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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1565327
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Despite the rapid growth of research in digital health, there is a significant gap in understanding how psychological factors such as self-efficacy, self-esteem, and perceived social support collectively influence digital mental health engagement, particularly within the Malaysian context. While previous studies have explored these constructs individually, few have examined their integrated effects on user engagement with e-health platforms. The study aims to fill that gap by exploring the direct relationships between self-efficacy, self-esteem, and perceived social support with digital mental health engagement, while also analyzing the mediating role of perceived social support. The novelty of the research lies in the integration of these psychological constructs into a unified conceptual framework to provide a more comprehensive understanding of digital mental health engagement. Using a quantitative, cross-sectional design, the study surveyed 400 active Malaysian e-health users through a self-administered questionnaire. The survey used validated scales to measure self-efficacy, self-esteem, perceived social support, and engagement with digital mental health platforms. Structural Equation Modeling (SEM) was employed to test five hypotheses regarding direct and mediated relationships. Demographic analysis revealed that many participants were female (71.3%), aged between 25 and 45 years (76.6%), and from higher income brackets (RM5,001-RM20,000). WhatsApp (400 users) was found to be the most popular tool, followed by Facebook (387 users) and Instagram (371 users), highlighting the importance of these platforms in connectivity and information sharing. The study found that perceived social support had the strongest direct effect on digital mental health engagement (β = 0.523), followed by selfesteem (β = 0.384) and self-efficacy (β = 0.236). Additionally, perceived social support significantly mediated the impact of both self-efficacy and self-esteem on engagement. These findings underscore the importance of fostering supportive digital environments to enhance users' confidence and self-worth. However, the cross-sectional nature of the study limits causal interpretations, and the localized sample restricts generalizability. Future research should incorporate longitudinal methods and explore cultural differences. Overall, the study contributes to the development of effective digital mental health engagement strategies in Malaysia and beyond.
Keywords: E-health technologies, self-efficacy, perceived social support, self-esteem, digital mental health engagement
Received: 25 Jan 2025; Accepted: 07 Apr 2025.
Copyright: © 2025 Kok Wah. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jack Ng Kok Wah, Multimedia University, Cyberjaya, Malaysia
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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