Associations of Health Literacy, Social Media Use, and Self-Efficacy With Health Information-Seeking Intentions Among Social Media Users in China: Cross-sectional Survey

Zhaomeng Niu, Jessica Willoughby, Rongting Zhou, Zhaomeng Niu, Jessica Willoughby, Rongting Zhou

Abstract

Background: Empirical research has demonstrated that people frequently use social media for gathering and sharing online health information. Health literacy, social media use, and self-efficacy are important factors that may influence people's health behaviors online.

Objective: We aimed to examine the associations between health literacy, health-related social media use, self-efficacy, and health behavioral intentions online.

Methods: We conducted a cross-sectional survey of adults 18 years and older (n=449) to examine predictors of health-related behavioral intentions online including health literacy, social media use, and self-efficacy in China using 2 moderated mediation models. Mediation and moderation analyses were conducted.

Results: Self-efficacy mediated the effects of health literacy (Bindirect=0.213, 95% CI 0.101 to 0.339) and social media use (Bindirect=0.023, 95% CI 0.008 to 0.045) on health behavioral intentions on social media. Age moderated the effects of health literacy on self-efficacy (P=.03), while previous experience moderated the effects of social media use on self-efficacy (P<.001).

Conclusions: Health literacy and health-related social media use influenced health behavioral intentions on social media via their prior effects on self-efficacy. The association between health literacy and self-efficacy was stronger among younger respondents, whereas the association between health-related social media use and self-efficacy was stronger among those who previously had positive experiences with health information on social media. Health practitioners should target self-efficacy among older populations and increase positive media experience related to health.

Keywords: behavioral intention; health literacy; self-efficacy; social media.

Conflict of interest statement

Conflicts of Interest: None declared.

©Zhaomeng Niu, Jessica Willoughby, Rongting Zhou. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 25.02.2021.

Figures

Figure 1
Figure 1
Conceptual framework.

