{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:20:28Z","timestamp":1785338428294,"version":"3.55.0"},"reference-count":99,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In the digital era, media have become critical conduits for information dissemination, exerting increasing influence on mental health. Traditional print media and digital interactive media differ significantly in how individuals access and process information, potentially influencing psychological well-being through distinct mechanisms. Health literacy\u2014the integrated capacity to acquire, understand, and apply health information\u2014has been recognized as a key mediator in the relationship between media use and mental health. However, the precise mechanisms and age-related variations of this mediating effect remain underexplored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to investigate the differential pathways through which print media and digital interactive media influence depressive symptoms (measured by the Patient Health Questionnaire, PHQ) and anxiety symptoms (measured by the Generalized Anxiety Disorder scale, GAD), with a focus on the mediating role of health literacy and its heterogeneity across age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the 2021 China Mental and Behavioral Survey, a total of 9,966 adults aged 19 and older were selected as the study sample. Key variables included: independent variables\u2014frequency of print media and digital interactive media use; mediating variables\u2014three dimensions of health literacy (healthcare, disease prevention, and health promotion); and dependent variables\u2014scores on depression and anxiety symptoms. Descriptive statistics, Spearman correlation analysis, ANOVA, and bootstrap-based mediation tests (resampled 1,000 times) were conducted to systematically examine how different media types affect mental health through specific mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Digital interactive media use was significantly positively correlated with all dimensions of health literacy (<jats:italic>r<\/jats:italic> =\u202f0.242\u20130.297, <jats:italic>p<\/jats:italic> &amp;lt;\u202f0.01). It directly reduced levels of depression and anxiety (PHQ-9 effect size\u202f=\u202f\u22120.138; GAD-7 effect size\u202f=\u202f\u22120.145) and partially mediated this effect through the \u201cdisease prevention\u201d dimension of health literacy (<jats:italic>\u03b2<\/jats:italic> =\u202f\u22120.021, 95% CI [\u22120.105, \u22120.025]). In contrast, print media use was positively associated with depression and anxiety scores (<jats:italic>r<\/jats:italic> =\u202f0.025\u20130.039, <jats:italic>p<\/jats:italic> &amp;lt;\u202f0.05), and all three dimensions of health literacy\u2014\"healthcare,\u201d \u201cdisease prevention,\u201d and \u201chealth promotion\u201d\u2014exerted a suppressing effect on this relationship (<jats:italic>\u03b2<\/jats:italic> =\u202f0.003\u20130.004). Moreover, these mechanisms varied significantly across age groups: among individuals aged 19\u201340 and 41\u201360, the \u201cdisease prevention\u201d dimension served as the primary mediator; whereas in the 61\u202f+\u202fage group, the \u201chealth promotion\u201d dimension emerged as the dominant pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Print and digital interactive media influence mental health through different mechanisms, which vary significantly across age groups. Based on these findings, a stratified intervention strategy\u2014\"digital prevention + print promotion\u201d\u2014is recommended: for younger populations, leveraging digital media to enhance disease prevention awareness is essential, while for older populations, an integrated media ecosystem should be developed to reduce cognitive load. This study proposes a media-type-centered framework for mental health intervention, and future research should employ longitudinal designs to establish causal inferences.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1618570","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T04:12:35Z","timestamp":1756959155000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Differential impacts of digital interactive media and print media on mental health: mediating mechanism of health literacy and group heterogeneity"],"prefix":"10.3389","volume":"13","author":[{"given":"Junfeng","family":"Yuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1080\/09540261.2022.2040450","article-title":"Analysis of global prevalence of mental and substance use disorders within countries: focus on sociodemographic characteristics and income levels","volume":"34","author":"Castaldelli-Maia","year":"2022","journal-title":"Int Rev Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1192\/bjp.2024.267","article-title":"Burden of depressive and anxiety disorders in China and its provinces, 1990\u20132021: findings from the global burden of disease study 2021","author":"Tian","year":"2025","journal-title":"Br. J. Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1215\/03335372-25-1-67","article-title":"Print is flat, code is deep: the importance of media-specific analysis","volume":"25","author":"Hayles","year":"2004","journal-title":"Poet Today"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1177\/1464884914545439","article-title":"Print and online newspapers as material artefacts","volume":"16","author":"Fortunati","year":"2015","journal-title":"Journalism"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1080\/15456870.2019.1540418","article-title":"A new culture of advocacy: an exploratory analysis of social activism on the web and social media","volume":"27","author":"Seelig","year":"2019","journal-title":"Atl J Commun"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"568","DOI":"10.3145\/epi.2010.nov.02","article-title":"Investigaci\u00f3n internacional sobre ciberperiodismo: hipertexto, interactividad, multimedia y convergencia","volume":"19","author":"Masip","year":"2010","journal-title":"El Prof Inf"},{"key":"ref7","first-page":"20","article-title":"Comparative media studies in the digital age| the everything-ness and the more-ness of the internet: how digital is different from other media","volume":"14","author":"Rainie","year":"2020","journal-title":"Int. J. Commun."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1471-2458-12-80","article-title":"Health literacy and public health: a systematic review and integration of definitions and models","volume":"12","author":"S\u00f8rensen","year":"2012","journal-title":"BMC Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.3233\/SHTI210343","article-title":"Importance of digital literacy in the process of confronting the stress during COVID-19 pandemic","author":"Bosanac","year":"2021","journal-title":"Stud Health Technol Info Stud Health Technol Info"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e48685","DOI":"10.2196\/48685","article-title":"Digital health literacy of the population in Germany and its association with physical health, mental health, life satisfaction, and health behaviors: nationally representative survey study","volume":"10","author":"K\u00f6nig","year":"2024","journal-title":"JMIR Public Health Surveill."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e85","DOI":"10.2196\/jmir.1933","article-title":"A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication","volume":"15","author":"Moorhead","year":"2013","journal-title":"J. Med. Internet Res."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1080\/15456870.2017.1350682","article-title":"Understanding the message of understanding media","volume":"25","author":"Strate","year":"2017","journal-title":"Atlantic J Commun"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"554678","DOI":"10.3389\/fpsyg.2020.554678","article-title":"Together apart: the mitigating role of digital communication technologies on negative affect during the COVID-19 outbreak in Italy","volume":"11","author":"Gabbiadini","year":"2020","journal-title":"Front. Psychol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2397","DOI":"10.1177\/02654075211029378","article-title":"Mediated communication matters during the COVID-19 pandemic: the use of interpersonal and masspersonal media and psychological well-being","volume":"38","author":"Choi","year":"2021","journal-title":"J. Soc. Pers. Relat."},{"key":"ref15","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/j.2048-7940.1985.tb00412.x","article-title":"Learned helplessness and decreased social interaction in elderly disabled persons","volume":"10","author":"Sasaki","year":"1985","journal-title":"Rehabil Nurs"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"753","DOI":"10.7752\/jpes.2017.02114","article-title":"Relationships among sports helplessness, depression, and social support in American college student-athletes","volume":"17","author":"Hagiwara","year":"2017","journal-title":"J Phys Educ Sport"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1177\/1075547003259209","article-title":"Effects of online reading on popular science comprehension","volume":"25","author":"Macedo-Rouet","year":"2003","journal-title":"Sci. Commun."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.neuroimage.2016.04.011","article-title":"Media multitasking is associated with distractibility and increased prefrontal activity in adolescents and young adults","volume":"134","author":"Moisala","year":"2016","journal-title":"NeuroImage"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1027\/1016-9040\/a000477","article-title":"Effects of media multitasking and video gaming on cognitive functions and their neural bases in adolescents and young adults","volume":"27","author":"Alho","year":"2022","journal-title":"Eur. Psychol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e0249457","DOI":"10.1371\/journal.pone.0249457","article-title":"Determinants of content marketing effectiveness: conceptual framework and empirical findings from a managerial perspective","volume":"16","author":"Koob","year":"2018","journal-title":"J. Commun."