Abstract
Determinants of user mental health are diverse, interrelated, and often multifaceted. This study explores how internet use, perceived care quality, patient education, and patient centered communication influence mental health, using structural equation modeling. Findings suggest that increased internet use even for health purposes negatively impacts mental health <inline-formula><tex-math notation="LaTeX">(\beta =-0.087,\;\beta =-0.065,\;P< 0.001)</tex-math></inline-formula>.On the other hand, education level, patient centered-communication (PC-Com) and perception of care quality impact mental health positively <inline-formula><tex-math notation="LaTeX">(\beta =0.082,\;\beta =0.146,\;\beta =0.077,\;P< 0.001,\;\text{respectively})</tex-math></inline-formula>. Moreover, we also explored the changes across various demographics. The influence of patient education on PC-Com was only significant for Hispanic respondents <inline-formula><tex-math notation="LaTeX">(\beta =-0.160,\;P< 0.001)</tex-math></inline-formula>. Internet use for health purposes influenced PC-Com negatively for White American respondents <inline-formula><tex-math notation="LaTeX">(\beta =-0.047,\;P=0.015)</tex-math></inline-formula>. The study reinstated that the internet use, patient centered communication, patient education, and perceived care quality might influence mental health. The society will increasingly seek health information from online sources, so our study provides recommendations to make online health information sources more user friendly and trustworthy, ultimately to minimize negative impact on mental health.