References

    1. Cotten SR, Gupta SS. Characteristics of online and offline health information seekers and factors that discriminate between them. Soc Sci Med. 2004 Nov;59(9):1795–806. doi: 10.1016/j.socscimed.2004.02.020.
    1. Li Y, Wang X, Lin X, Hajli M. Seeking and sharing health information on social media: a net valence model and cross-cultural comparison. Technological Forecasting and Social Change. 2018 Jan;126:28–40. doi: 10.1016/j.techfore.2016.07.021.
    1. Di Z, Junsheng G, Ruosi S. Clustering analysis of health information acquisition channels: active acquisition and passive receiving. J Int Commun. 2015;5:81–93.
    1. Oh S, Syn SY. Motivations for sharing information and social support in social media: a comparative analysis of Facebook, Twitter, Delicious, YouTube, and Flickr. J Assn Inf Sci Tec. 2015 Apr 21;66(10):2045–2060. doi: 10.1002/asi.23320.
    1. Zhu Y. Social media engagement and Chinese international student recruitment: understanding how UK HEIs use Weibo and WeChat. Journal of Marketing for Higher Education. 2019 Jun 23;29(2):173–190. doi: 10.1080/08841241.2019.1633003.
    1. Zhang X, Wen D, Liang J, Lei J. How the public uses social media wechat to obtain health information in china: a survey study. BMC Med Inform Decis Mak. 2017 Jul 05;17(Suppl 2):66. doi: 10.1186/s12911-017-0470-0.
    1. Zhang L, Pentina I. Motivations and usage patterns of Weibo. Cyberpsychol Behav Soc Netw. 2012 Jun;15(6):312–7. doi: 10.1089/cyber.2011.0615.
    1. Roberts M, Callahan L, O’Leary C. Social media: a path to health literacy. ISU. 2017 Jun 26;37(2):177–187. doi: 10.3233/isu-170836.
    1. Sørensen Kristine, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H, (HLS-EU) Consortium Health Literacy Project European Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012 Jan 25;12(1):80. doi: 10.1186/1471-2458-12-80.
    1. Lambert SD, Loiselle CG. Health information seeking behavior. Qual Health Res. 2007 Oct;17(8):1006–19. doi: 10.1177/1049732307305199.
    1. Verhoef LM, Van de Belt TH, Engelen LJ, Schoonhoven L, Kool RB. Social media and rating sites as tools to understanding quality of care: a scoping review. J Med Internet Res. 2014 Feb 20;16(2):e56. doi: 10.2196/jmir.3024.
    1. Fox S, Duggan M. Pew Research Center. Washington DC: [2018-06-06]. Health online 2013. .
    1. Kamel Boulos Maged N, Wheeler S. The emerging Web 2.0 social software: an enabling suite of sociable technologies in health and health care education. Health Info Libr J. 2007 Mar;24(1):2–23. doi: 10.1111/j.1471-1842.2007.00701.x. doi: 10.1111/j.1471-1842.2007.00701.x.
    1. Laranjo L, Arguel A, Neves A, Gallagher A, Kaplan R, Mortimer N, Mendes G, Lau A. The influence of social networking sites on health behavior change: a systematic review and meta-analysis. J Am Med Inform Assoc. 2015 Jan;22(1):243–56. doi: 10.1136/amiajnl-2014-002841.
    1. Wang S, Paul M, Dredze M. Exploring health topics in Chinese social media: an analysis of Sina Weibo. Workshops at the Twenty-Eighth AAAI Conference on Artificial Intelligence; Jun 18; Québec, Canada. 2014.
    1. Niu Z, Willoughby JF. Examining cultural identity and media use as predictors of intentions to seek mental health information among Chinese. Asian Journal of Communication. 2018 Feb 17;28(4):360–376. doi: 10.1080/01292986.2018.1441319.
    1. Wu T, Deng Z, Zhang D, Buchanan PR, Zha D, Wang R. Seeking and using intention of health information from doctors in social media: the effect of doctor-consumer interaction. Int J Med Inform. 2018 Jul;115:106–113. doi: 10.1016/j.ijmedinf.2018.04.009.
    1. Liu Y, Liu L, Li Y, Chen Y. Relationship between health literacy, health-related behaviors and health status: a survey of elderly Chinese. Int J Environ Res Public Health. 2015 Aug 18;12(8):9714–25. doi: 10.3390/ijerph120809714.
    1. Wu Y, Wang L, Cai Z, Bao L, Ai P, Ai Z. Prevalence and risk factors of low health literacy: a community-based study in Shanghai, China. Int J Environ Res Public Health. 2017 Jun 12;14(6):628. doi: 10.3390/ijerph14060628.
    1. Liu Y, Xue L, Xue H, Hou P. Health literacy, self-care agency, health status and social support among elderly Chinese nursing home residents. Health Education Journal. 2017 Nov 17;77(3):303–311. doi: 10.1177/0017896917739777.
    1. Yang Y, Zhang B, Meng H, Liu D, Sun M. Mediating effect of social support on the associations between health literacy, productive aging, and self-rated health among elderly Chinese adults in a newly urbanized community. Medicine. 2019;98(16):e15162. doi: 10.1097/md.0000000000015162.
    1. Squiers L, Peinado S, Berkman N, Boudewyns V, McCormack L. The health literacy skills framework. J Health Commun. 2012 Oct;17 Suppl 3(sup3):30–54. doi: 10.1080/10810730.2012.713442.
    1. Bandura A. Media Effects. New York: Routledge; 2009. Social cognitive theory of mass communication; pp. 110–140.
    1. Wang C, Li H, Li L, Xu D, Kane RL, Meng Q. Health literacy and ethnic disparities in health-related quality of life among rural women: results from a Chinese poor minority area. Health Qual Life Outcomes. 2013 Sep 11;11(1):153. doi: 10.1186/1477-7525-11-153.
    1. Schillinger D. Improving the quality of chronic disease management for populations with low functional health literacy: a call to action. Disease Management. 2001 Sep;4(3):103–109. doi: 10.1089/10935070152596025.
    1. Lee SD, Arozullah AM, Cho YI. Health literacy, social support, and health: a research agenda. Social Science & Medicine. 2004 Apr;58(7):1309–1321. doi: 10.1016/s0277-9536(03)00329-0.
    1. Cao W, Zhang X, Xu K, Wang Y. Modeling online health information-seeking behavior in China: the roles of source characteristics, reward assessment, and internet self-efficacy. Health Commun. 2016 Sep 09;31(9):1105–14. doi: 10.1080/10410236.2015.1045236.
    1. Deng Z, Liu S. Understanding consumer health information-seeking behavior from the perspective of the risk perception attitude framework and social support in mobile social media websites. Int J Med Inform. 2017 Sep;105:98–109. doi: 10.1016/j.ijmedinf.2017.05.014.