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1001\/archpediatrics.2011.27","article-title":"Using ecological momentary assessment to determine media use by individuals with and without major depressive disorder","volume":"165","author":"Primack","year":"2011","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1093\/geronb\/gbu018","article-title":"Internet use and depression among retired older adults in the United States: a longitudinal analysis","volume":"69","author":"Cotten","year":"2014","journal-title":"J. Gerontol. Ser. B Psychol. Sci. Soc. Sci."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.susoc.2022.05.004","article-title":"Understanding the role of digital technologies in education: a review","volume":"3","author":"Haleem","year":"2022","journal-title":"Sustain Operations Computers"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1111\/j.1365-2850.2009.01497.x","article-title":"Young students\u2019 use of the internet for mental health information and support","volume":"17","author":"Horgan","year":"2010","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1027\/1016-9040\/a000318","article-title":"Internet- and Mobile-based psychological interventions: applications, efficacy, and potential for improving mental health","volume":"23","author":"Ebert","year":"2018","journal-title":"Eur. Psychol."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1080\/09638230701482378","article-title":"Online information, extreme communities and internet therapy: is the internet good for our mental health?","volume":"16","author":"Bell","year":"2007","journal-title":"J. Ment. Health"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/16506073.2017.1401115","article-title":"Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis","volume":"47","author":"Carlbring","year":"2018","journal-title":"Cogn. Behav. Ther."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1192\/bjp.bp.114.152835","article-title":"The role of social media in reducing stigma and discrimination","volume":"206","author":"Betton","year":"2015","journal-title":"Br. J. Psychiatry"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1017\/edp.2014.2","article-title":"Social media use and social connectedness in adolescents: the positives and the potential pitfalls","volume":"31","author":"Meier","year":"2014","journal-title":"Aust. Educ. Dev. Psychol."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1111\/jcpp.13190","article-title":"Annual research review: adolescent mental health in the digital age: facts, fears, and future directions","volume":"61","author":"Odgers","year":"2020","journal-title":"Child Psychol. Psychiatry"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1037\/0003-066X.53.9.1017","article-title":"Internet paradox: a social technology that reduces social involvement and psychological well-being?","volume":"53","author":"Kraut","year":"2010","journal-title":"Am Psychol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1080\/07053436.2005.10707700","article-title":"Adolescent participation and flow in physically active leisure and electronic media activities: testing the displacement hypothesis","volume":"28","author":"Mannell","year":"2005","journal-title":"Loisir Soc"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.chb.2016.05.083","article-title":"\u201cI don\u2019t want to miss a thing\u201d: adolescents\u2019 fear of missing out and its relationship to adolescents\u2019 social needs, Facebook use, and Facebook related stress","volume":"64","author":"Beyens","year":"2016","journal-title":"Comput. Hum. Behav."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1177\/0956797616678438","article-title":"A large-scale test of the goldilocks hypothesis","volume":"28","author":"Przybylski","year":"2017","journal-title":"Psychol. Sci."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e023191","DOI":"10.1136\/bmjopen-2018-023191","article-title":"Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews","volume":"9","author":"Stiglic","year":"2019","journal-title":"BMJ Open"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.janxdis.2018.11.005","article-title":"The relationship between anxiety symptom severity and problematic smartphone use: a review of the literature and conceptual frameworks","volume":"62","author":"Elhai","year":"2019","journal-title":"J Anxiety Disord"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.addbeh.2018.08.011","article-title":"The relationship between internet use disorder, depression and burnout among Chinese and German college students","volume":"89","author":"Peterka-Bonetta","year":"2019","journal-title":"Addict. Behav."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e59131","DOI":"10.2196\/59131","article-title":"Age differences in electronic mental health literacy: qualitative study","volume":"26","author":"Xu","year":"2024","journal-title":"J. Med. Internet Res."