Abstract

Background: Online health communities (OHCs) are one of the developments related to online health. Patient compliance plays a vital role in improving health treatment outcomes. Patient activation is associated with patient activities in OHCs, such as physician-patient communication and health information seeking. In other words, OHCs influence patient compliance. Therefore, identifying the relationship between patient activation in OHCs and patient compliance is important for improved health outcomes. Methods: This study established a research model consisting of one independent variable (patient activation), four mediators (physician-patient communication, health information seeking, perceived information asymmetry, and e-health literacy), one dependent variable (patient compliance) and four control variables (gender, age, education level, and status). Data were obtained through a web-based survey, involving a total of 387 valid participants in China. These data were analyzed and tested through structural equation modeling and partial least squares. Results: Patient activation positively affects patient compliance through the mediation of physician-patient communication, health information seeking, perceived information asymmetry, and e-health literacy. Perceived information asymmetry has no direct effect on patient compliance. However, perceived information asymmetry affects patient compliance through the mediation of e-health literacy. Conclusions: Patient compliance is significantly affected by patient activation. Thus, physicians can achieve higher patient compliance by improving patient activation. Guaranteeing and improving the information quality in OHCs is essential for physicians and OHCs operators. Physicians should pay extra attention in cultivating patients' e-health literacy through communications and health information-seeking behaviors to further improve patient compliance.

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