Exploratory scale development for young-old adults’ perceived online health information overload and its relationship with health anxiety

Purpose This study aims to examine young-old adults’ perceived online health information overload, identifies its preliminary dimensions, and tests its associations with online health information-seeking behavior, health anxiety and digital health literacy. Design/methodology/approach This study used a mixed-methods design. Interview data were analyzed through three-stage coding to identify the construct, dimensions and items of young-old adults’ perceived online health information overload. A first sample supported item analysis and EFA, producing a 20-item, four-dimensional scale. A second sample supported CFA of the first- and second-order structures, while a third sample examined preliminary associations among online health information seeking, perceived overload, health anxiety and digital health literacy. Findings Perceived online health information overload comprised four dimensions: information input load, cognitive processing difficulties, psychological and physiological stress, and suboptimal decisions and behavioral dysfunction. Online health information-seeking behavior was positively associated with health anxiety. Perceived overload showed a significant indirect association, and digital health literacy showed a significant interaction effect. Originality/value This study develops a four-dimensional, context-specific measurement framework for perceived online health information overload among young-old adults. Unlike prior research on search frequency or general information overload, it focuses on subjective load during continuous searching, multi-channel comparison, and health risk appraisal. It also examines the construct’s preliminary association with health anxiety and incorporates digital health literacy to explain variation in association strength, supporting digital health service optimization and subsequent scale validation.