},{"key":"ref39","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1176\/ps.49.6.808","article-title":"Cost-effectiveness of television, radio, and print media programs for public mental health education","volume":"49","author":"Austin","year":"1998","journal-title":"Psychiatr. Serv."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1177\/1464884911427800","article-title":"Negativity in political news: a review of concepts, operationalizations and key findings","volume":"13","author":"Lengauer","year":"2012","journal-title":"Journalism"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1093\/joc\/jqad041","article-title":"The journalistic preference for extreme exemplars: educational socialization, psychological biases, or editorial policy?","volume":"74","author":"Aar\u00f8e","year":"2024","journal-title":"J. Commun."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"18888","DOI":"10.1073\/pnas.1908369116","article-title":"Cross-national evidence of a negativity bias in psychophysiological reactions to news","volume":"116","author":"Soroka","year":"2019","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"107050","DOI":"10.1016\/j.chb.2021.107050","article-title":"Passive social media use and psychological well-being during the COVID-19 pandemic: the role of social comparison and emotion regulation","volume":"127","author":"Yue","year":"2022","journal-title":"Comput. Hum. Behav."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1080\/10410236.2014.973549","article-title":"A content analysis of organ donation stories printed in U.S. newspapers: application of newsworthiness","volume":"31","author":"Feeley","year":"2016","journal-title":"Health Commun."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1080\/10810730.2011.571341","article-title":"The picture of mental health\/illness in the printed Media in Three Central European Countries","volume":"17","author":"Nawkov\u00e1","year":"2012","journal-title":"J. Health Commun."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1007\/BF02640361","article-title":"The test of functional health literacy in adults: a new instrument for measuring patients\u2019 literacy skills","volume":"10","author":"Parker","year":"1995","journal-title":"J. Gen. Intern. Med."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1370\/afm.405","article-title":"Quick assessment of literacy in primary care: the newest vital sign","volume":"3","author":"Weiss","year":"2005","journal-title":"Ann. Fam. Med."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"e91","DOI":"10.3928\/24748307-20190225-01","article-title":"Development and validation of a new short-form health literacy instrument (HLS-SF12) for the general public in six Asian countries","volume":"3","author":"Duong","year":"2019","journal-title":"HLRP Health Liter Res Pract"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1186\/1471-2458-13-658","article-title":"The grounded psychometric development and initial validation of the health literacy questionnaire (HLQ)","volume":"13","author":"Osborne","year":"2013","journal-title":"BMC Public Health"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"e507","DOI":"10.2196\/jmir.8.4.e27","article-title":"eHEALS: the eHealth literacy scale","volume":"8","author":"Norman","year":"2006","journal-title":"J. Med. Internet Res."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1186\/s12889-023-15237-2","article-title":"Validity and reliability of the Chinese version of the health literacy scale short-form in the Chinese population","volume":"23","author":"Sun","year":"2023","journal-title":"BMC Public Health"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1613375","DOI":"10.3389\/fpubh.2025.161337","article-title":"Associations of infectious disease-specific, electronic, and general health literacy among high school students with prevalent health challenges: a cross-sectional study","volume":"13","author":"Qin","year":"2025","journal-title":"Front. Public Health"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1177\/00207640221111756","article-title":"The portrayal of mental health in Irish mainstream news media","volume":"69","author":"Gallagher","year":"2023","journal-title":"Int J Soc Psychiatry"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1192\/bjp.bp.116.189464","article-title":"Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis","volume":"210","author":"Schnyder","year":"2017","journal-title":"Br. J. Psychiatry"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.jpsychires.2021.02.014","article-title":"Support for the social-cognitive model of internalized stigma in serious mental illness","volume":"137","author":"Catalano","year":"2021","journal-title":"J. Psychiatr. Res."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"e59574","DOI":"10.7759\/cureus.59574","article-title":"Print media role and its impact on public health: a narrative review","volume":"16","author":"Kanchan","year":"2024","journal-title":"Cureus"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1080\/10810730.2016.1193920","article-title":"Health literacy and online health information processing: unraveling the underlying mechanisms","volume":"21","author":"Meppelink","year":"2016","journal-title":"J. Health Commun."