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农村中老年人智能手机使用与自评健康关系及健康促进行为的中介作用

The relationship between smartphone use and self-rated health among rural middle-aged and older adults, and the mediating role of health-promoting behaviors: an analysis of the 2020 China Rural Revitalization Survey

    摘要
  • 摘要:
    目的 了解农村中老年人智能手机使用与自评健康关系及其群体异质性，并探讨健康促进行为的中介效应，为推进农村健康老龄化提供科学建议。
    方法 本研究基于2020年中国乡村振兴综合调查（CRRS）数据，建立多元线性回归模型检验农村中老年人智能手机使用（包括是否使用、使用难度、使用时长3个维度）对其自评健康的直接效应；从性别、年龄和受教育程度3个方面进行异质性检验；采用三步回归法和Bootstrap检验法解析健康促进行为在智能手机使用与自评健康间的中介效应。
    结果 共纳入2 876名受访者，平均年龄为（58.82±8.54）岁，男性2 266人（78.79%），2 221人（77.23%）使用智能手机，958人（43.13%）使用智能手机不存在困难，智能手机每天使用时长平均为（2.44±1.86）h，健康促进行为平均得分为（4.66±2.14）分，476人（16.55%）自评健康很好。多元线性回归结果显示，农村中老年人使用智能手机显著正向影响其健康促进行为（β=0.182）和自评健康（β=0.135）；智能手机使用时长显著正向影响其健康促进行为（β=0.076）和自评健康（β=0.032）；智能手机使用难度显著负向影响其健康促进行为（β= −0.173）和自评健康（β= −0.169）（均P<0.05）。使用智能手机对自评健康的积极影响在不同性别、年龄和受教育程度的农村中老年人中存在异质性。健康促进行为在智能手机使用（3个维度）与自评健康之间均发挥中介效应（间接效应值分别为0.125，–0.161，0.030），占总效应的比值分别为91.91%，95.27%和90.91%。
    结论 农村中老年人智能手机使用对改善群体自评健康具有促进作用，在不同性别、年龄和受教育程度群体间具有差异性。健康促进行为在智能手机使用与农村中老年人自评健康之间发挥中介效应。

     

    Abstract:
    Objective To understand the relationship between smartphone use and self-rated health among rural middle-aged and older adults, investigate its heterogeneity among different groups, and explore the mediating effect of health-promoting behaviors, so as to provide scientific recommendations for promoting healthy aging in rural areas.
    Methods Based on data from the 2020 China Rural Revitalization Survey (CRRS), multiple linear regression models were established to examine the direct effect of smartphone use (including whether to use, difficulty of use, and duration of use) on self-rated health among rural middle-aged and older adults. Heterogeneity tests were conducted based on gender, age, and education level. The mediating effect of health-promoting behaviors between smartphone use and self-rated health was analyzed using a three-step regression method and the Bootstrap test.
    Results A total of 2 876 respondents were included, with an average age of (58.82 ± 8.54) years. Among them, 2 266 (78.79%) were male, 2 221 (77.23%) used smartphones, 958 (43.13%) reported no difficulty using smartphones, the average daily smartphone use duration was (2.44 ± 1.86) h, the average health-promoting behavior score was (4.66 ± 2.14) points, and 476 (16.55%) self-rated their health as very good. Multiple linear regression results showed that smartphone use among rural middle-aged and older adults had a significant positive impact on their health-promoting behaviors (β = 0.182) and self-rated health (β = 0.135). Smartphone use duration had a significant positive impact on their health-promoting behaviors (β = 0.076) and self-rated health (β = 0.032). Smartphone use difficulty had a significant negative impact on their health-promoting behaviors (β = -0.173) and self-rated health (β = -0.169) (all P < 0.05). The positive impact of smartphone use on self-rated health varied among rural middle-aged and older adults of different genders, ages, and education levels. Health-promoting behaviors played a mediating role between smartphone use (three dimensions) and self-rated health (indirect effect values were 0.125, -0.161, and 0.030, respectively), accounting for 91.91%, 95.27%, and 90.91% of the total effect, respectively.
    Conclusions Smartphone use among rural middle-aged and older adults has a positive effect on improving self-rated health, with variations among groups with different genders, ages, and education levels. Health-promoting behaviors play a mediating role between smartphone use and self-rated health among rural middle-aged and older adults.

     

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