    1. Sun Young Lee. Hwang H, Hawkins R, Pingree S. Interplay of negative emotion and health self-efficacy on the use of health information and its outcomes. Communication Research. 2008 Apr 14;35(3):358–381. doi: 10.1177/0093650208315962.
    1. Lee JY, Divaris K, Baker AD, Rozier RG, Vann WF. The relationship of oral health literacy and self-efficacy with oral health status and dental neglect. Am J Public Health. 2012 May;102(5):923–929. doi: 10.2105/ajph.2011.300291.
    1. Niu Z, Willoughby JF, Mei J, Li S, Hu P. A cross-cultural comparison of an extended planned risk information seeking model on mental health among college students: cross-sectional study. J Med Internet Res. 2020 May 11;22(5):e15817. doi: 10.2196/15817.
    1. Kushin M, Yamamoto M. Did social media really matter? college students' use of online media and political decision making in the 2008 election. Mass Communication and Society. 2010 Oct 29;13(5):608–630. doi: 10.1080/15205436.2010.516863.
    1. Bandura A. Self-efficacy and health behaviour. Cambridge Handbook of Psychology, Health and Medicine. 1997:160–2.
    1. Jiang S, Street RL. Pathway linking internet health information seeking to better health: a moderated mediation studyPathway Linking Internet Health Information Seeking to Better Health: A Moderated Mediation Study. Health Commun. 2017 Aug 27;32(8):1024–1031. doi: 10.1080/10410236.2016.1196514.
    1. Chinn D, McCarthy C. All Aspects of Health Literacy Scale (AAHLS): developing a tool to measure functional, communicative and critical health literacy in primary healthcare settings. Patient Educ Couns. 2013 Feb;90(2):247–53. doi: 10.1016/j.pec.2012.10.019.
    1. Hu Y, Shyam Sundar S. Effects of online health sources on credibility and behavioral intentions. Commun Res. 2009 Nov 25;37(1):105–132. doi: 10.1177/0093650209351512.
    1. Hayes A. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York: Guilford Publications; 2017.
    1. Lee JY, Sundar SS. To tweet or to retweet? that is the question for health professionals on twitter. Health Commun. 2013 Aug 08;28(5):509–24. doi: 10.1080/10410236.2012.700391.
    1. Ho SS, Detenber BH, Rosenthal S, Lee EWJ. Seeking information about climate change. Sci Commun. 2014 Feb 07;36(3):270–295. doi: 10.1177/1075547013520238.
    1. Hovick SR, Kahlor L, Liang M. Personal cancer knowledge and information seeking through PRISM: the planned risk information seeking model. J Health Commun. 2014 Apr 16;19(4):511–27. doi: 10.1080/10810730.2013.821556.
    1. Crook B, Stephens KK, Pastorek AE, Mackert M, Donovan EE. Sharing health information and influencing behavioral intentions: the role of health literacy, information overload, and the internet in the diffusion of healthy heart information. Health Commun. 2016 Feb 10;31(1):60–71. doi: 10.1080/10410236.2014.936336.
    1. Ledford CJW, Cafferty LA, Russell TC. The influence of health literacy and patient activation on patient information seeking and sharing. J Health Commun. 2015;20 Suppl 2:77–82. doi: 10.1080/10810730.2015.1066466.
    1. Hu S, Gu J, Zhang S. Social media usage, self-efficacy and cultural intelligence: a longitudinal empirical research in China. Wuhan International Conference on e-Business. Association For Information Systems; May 26; Wuhan, China. 2017.
    1. Schwarzer R, Schüz B, Ziegelmann JP, Lippke S, Luszczynska A, Scholz U. Adoption and maintenance of four health behaviors: theory-guided longitudinal studies on dental flossing, seat belt use, dietary behavior, and physical activity. Ann Behav Med. 2007 Jun;33(2):156–166. doi: 10.1007/bf02879897.
    1. Gao Z, Xiang P, Lee AM, Harrison L. Self-efficacy and outcome expectancy in beginning weight training class: their relations to students' behavioral intention and actual behavior. Res Quart Exerc Sport. 2008 Mar 01;79(1):92–100. doi: 10.5641/193250308x13086753543059.
    1. Clark DO. Age, socioeconomic status, and exercise self-efficacy. Gerontologist. 1996 Apr 01;36(2):157–64. doi: 10.1093/geront/36.2.157.
    1. Baker DW, Gazmararian JA, Sudano J, Patterson M. The association between age and health literacy among elderly persons. J Gerontol B Psychol Sci Soc Sci. 2000 Nov 01;55(6):S368–74. doi: 10.1093/geronb/55.6.s368.
    1. Kobayashi LC, Wardle J, Wolf MS, von Wagner C. Aging and functional health literacy: a systematic review and meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2016 May;71(3):445–57. doi: 10.1093/geronb/gbu161.
    1. Gecas V. The social psychology of self-efficacy. Annu Rev Sociol. 1989 Aug;15(1):291–316. doi: 10.1146/annurev.so.15.080189.001451.
    1. Niu Z, Jeong DC, Willoughby JF. Friends over doctors? the influences of source and perceived customization on college drinking. Health Commun. 2020 Jan 10;:1–11. doi: 10.1080/10410236.2020.1712034.
    1. Rosenberg D, Depp CA, Vahia IV, Reichstadt J, Palmer BW, Kerr J, Norman G, Jeste DV. Exergames for subsyndromal depression in older adults: a pilot study of a novel intervention. The American Journal of Geriatric Psychiatry. 2010 Mar;18(3):221–226. doi: 10.1097/jgp.0b013e3181c534b5.
    1. Seifert A, Reinwand DA, Schlomann A. Designing and using digital mental health interventions for older adults: being aware of digital inequality. Front Psychiatry. 2019;10:568. doi: 10.3389/fpsyt.2019.00568.
    1. Kim H, Xie B. Health literacy in the eHealth era: a systematic review of the literature. Patient Educ Couns. 2017 Jun;100(6):1073–1082. doi: 10.1016/j.pec.2017.01.015.
    1. Braithwaite DO, Waldron VR, Finn J. Communication of social support in computer-mediated groups for people with disabilities. Health Commun. 1999 Apr;11(2):123–51. doi: 10.1207/s15327027hc1102_2.
    1. Slater MD. Reinforcing spirals: the mutual influence of media selectivity and media effects and their impact on individual behavior and social identity. Commun Theory. 2007 Aug;17(3):281–303. doi: 10.1111/j.1468-2885.2007.00296.x.

Source: PubMed

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