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1146\/annurev-publhealth-090419-102529","article-title":"Understanding and responding to health literacy as a social determinant of health","volume":"42","author":"Nutbeam","year":"2021","journal-title":"Annu. Rev. Public Health"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1080\/10410236.2020.1748829","article-title":"Online health information seeking: a review and meta-analysis","volume":"36","author":"Wang","year":"2024","journal-title":"Health Commun."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"177","DOI":"10.3233\/ISU-170836","article-title":"Social media: a path to health literacy","volume":"37","author":"Wang","year":"2017","journal-title":"ISU"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"13","DOI":"10.46336\/ijlcb.v2i1.89","article-title":"Digital health literacy and telemedicine in the information age: a comprehensive review and future prospects","volume":"2","author":"Azahra","year":"2024","journal-title":"IJLCB"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1080\/21645515.2019.1581543","article-title":"A systematic literature review to examine the potential for social media to impact HPV vaccine uptake and awareness, knowledge, and attitudes about HPV and HPV vaccination","volume":"15","author":"Ortiz","year":"2019","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref63","doi-asserted-by":"publisher","first-page":"e19697","DOI":"10.2196\/19697","article-title":"Adolescent peer influence on eating behaviors via social media: scoping review","volume":"23","author":"Chung","year":"2019","journal-title":"Am. J. Prev. Med."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"97","DOI":"10.7326\/0003-4819-155-2-201107190-00005","article-title":"Low health literacy and health outcomes: an updated systematic review","volume":"155","author":"Berkman","year":"2011","journal-title":"Ann. Intern. Med."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1016\/j.pec.2017.01.015","article-title":"Health literacy in the eHealth era: a systematic review of the literature","volume":"100","author":"Kim","year":"2017","journal-title":"Patient Educ. Couns."},{"key":"ref66","doi-asserted-by":"publisher","first-page":"e213","DOI":"10.3928\/24748307-20220718-01","article-title":"Decision-making ability: a missing link between health literacy, contextual factors, and health","volume":"6","author":"R\u00fcegg","year":"2022","journal-title":"HLRP: Health Literacy Res Prac"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"13639","DOI":"10.1038\/s41598-024-64656-7","article-title":"Health literacy and mental health: a national cross-sectional inquiry","volume":"14","author":"Haeri-Mehrizi","year":"2024","journal-title":"Sci. Rep."},{"key":"ref68","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1186\/s12889-021-11437-w","article-title":"Mental health, compliance with measures and health prospects during the COVID-19 epidemic: the role of health literacy","volume":"21","author":"Hermans","year":"2021","journal-title":"BMC Public Health"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1177\/00207640231166628","article-title":"The mediating effect of family health on the relationship between health literacy and mental health: a national cross-sectional survey in China","volume":"69","author":"Wang","year":"2023","journal-title":"Int J Soc Psychiatry"},{"key":"ref70","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/000276427902300102","article-title":"Media use and the life span","volume":"23","author":"Dimmick","year":"1979","journal-title":"Am Behav Sci"},{"key":"ref71","first-page":"373","article-title":"Media use across the life-span","volume-title":"The international encyclopedia of communication","author":"Van Der Goot","year":"2015"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"127","DOI":"10.31857\/S013216250028539-5","article-title":"Media consumption by different age groups","author":"Poluekhtova","year":"2023","journal-title":"Sotsiol Issled"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"2109","DOI":"10.29121\/shodhkosh.v4.i2.2023.3351","article-title":"Demographic variations in media consumption: a comparative analysis","volume":"4","author":"Singh","year":"2023","journal-title":"ShodhKosh J Vis Per Arts"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"14","DOI":"10.47941\/jcomm.1973","article-title":"Digital literacy and media consumption among different age groups","volume":"5","author":"Akello","year":"2024","journal-title":"J. Commun."},{"key":"ref75","doi-asserted-by":"publisher","first-page":"41","DOI":"10.3928\/00989134-20110503-02","article-title":"Health literacy among older adults: a systematic literature review","volume":"37","author":"Zamora","year":"2011","journal-title":"J. Gerontol. Nurs."