Association Between Intergenerational Support, Technology Perception and Trust, and Intention to Seek Medical Care on the Internet Among Chinese Older Adults: Cross-Sectional Questionnaire Study
Authors: Jin Hengjiang , Qu Ying 
Published: January 2025

Background
Avoiding technological innovation does not simplify life. In fact, using internet-based medical services can enhance the quality of life for older adults. In the context of an aging population and the growing integration of information technology, the demand for internet-based medical services among older adults is gaining increased attention. While scholars have highlighted the important role of intergenerational support in promoting digital inclusion for older adults, research on the relationship between intergenerational support and older adults’ intentions to seek online care remains limited.

Objective
This study aims (1) to explore the association between intergenerational support, online medical information, and older adults’ intention to seek medical care online, and (2) to examine the mediating role of technology perception and trust, as well as the moderating role of eHealth literacy.

Methods
A cross-sectional survey was conducted in China, collecting 958 valid responses from older adults aged 60 years and above. A vast majority of participants were between the ages of 60 and 75 years (771/958, 80.5%). Of the 958 participants, 559 (58.4%) resided in rural areas, while 399 (41.6%) lived in urban areas. The survey included questions on intergenerational support, perceived usefulness, perceived ease of use, trust, online medical information, eHealth literacy, and the intention to seek medical care online. Structural equation modeling and linear regression analysis were applied to explore the relationship between intergenerational support and the intention to seek medical care on the internet.

Results
Intergenerational support was positively associated with perceived ease of use (β=.292, P<.001), perceived usefulness (β=.437, P<.001), trust (β=.322, P<.001), and the intention to seek medical care online (β=.354, P<.001). Online medical information also positively affected the intention to seek medical care online among older adults (β=.109, P<.001). Perceived ease of use (β=.029, 95% CI 0.009-0.054), perceived usefulness (β=.089, 95% CI 0.050-0.130), and trust (β=.063, 95% CI 0.036-0.099) partially mediated the association between intergenerational support and the intention to seek medical care online. Further analysis found that perceived ease of use, perceived usefulness, and trust played a chain mediating role between intergenerational support and the intention to seek medical care online (β=.015, 95% CI 0.008-0.027; β=.022, 95% CI 0.012-0.036). Additionally, eHealth literacy played a moderating role in the relationship between intergenerational support and perceived ease of use (β=.177, P<.001), perceived usefulness (β=.073, P<.05), trust (β=.090, P<.01), and the intention to seek medical care online (β=.124, P<.001).

Conclusions
An integrated model of health communication effects was constructed and validated, providing empirical support for the intention to seek medical care online and for the impact of health communication. This model also helps promote the role of technology in empowering the lives of seniors.