Aims: This study examined the relationships among attitudes toward artificial intelligence (AI), digital health literacy, and health empowerment and investigated whether digital health literacy mediated the relationship between attitudes toward AI and health empowerment among adults in South Korea.

Methods: A cross-sectional descriptive correlational study was conducted with 250 adults aged 20 years or older. Data were collected using structured self-report questionnaires. Descriptive statistics, t-tests, one-way analysis of variance, Pearson’s correlations, and mediation analysis using Hayes’ PROCESS macro Model 4 were performed. Frequency of health information use was included as a covariate, and indirect effects were tested using 5,000 bootstrap resamples.

Findings: Attitudes toward AI were positively correlated with digital health literacy (r = 0.45) and health empowerment (r = 0.35), while digital health literacy was strongly correlated with health empowerment (r = 0.70). After controlling for frequency of health information use, attitudes toward AI were positively associated with digital health literacy (B = 0.35, p < 0.001), and digital health literacy was positively associated with health empowerment (B = 0.67, p < 0.001). The direct effect of attitudes toward AI on health empowerment was not significant (B = 0.02, p = 0.76), whereas the indirect effect through digital health literacy was significant (effect = 0.23, Boot SE = 0.05, 95% CI [0.14, 0.34]).

Conclusion: Digital health literacy significantly mediated the relationship between attitudes toward AI and health empowerment. Strengthening adults’ ability to critically evaluate and appropriately use health information in AI-based digital environments may enhance health empowerment.