{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:15:30Z","timestamp":1788156930420,"version":"build-2803163510"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the digital age, health-promoting lifestyle (HPL) among occupational populations is critical for chronic disease prevention. Social support has been recognized as a key facilitator of HPL, yet the underlying mechanisms remain unclear. Digital health literacy (DHL)\u2014the ability to access, understand, and apply online health information\u2014may serve as a potential mediator. However, empirical evidence on this mediation model in occupational settings is limited. This study aims to examine the mediating role of DHL in the relationship between social support and HPL among occupational populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multistage stratified cluster sampling method was used to recruit 1,030 occupational participants in Huangpu District, Shanghai, between July and September 2024. Data were collected using standardized questionnaires assessing social support, DHL, and HPL. Descriptive statistics, Pearson correlation analysis, and bootstrap-based mediation analyses were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Social support was positively correlated with DHL (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.176,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and HPL (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.324,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), while DHL was also positively associated with HPL (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.306,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Mediation analysis indicated that DHL partially mediated the relationship between social support and HPL (indirect effect = 0.113, 95% CI [0.065, 0.170]), accounting for 13.9% of the total effect. Parallel mediation analysis further showed that only the application dimension of DHL had a significant mediating effect (effect = 0.081, 95% CI [0.026, 0.146]), whereas the other dimensions were not significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Social support is positively associated with HPL both directly and indirectly through DHL. Notably, the application of digital health information plays a key role in translating social support into health-promoting behaviors. Interventions aiming to improve occupational health should prioritize not only strengthening social support but also enhancing individuals' ability to apply digital health information in daily life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1865814","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:39:20Z","timestamp":1788154760000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The mediating role of digital health literacy in the relationship between social support and health-promoting lifestyle among occupational populations: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yun","family":"Pan","sequence":"first","affiliation":[{"name":"Shanghai Huangpu District Center for Disease Control and Prevention (Shanghai Huangpu District Health Supervision Institute)","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tantan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Key Laboratory of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Sha","sequence":"additional","affiliation":[{"name":"Shanghai Huangpu District Center for Disease Control and Prevention (Shanghai Huangpu District Health Supervision Institute)","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiakui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Shanghai Huangpu District Center for Disease Control and Prevention (Shanghai Huangpu District Health Supervision Institute)","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeqing","family":"Gu","sequence":"additional","affiliation":[{"name":"Shanghai Huangpu District Health Affairs Management Center","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"B1","unstructured":"Statistical Communiqu\u00e9 Of The People's Republic Of China On The 2023 National Economic And Social Development a2024\n          \n          \n            \n              China\n              NBoSo"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-024-1261-1_1","article-title":"Work, health, safety and well-being: Current state of the art","author":"Jain","year":"2018","journal-title":"Managing Health, Safety and Well-Being."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.11847\/zgggws1146578","article-title":"Healthy lifestyles and chronic disease prevention and control","volume":"40","author":"Li","year":"2024","journal-title":"Chin J Public Health."},{"key":"B4","article-title":"Health promotion model-instruments to measure health promoting lifestyle: Health-promoting lifestyle profile [HPLP II](Adult version)","author":"Walker","year":""},{"key":"B5","first-page":"1","article-title":"Determinants of Health, Health Promotion, and Illness Prevention","author":"Zaid","year":""},{"key":"B6","doi-asserted-by":"publisher","first-page":"1323277","DOI":"10.3389\/fpubh.2024.1323277","article-title":"Determinants influencing health-promoting behaviors in individuals at high risks of stroke: a cross-sectional study","volume":"12","author":"Chen","year":"2024","journal-title":"Front Public Health."},{"key":"B7","doi-asserted-by":"publisher","first-page":"22","DOI":"10.4103\/SHB.SHB_50_19","article-title":"Can social support predict health-promoting behaviors among community-dwelling older adults?","volume":"3","author":"Khami","year":"2020","journal-title":"Asian Journal of Social Health and Behavior."},{"key":"B8","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1186\/s12884-022-04784-y","article-title":"Health-promoting behaviors and intermediary social determinants of health in low and high-risk pregnant women: an unmatched case-control study","volume":"22","author":"Masjoudi","year":"2022","journal-title":"BMC Pregnancy Childbirth."