networks, while their urban counterparts tend to obtain health information directly via the Internet. It is recommended that health information communication strategies be formulated in consideration of urban-rural differences, with targeted measures to improve older adults' digital health literacy and bridge the digital divide. Limitations of the study include data constraints, as CLASS data lacks in-depth exploration of older adults' motivations and resistance toward health information exposure, and incomplete measurement of the digital divide, excluding variables such as network speed and regional infrastructure. Future research should adopt mixed methods, integrating questionnaires and semi-structured interviews to supplement qualitative data, expand the measurement dimensions of health management behaviors, and explore the dynamic relationship between technology adoption and health behaviors from the perspective of older adults, providing a more solid basis for targeted interventions.

Key words: health management, Triadic Reciprocal Determinism, web-based health information, older adults, digital divide