The influence of sports technology device usage on middle-aged health anxiety: chain mediation effects of health control perception and self-efficacy reconstruction

Background: The accelerating aging of the population and the digital transformation of health management have created new challenges for middle-aged cohorts (MACs). These individuals face escalating health anxiety (HA) stemming from declining physiological functions and compounded social role pressures. Sports technology devices (STDs) offer novel behavioral intervention pathways through real-time monitoring and data feedback. However, their buffering mechanisms (BMs) against HA and the associated psychological pathways remain insufficiently explored. This study examines the chain mediation relationship involving health control perception (HCP) and self-efficacy reconstruction (SER). Our primary objective is to delineate the psychological pathways linking STD usage to HA among middle-aged individuals. This investigation provides a novel theoretical contribution to the development of targeted digital health interventions. Methods: We conducted a cross-sectional survey with 930 middle-aged participants. The study employed validated scales to measure sports technology usage, health anxiety, health locus of control, and self-efficacy. To examine the psychological mechanisms, we performed a chain mediation analysis using bootstrap regression with 5,000 iterations while controlling for key demographic factors, including age, sex, and income. Results: = -0.624) exhibited independent mediation effects. Notably, the chain mediation pathway explained 31.12% of the total association. The largest contributing pathway was "STD → HCP → SER → HA" (effect = -0.1438, proportion = 18.81%). Conclusion: STD usage alleviates HA among middle-aged individuals through a sequential "data-driven control enhancement → efficacy accumulation → anxiety mitigation" relationship. The core process involves reducing health uncertainty via real-time monitoring while rebuilding behavioral confidence through personalized feedback. This creates a synergistic association between "technological empowerment" and "psychological adaptation." Theoretically, our findings extend social cognitive theory into digital health contexts by revealing dynamic "environment-behavior-psychology" couplings. Practically, we recommend balancing data precision with psychological adaptability in technology design. Implementing tiered feedback systems can optimize health management experiences, establishing an actionable framework for digital interventions targeting HA among middle-aged individuals.