Objectives: The purpose of this study was to investigate the impact of eHealth, the use of information and communications technologies to improve or enable health and health care, on lifestyle behaviors through social support and patient empowerment as serial mediators.

Methods: We conducted an anonymous online survey of 29 items in October 2019 to assess Chinese people’s eHealth activ- ities (i.e. engaging in online health-related activities), social support (including emotional and instrumental support) and patient empowerment, for a lifestyle change. A total of 681 respondents aged 18 or above (49.9% males) with an average age of 30.8 completed the survey.

Results: Social support (including emotional and instrumental support) and patient empowerment were found to be salient mediators between eHealth and lifestyle behaviors. Specifically, engaging in eHealth activities can improve both perceived emotional support and instrumental support from care networks, of which both would increase patient empowerment, which subsequently prompted healthy lifestyle behaviors (β = .01, confidence interval (CI): [.003, .013] for emotional support as the first mediator; β < .01, CI: [.003, .010] for instrumental support as the first mediator). However, the results showed that engaging in eHealth activities was not directly associated with a healthy lifestyle (β = .01, p = .65).

Conclusions: Our findings suggest that eHealth is effective and useful to drive people into action to develop healthy lifestyle behaviors. Particularly, by providing multiple potential sources of social support, eHealth will promote both emotional sup- port and instrumental support, which is vital to increase patient empowerment, and eventually leads to healthy lifestyle behaviors.