How Does the eHealth Information Use Mitigate Cancer Fatalism in Family Cancer Histories Groups? A Study of Chain Mediation Effects Based on Social Cognitive Theory

Background: Cancer fatalism is the greatest obstacle to cancer prevention and treatment behavior and is particularly prevalent among people with a family history of cancer. While previous studies have shown that the use of eHealth information influences cancer fatalism beliefs in the general population, a deeper exploration of the underlying mechanisms is imperative. Using Social Cognitive Theory as a theoretical framework and targeting people with a family history of cancer, this study aimed to investigate whether eHealth information use can effectively alleviate cancer fatalism and elucidate the mechanisms driving this association. Methods: Data for this study were obtained from the sixth iteration of the National Trends in Health Information Survey (HINTS6), using the survey sample of 3,131 individuals with a family history of cancer. Firstly, this study assesses the direct and indirect effects of eHealth information use on cancer fatalism beliefs; Secondly, exploring the mediating roles of cancer worry, frequency of doctor visits, and trust in cancer information from doctors; Finally, examining a chained mediation model to explain how individuals may change their inherent beliefs about cancer through the eHealth information use. Results: The results showed that the direct effect (bp =-0.062, p <0.001) and the total effect (bp=-0.059, p <0.001) of eHealth information use were negatively correlated with cancer fatalism. Cancer worry, frequency of doctor visits, and trustin cancer information from doctors were mediating mechanisms and were positively correlated with eHealth information use. In addition, the study revealedthat trustin cancer information from doctors was negatively correlated with cancer fatalism (bp =-0.071, p < 0.001). Conclusions: eHealth information use combinedwith interventions and offline communication with physicians plays a positive role in reducing cancer fatalism in the family cancer history, providing individuals with more health information and support. Public health departments should use eHealth information platforms to communicate correct cancer science knowledge and positive attitudes toward cancer and encourage people to trust health information from authoritative science, such as doctors, to reduce cancer fatalism and adopt positive health behaviors.