Mediating effect of digital health literacy between preventive health service utilization and mental health among hospital personnel

doi:10.5498/wjp.120446

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Publication Name

World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Sep 19, 2026; 16(9): 120446
Published online Sep 19, 2026. doi: 10.5498/wjp.120446

Mediating effect of digital health literacy between preventive health service utilization and mental health among hospital personnel

Shao-Jun Zhang, Jian-Jian Wang

Shao-Jun Zhang, Labor Union, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China

Jian-Jian Wang, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China

Author contributions: Zhang SJ was responsible for conceptualization, data curation, methodology, software, formal analysis, project administration, investigation, supervision, validation, writing - review & editing, writing - original draft; and Wang JJ was responsible for visualization.

AI contribution statement: The entirety or any portion of the main text of the manuscript (Abstract, Introduction, Materials and Methods, Results, Discussion, and Conclusion) was not AI-generated? No AI tool used for language polishing, translation, data analysis, or writing assistance of the manuscript.

Institutional review board statement: This study has been approved by the Clinical Research Ethics Committee of the Second Xiangya Hospital of Central South University (Approval No. LYEC2026-K0212).

Informed consent statement: This study uses de-identified retrospective electronic health records and anonymous questionnaire data, presenting no more than minimal risk to participants. Therefore, informed consent was not required.

Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Data sharing statement: The original anonymous dataset is available on request from the corresponding author at eraldo.SshhaoJun8@163.com.

Corresponding author: Shao-Jun Zhang, Labor Union, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, Changsha 410011, Hunan Province, China. sshhaojun8@163.com

Received: April 10, 2026
Revised: June 8, 2026
Accepted: July 28, 2026
Published online: September 19, 2026
Processing time: 135 Days and 21.4 Hours

Abstract

BACKGROUND

Preventive health service utilization (PHSU) is positively associated with the mental health of hospital employees. Digital health literacy (DHL), a core competence for utilizing digital health services, has been shown to influence health behaviors and outcomes. However, the mediating role of DHL in the relationship between PHSU and mental health among hospital personnel remains unclear.

AIM

To explore relationships among DHL, PHSU, and mental health in hospital employees, and to examine the mediating role of DHL.

METHODS

PHSU-related data, including completion rates of annual physical examinations, vaccination records, and participation in specific disease screenings between 2021 and 2023 were extracted from electronic health records. In the first quarter of 2024, standardized questionnaires were used to measure DHL (DHL scale), mental health status [12-item General Health Questionnaire (GHQ-12)], and occupational burnout [Maslach Burnout Inventory (MBI)]. The mediating effect of DHL was tested using correlation and hierarchical regression analyses and PROCESS macro model 4.

RESULTS

The mean (± SD) age of the cohort (n = 688; 69.2% female) was 35.6 ± 8.3 years. The mean comprehensive PHSU index was 6.8 ± 1.9, with an annual physical examination completion rate of 82.8%, and a recommended vaccination rate of 76.5%. Mean scores were distributed as follows: Total DHL, 28.8 ± 5.5; total GHQ-12, 14.0 ± 4.3; and MBI subscale scores, emotional exhaustion (22.5 ± 7.0), depersonalization (6.4 ± 3.7), and reduced personal accomplishment (32.6 ± 6.8). There were significant positive correlations among PHSU, DHL, and mental health indicators (all P < 0.01). Regression analysis revealed that PHSU predicted better mental health status (β = -0.26; P < 0.001) and higher DHL (β = 0.33; P < 0.001). DHL played a partial mediating role between PHSU and mental health [indirect effect = -0.10 (95% confidence interval: -0.15 to -0.06), while the direct effect remained significant].

CONCLUSION

PHSU among hospital personnel is directly associated with better mental health status, indirectly strengthened by improved DHL. Enhancing psychological well-being of healthcare workers encourages regular participation in preventive health services.

Keywords: Digital health literacy; Preventive health service utilization; Mental health; Hospital staff; Mediating effect; Retrospective cohort study

Core Tip: This retrospective cohort study investigated the relationships among preventive health service utilization (PHSU), digital health literacy (DHL), and mental health in 688 hospital employees. Data analysis, including correlation and regression methods, revealed a significant association between higher levels of DHL and better mental health. Crucially, DHL was identified as a key mediating variable in this relationship. The findings indicate that while PHSU directly promotes employee mental health, its positive effects are also indirectly enhanced through improved DHL.