},{"key":"ref76","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1093\/hsw\/hlx026","article-title":"Age differences in health literacy: do younger Korean adults have a higher level of health literacy than older Korean adults?","volume":"42","author":"Lee","year":"2017","journal-title":"Health Soc. Work"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1055\/a-0667-8382","article-title":"Gesundheitskompetenz im h\u00f6heren Lebensalter","volume":"82","author":"Vogt","year":"2020","journal-title":"Gesundheitswesen"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"525","DOI":"10.3389\/fpubh.2021.690525","article-title":"Research on influencing factors and dimensions of health literacy in different age groups: before and after the COVID-19 era in Chongqing, China","volume":"9","author":"Yang","year":"2021","journal-title":"Front. 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Med."},{"key":"ref85","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref86","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s12966-016-0432-4","article-title":"The associations between sedentary behaviour and mental health among adolescents: a systematic review","volume":"13","author":"Hoare","year":"2016","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref87","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1176\/appi.prcp.20190015","article-title":"Increases in depression, self-harm, and suicide among U.S. adolescents after 2012 and links to technology use: possible mechanisms","volume":"2","author":"Twenge","year":"2020","journal-title":"PRCP"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"949062","DOI":"10.3389\/fpubh.2022.949062","article-title":"The impact of media use on disparities in physical and mental health among the older people: an empirical analysis from China","volume":"10","author":"Wang","year":"2022","journal-title":"Front. Public Health"},{"key":"ref89","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12911-017-0470-0","article-title":"How the public uses social media wechat to obtain health information in China: a survey study","volume":"17","author":"Zhang","year":"2017","journal-title":"BMC Med Inform Decis Mak"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1016\/j.chb.2012.11.024","article-title":"Cultural differences in social networking site use: a comparative study of China and the United States","volume":"29","author":"Jackson","year":"2013","journal-title":"Comput. Hum. Behav."},{"key":"ref91","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1007\/s11482-023-10165-0","article-title":"The effect of intolerance of uncertainty on state anxiety in the regular epidemic prevention and control phase in the context of Informatization: a moderated chain mediation model","volume":"18","author":"Fu","year":"2023","journal-title":"Appl. Res. Qual. Life"},{"key":"ref92","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1080\/02699930903407948","article-title":"Emotion regulation in depression: relation to cognitive inhibition","volume":"24","author":"Joormann","year":"2010","journal-title":"Cognit. Emot."},{"key":"ref93","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1002\/da.20755","article-title":"A meta-analysis of the magnitude of biased attention in depression","volume":"27","author":"Peckham","year":"2010","journal-title":"Depress. Anxiety"},{"key":"ref94","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1177\/1460458214534092","article-title":"A systematic review of eHealth interventions to improve health literacy","volume":"22","author":"Jacobs","year":"2016","journal-title":"Health Informatics J"},{"key":"ref95","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/8866386","article-title":"From uncertainty to anxiety: how uncertainty fuels anxiety in a process mediated by intolerance of uncertainty","volume":"2020","author":"Gu","year":"2020","journal-title":"Neural Plast"},{"key":"ref96","doi-asserted-by":"publisher","first-page":"e50276","DOI":"10.2196\/50276","article-title":"Social media as an effective provider of quality-assured and accurate information to increase vaccine rates: systematic review","volume":"25","author":"Hansen","year":"2018","journal-title":"Life (Basel)"},{"key":"ref97","doi-asserted-by":"publisher","first-page":"36","DOI":"10.34172\/jrcm.35126","article-title":"The role of health literacy in enhancing preventive healthcare: a comprehensive review of challenges, interventions, and future directions","volume":"12","author":"Abdi Almachavan","year":"2024","journal-title":"J Res Clin Med"},{"key":"ref98","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1093\/geronj\/40.5.569","article-title":"Health practices and illness cognition in young, middle aged, and elderly adults","volume":"40","author":"Prohaska","year":"1985","journal-title":"J. Gerontol."},{"key":"ref99","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/00012272-198810000-00008","article-title":"Health-promoting life styles of older adults","volume":"11","author":"Walker","year":"1988","journal-title":"Adv. Nurs. 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