Relationship Between E-Health Service Use and Psychological Distress: The Mediating Role of Health Lifestyle Behaviors and the Moderating Role of Belief in Genetic Determinism

Abstract Background: The growing severity of psychological distress on a global scale is increasingly concerning. Existed studies show that e-health services have great potential for reducing psychological distress. However, its impact on psychological distress remains complex and multifaceted. Objectives: This study aims to (1) examine the effect of e-health service use on psychological distress; (2) explore the health lifestyle behaviors as a mediating factor in the relationship between e-health service use and psychological distress; (3) analyze the moderating role of belief in genetic determinism on the pathways between e-health service use and health lifestyle behaviors. Method: Based on Health Information National Trends Survey 5 (HINTS 5, Cycle 4) data, this study tests the relationship between e-health service use and psychological distress, and the mediating role of health lifestyle behaviors and the moderating role of belief in genetic determinism. A total of 3865 respondents aged 18 or above (49.1% males) with an average age of 57 completed the survey. Result: This study finds that e-health service use exerted positive effects on psychological distress directly. Their relationship can be mediated by health lifestyle behaviors. This study also finds a negative moderating effect of genetic determination on the relationship between e-health service use and health lifestyle behaviors. Conclusion: This study suggests that e-health services can reduce psychological distress through health lifestyle behaviors. In addition, the belief in genetic determinism has a negative impact on health lifestyle behaviors..