},{"key":"B9","first-page":"137","article-title":"Social Support","author":"Drageset","year":""},{"key":"B10","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1177\/1088868314544222","article-title":"A new look at social support: a theoretical perspective on thriving through relationships","volume":"19","author":"Feeney","year":"2015","journal-title":"Pers Soc Psychol Rev."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e91","DOI":"10.1002\/lim2.91","article-title":"A healthy lifestyle is a social lifestyle: the vital link between social connection and health outcomes","volume":"4","author":"Proctor","year":"2023","journal-title":"Lifestyle Medicine."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2022","DOI":"10.3389\/fpsyg.2022.1036383","article-title":"Exploring the relationship between perceived social support and college students' autonomous fitness behavior: chain mediating effect test","volume":"13","author":"Li","year":"2023","journal-title":"Frontiers in Psychology."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1264780","DOI":"10.3389\/fdgth.2023.1264780","article-title":"Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners","volume":"5","author":"Fitzpatrick","year":"2023","journal-title":"Frontiers in Digital Health."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1259412","DOI":"10.3389\/fpubh.2023.1259412","article-title":"Research into the relationship between digital health literacy and healthy lifestyle behaviors: an intergenerational comparison","volume":"11","author":"\u00c7etin","year":"2023","journal-title":"Front Public Health."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e54135","DOI":"10.2196\/54135","article-title":"Online health information seeking, ehealth literacy, and health behaviors among Chinese internet users: cross-sectional survey study","volume":"26","author":"Liu","year":"2024","journal-title":"J Med Internet Res."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1735211","DOI":"10.3389\/fpubh.2026.1735211","article-title":"The impact of digital literacy on health behaviors among middle-aged and older adults: the mediating roles of proactive health awareness and social capital","volume":"14","author":"Tang","year":"2026","journal-title":"Front Public Health."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2458309","DOI":"10.1080\/17482631.2025.2458309","article-title":"Health behavioural change - the influence of social-ecological factors and health identity","volume":"20","author":"Eriksson","year":"2025","journal-title":"Int J Qual Stud Health Well-being."},{"key":"B18","doi-asserted-by":"publisher","first-page":"S15","DOI":"10.3928\/24748307-20190408-01","article-title":"Novel approach to improve health literacy in immigrant communities","volume":"3","author":"Johnson","year":"2019","journal-title":"Health Lit Res Pract."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1186\/s12889-024-18163-z","article-title":"The roles of health literacy and social support in the association between smartphone ownership and frailty in older adults: a moderated mediation model","volume":"24","author":"Yi","year":"2024","journal-title":"BMC Public Health."},{"key":"B20","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1111\/j.1467-9280.2007.01882.x","article-title":"Required sample size to detect the mediated effect","volume":"18","author":"Fritz","year":"2007","journal-title":"Psychol Sci."},{"key":"B21","first-page":"98","article-title":"The theoretical basis and research application of social support rating scale","volume":"4","author":"Xiao","year":"1994","journal-title":"J Clin Psychiatry."},{"key":"B22","article-title":"Research on the Measurement and Improvement Strategy of Residents' Digital Health Literacy [Unpublisged Master's Thesis]: Hangzhou Normal University; 2022","author":"Zhao","year":""},{"key":"B23","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.2196\/jmir.6709","article-title":"Drossaert C. Development of the digital health literacy instrument: measuring a broad spectrum of health 10 and health 20 skills","volume":"19","author":"van","year":"2017","journal-title":"J Med Internet Res."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1200722","DOI":"10.3389\/fpubh.2023.1200722","article-title":"Impact of digital health literacy on health-related quality of life in Chinese community-dwelling older adults: the mediating effect of health-promoting lifestyle","volume":"11","author":"Liu","year":"2023","journal-title":"Front in Public Health."},{"key":"B25","doi-asserted-by":"publisher","first-page":"286","DOI":"10.16462\/j.cnki.zhjbkz.2016.03.018","article-title":"Development and performance testing of the Chinese version of the HPLP-II health promotion lifestyle scale","volume":"20","author":"Cao","year":"2016","journal-title":"Chin J Disease Control."},{"key":"B26","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1037\/0021-9010.88.5.879","article-title":"Common method biases in behavioral research: a critical review of the literature and recommended remedies","volume":"88","author":"Podsakoff","year":"2003","journal-title":"J Appl Psychol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1584","DOI":"10.12114\/j.issn.1007-9572.2022.0752","article-title":"Effect of dementia prevention beliefs on health promoting lifestyle in Chinese adults","volume":"26","author":"Li","year":"2023","journal-title":"Chinese General Practice."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.12114\/j.issn.1007-9572.2022.0782","article-title":"Habits of using online health information and eHealth literacy in middle-aged and elderly residents","volume":"26","author":"Yuan","year":"2023","journal-title":"Chinese general practice."