How Online Health Platform Engagement Shapes Atrial Fibrillation Treatment Attitudes: The Role of Psychological Mediators

Background: This study investigates the impact of engagement with online health platforms (OHPs), perceived treatment effectiveness, and country of residence on patient attitudes toward atrial fibrillation (AF) treatments, mediated by threat perception and behavioral evaluation within an adapted Health Belief Model (HBM). Methods: A cross-sectional survey conducted in June 2024 included 589 members of two professionally curated OHPs: the AFIP Foundation (Amsterdam, The Netherlands) and StopAfib.org (Decatur, United States). Data were analyzed using Structural Equation Modeling (SEM) to examine both direct and indirect relationships among engagement behaviors, perceived treatment effectiveness, country of residence, and patient attitudes toward AF treatments (PAAT). Results: Results indicate that higher engagement (i.e., frequency of OHP visits and time spent on the OHP) positively predicts more favorable PAAT, whereas the number of content types consumed showed no significant mediating effect via threat perception or behavioral evaluation. Conclusions: By increasing awareness of AF and reinforcing the perceived effectiveness of treatments, OHPs can serve as effective tools for patient education and support. From a managerial perspective, these findings provide actionable insights for platform operators and healthcare stakeholders on which engagement factors most effectively enhance patient attitudes toward treatment options.