Level of eHealth Literacy and Its Associations With Health Behaviors and Outcomes in Chinese Older Adults: Cross-Sectional Analysis of Baseline Data From a Large-Scale Community Project

Background: eHealth literacy is important for older adults to be able to seek and evaluate online health information. However, there is a scarcity of large-scale data on their eHealth literacy levels, particularly among the oldest older individuals (aged >75 years) in unique, high-income Asian regions such as Hong Kong. A comprehensive understanding of how eHealth literacy is associated with specific health behaviors, mental well-being, and physical health outcomes in this population is lacking. Objective: This study aims to assess the level of eHealth literacy and its associations with health behaviors and health-related outcomes among older adults in Hong Kong. Methods: We conducted a cross-sectional analysis of baseline data from the Generations Connect Project. This is an ongoing large-scale community-based project, where we trained university students to conduct home visits and assess the health status of older adults (N=6704) in Hong Kong. eHealth literacy was measured using the eHealth Literacy Scale (eHEALS; score: 8-40). Health behavior measurements included physical activity levels (metabolic equivalent of task minutes per week) and smoking, drinking, and eating habits. Mental well-being was measured using the World Health Organization-Five Well-Being Index (percentage score: 0-100) and UCLA 3-item Loneliness Scale (score: 3-9). Physical health was assessed on the basis of self-reported medical diagnosis of noncommunicable diseases (yes/no), including hypertension, diabetes, cardiovascular disease, and stroke. Adjusted unstandardized coefficients (b) and odds ratios (ORs) were calculated to determine the associations between variables. Results: Among the 6704 participants (mean age 77.8, SD 7.0 years), the mean eHEALS score was 18.2 (SD 10.2), and 44.1% (2897/6566) of the participants had inadequate eHealth literacy (score: 8-15.99). Increasing age (adjusted b -0.32, 95% CI -0.35 to -0.28; P