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1186\/s12889-021-11322-6","article-title":"Food and health promotion literacy among employees with a low and medium level of education in the Netherlands","volume":"21","author":"Sponselee","year":"2021","journal-title":"BMC Public Health."},{"key":"B30","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1186\/s12913-025-13020-0","article-title":"Gender differences in health-seeking behaviour: insights from the national health and morbidity survey 2019","volume":"25","author":"Rata Mohan","year":"2025","journal-title":"BMC Health Serv Res."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1672-8467.2020.01.017","article-title":"The relationship between health literacy and health-promoting lifestyle in residents of Xuhui District in Shanghai: a cross-sectional study","author":"CHEN","year":"2020","journal-title":"Fudan Univ J Med Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e92207","DOI":"10.7759\/cureus.92207","article-title":"Health education and its role in the prevention and management of non-communicable diseases: a review","volume":"17","author":"Rudwan","year":"2025","journal-title":"Cureus."},{"key":"B33","doi-asserted-by":"publisher","first-page":"2105","DOI":"10.1007\/s11136-015-0942-6","article-title":"Consistency of prediction across generation: explaining quality of life by family functioning and health-promoting behaviors","volume":"24","author":"Ali","year":"2015","journal-title":"Quality of Life Research."},{"key":"B34","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s12687-014-0197-x","article-title":"Family health information sharing among older adults: reaching more family members","volume":"6","author":"Ashida","year":"2015","journal-title":"J Community Genet."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1177\/0002764213487347","article-title":"Bad jobs, bad health? How work and working conditions contribute to health disparities","volume":"57","author":"Burgard","year":"2013","journal-title":"Am Behav Sci."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2263","DOI":"10.3390\/ijerph17072263","article-title":"The associations among health-promoting lifestyle, eHealth literacy, and cognitive health in older Chinese adults: a cross-sectional study","volume":"17","author":"Li","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B37","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1177\/0145721718816630","article-title":"Exploring the relationship between lifestyle behaviors and health-related quality of life among older adults with diabetes","volume":"45","author":"Qin","year":"2019","journal-title":"Diabetes Educ."},{"key":"B38","doi-asserted-by":"publisher","first-page":"96","DOI":"10.34172\/jcs.2021.018","article-title":"Association between perceived social support and health-promoting lifestyle in pregnant women: a cross-sectional study","volume":"10","author":"Fathnezhad-Kazemi","year":"2021","journal-title":"Int J Caring Sci."},{"key":"B39","doi-asserted-by":"publisher","first-page":"2827","DOI":"10.3390\/ejihpe13120195","article-title":"Social support and its impact on job satisfaction and emotional exhaustion","volume":"13","author":"Garmendia","year":"2023","journal-title":"Eur J Investig Health Psychol Educ."},{"key":"B40","doi-asserted-by":"publisher","first-page":"ckae144","DOI":"10.1093\/eurpub\/ckae144.1715","article-title":"Impact of digital health literacy on public health: an umbrella review","volume":"34","author":"Corvo","year":"2024","journal-title":"Eur J Public Health."},{"key":"B41","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1177\/21501319261418534","article-title":"Digital health literacy and self-reported health in older adults: the role of social support in internet use","author":"Baron-Epel","year":"2026","journal-title":"J Prim Care Community Health."},{"key":"B42","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/j.gerinurse.2024.12.002","article-title":"Family guidance regarding internet mitigates older adults' ehealth literacy inequality due to educational attainment through internet use","volume":"61","author":"Wu","year":"2025","journal-title":"Geriatric Nursing."},{"key":"B43","doi-asserted-by":"publisher","first-page":"20552076221102765","DOI":"10.1177\/20552076221102765","article-title":"Factors associated with eHealth literacy focusing on digital literacy components: a cross-sectional study of middle-aged adults in South Korea","volume":"8","author":"Lee","year":"2022","journal-title":"Digital health."},{"key":"B44","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/j.ijnss.2024.08.002","article-title":"Reflective practice and knowledge development: Transforming research for a practice-based discipline","volume":"11","author":"Sherwood","year":"2024","journal-title":"Int J Nurs Sci."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.1009802","article-title":"The Gap between Health Knowledge and Action: Understanding and Overcoming Psychological Barriers","author":"Carrillo-Gonz\u00e1lez","year":"2025"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.25122\/jml-2024-0340","article-title":"The transformative power of mHealth apps: empowering patients with obesity and diabetes - a narrative review","volume":"17","author":"Spinean","year":"2024","journal-title":"J Med Life."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1865814\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:39:27Z","timestamp":1788154767000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1865814\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":46,"alternative-id":["10.3389\/fpubh.2026.1865814"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1865814","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"article-number":"1865814"}}