Objective Chronic diseases have become a major public health burden globally, and online health information seeking behavior (OHISB) has emerged as a potential tool for improving health literacy and protecting individuals from chronic diseases. Nevertheless, previous studies have shown that OHISB may exacerbate health disparities, and its specific association with chronic disease prevalence remains unclear. This study aims to investigate the relationships between OHISB, chronic disease literacy, and chronic disease prevalence, with a focus on sociodemographic heterogeneity. Methods A cross-sectional questionnaire survey was conducted in China, from June to September 2024. Partial correlation analysis and restricted cubic spline (RCS) regression were used to analyze the specific relationships among OHISB engagement, chronic disease literacy and prevalence. Stratified interaction analyses were performed to explore the heterogeneous effects of OHISB across distinct sociodemographic subgroups. Results OHISB was positively associated with chronic disease literacy ( r = 0.218, P < 0.001), The RCS model revealed a significant nonlinear relationship between OHISB and chronic disease literacy ( P nonlinear < 0.001), characterized by an initial significant increase followed by a plateau. Significant interaction effects of OHISB and sociodemographic factors were observed ( P interaction < 0.001), OHISB conferred more benefits on vulnerable subgroups, including those aged ≥45, suburban residents, non-college graduates, and low-consumption individuals (≤¥3,000/month). Conversely, while the RCS plot revealed a descriptive risk convergence trend, no significant association was found between OHISB and chronic disease prevalence ( r = -0.005, P = 0.855). Conclusion OHISB was positively associated with chronic disease literacy, although its benefits were limited by a ceiling effect. Moreover, it was also associated with the narrowing of sociodemographic gaps in chronic disease literacy. However, we did not observe a significant link between OHISB and chronic disease prevalence. Therefore, targeted digital interventions are essential to bridge the knowledge-behavior gap and promote chronic disease prevention among vulnerable populations.
Shen et al. (Sun,) studied this question.