Factors in the Effectiveness of e-Health Interventions for Chronic Back Pain: How Self-Efficacy Mediates e-Health Literacy and Healthy Habits

Background: Self-management and healthy habits (long-term health-related behaviors) are life-long requirements for the prevention of chronic back pain. Adherence to health interventions is often low because of the target groups' lack of interest. Electronic health (e-Health) information offers an opportunity to solve this issue, but many e-Health interventions are of poor quality. This study explores factors in the effectiveness of e-Health interventions and health-related behavioral changes and, thus, is among the first to develop a theoretical basis for e-Health programs. Materials and Methods: An online survey was conducted among the target groups of primary and secondary health programs promoting the management of possibly chronic back pain in Germany and Austria (N = 224). Measurements of e-Health literacy (eHL), self-efficacy, organized physical exercise, and the patients' social and mental balance were applied in all cases. Participants were categorized into dichotomous subgroups regarding the severity of their back pain. In addition to several significance tests, a correlation analysis and mediation analysis were both performed using PROCESS version 2.0 for SPSS. Results: It was observed in the nonrisk group that self-efficacy has a mediation effect on the connection between eHL and healthy habits. Significant correlations between eHL and self-efficacy in both groups revealed associations between the major driving forces of healthy habits. Conclusion: In keeping with previous research, the findings suggest that a high level of self-efficacy plays a significant role in correctly performing e-Health interventions. Nevertheless, further research should identify the effects of online social surroundings on eHL and self-efficacy in detail.