Online Health-Seeking Behavior Among Primary Caregivers of Children with Chronic Diseases: A Cross-Sectional Analysis of eHealth Literacy, Caregiver Characteristics, and Child Clinical Context.

BACKGROUND

Primary caregivers of children with chronic diseases frequently use online resources to meet ongoing information needs, but the correlates and context of this behavior remain incompletely understood. This study assessed online health-seeking behavior (OHSB) and examined its associations with child clinical characteristics, caregiver sociodemographic factors, and caregiver psychosocial and cognitive characteristics.

METHODS

A single-center cross-sectional study using convenience sampling was conducted at the First Affiliated Hospital of Xinjiang Medical University, China, from October 2025 to February 2026. A total of 365 primary caregivers completed an electronic questionnaire including the OHSB Scale, eHealth Literacy Scale (eHEALS), Zarit Burden Interview, Family Caregiver Task Inventory, and GAD-7. Confirmatory factor analysis, univariate analyses, Pearson correlations, and hierarchical multiple linear regression were performed. HC3 robust standard errors and an expanded covariate model were used in sensitivity analyses.

RESULTS

The three-factor OHSB structure showed good fit (CFI = 0.960, RMSEA = 0.069). The mean OHSB score was 94.57 ± 44.91, and 71.8% of caregivers sought health information online at least weekly. OHSB was strongly correlated with eHealth literacy (r = 0.883, p < 0.001). The primary fully adjusted model explained 81.6% of OHSB variance; eHealth literacy was the strongest correlate (β = 0.735, p < 0.001). Higher education and urban residence also remained robustly associated with higher OHSB across sensitivity analyses, whereas associations for complications, caregiver burden, and anxiety were less stable. Expanded adjustment did not materially change the dominant association of eHealth literacy.

CONCLUSION

OHSB was common among caregivers of children with chronic diseases and was most strongly associated with eHealth literacy, alongside contextual and sociodemographic factors. Because OHSB and eHealth literacy are closely related self-reported constructs, the magnitude of their association should be interpreted cautiously. Targeted, literacy-sensitive digital health support may benefit caregivers with fewer educational or contextual resources.