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The purpose of this paper is to explore the factors influencing people’s health knowledge adoption in social media, with an eye toward promoting health information literacy and healthy behavior.

Based on the integration of sense-making theory, social influence theory, information richness theory, fear appeal theory, and ELM (elaboration likelihood method), a health knowledge adoption model is constructed. Taking spondylopathy as an example, high health threat and low health threat experiments and questionnaires are designed to complete the empirical study. In all, 355 effective survey samples are collected and analyzed, leveraging a partial least squares method.

Research results indicate that perceived knowledge quality, perceived knowledge consensus, and perceived source credibility have positive effects on health knowledge adoption via the mediator – trust; knowledge richness contributes to the perception of knowledge quality, source credibility, and knowledge consensus, especially under high health threat; health threat has significant positive moderating effects on the relationship between trust and health knowledge adoption, and the relationship between perceived knowledge quality and trust, with negative moderating effects on the relationships between perceived knowledge consensus, perceived source credibility, and trust.

This paper examines the mediating effecting of trust in the process of health knowledge adoption. Based on the integration of fear appeal theory, social influence theory, sense-making theory, information richness theory and elaboration likelihood model, this study investigates the factors influencing health knowledge adoption in social media from the perspective of a user, and explores the moderating effect of health threat on health knowledge adoption.

The purpose of this paper is to understand the role of perceived threat, brand congruence, and social support on consumer coping strategies for a preventative health service.

An online survey of 570 women aged over 50 in one Australian state was conducted (users and non-users of the service). The data were analyzed using structural equation modeling.

A competing models approach reveals that threat on its own is associated with avoidance coping; however, when brand congruence is high, there is an association with active coping. Social support appears to have a buffering effect on threat and is associated positively with active coping and negatively with avoidance coping.

The study findings suggest that threat appeals should be used with caution in increasing participation in transformative preventative health services due to its double-edged sword effect (increasing both avoidance and active coping). When consumers have social support, this results in active coping and buffers avoidance coping. This research offers useful insights for social marketing and transformative service research.

Prior researches on the adoption of mobile health services (MHS) concentrate on the subjective cognitive appraisals resulting in technology adoption, while ignoring how to shape those cognitive appraisals by the objective message design strategies which are easier to operate in practice. Based on protection motivation theory (PMT), the current research aims to explore the antecedents of cognitive appraisals by focusing on message design strategies of fear appeal and coping appeal.

A two-stage scenario-based survey of 204 participants was conducted to collect data. The authors chose SPSS and covariance-based structural equation modeling (CB-SEM) approach with the software LISREL 8.8 to test our model.

The results show that the relationship between fear appeal and fear arousal is inverted U-shaped such that the degree of fear arousal is the greatest when the fear appeal is at a moderate level. Perceived usefulness for the message with negative framing is higher than that with positive framing. Furthermore, fear appeal and coping appeal have a significant interaction on the adoption of MHS at different stages.

The sample data of this study come from a special health service of a special group in China, which limits the universality of our research results for other groups or health care services. Therefore, future researchers can validate the model in other research scenarios and sample populations.

This study shows how fear appeal and coping appeal work together to influence individuals' adoption intention. The authors’ findings expand the theoretical depth of PMT and fear theory, enriching the theoretical connotation of framing effect in mobile health technology adoption context, which add new insights to design more persuasive messages through fear appeal and coping appeal for researchers and MHS providers in mobile health communication or propaganda.

Advertisements often use fear appeals to encourage prevention focused behaviors. This approach has been somewhat successful in changing attitudes and behaviors, often encouraging consumers to secede from behaviors such as smoking or to adopt preventative behaviors such as engaging in health screenings. However, health-care marketers have been less successful in efforts to reduce obesity. The obesity crisis has led to an abundance of marketing communications designed to influence weight loss. Many of these focus on fear of physical health risks associated with being overweight which have a certain degree of uncertainty surrounding them. This study aims to examine financial threats that have lower perceptions of uncertainty, and the differential impact this type of threat has on elements of the Extended Parallel Process Model (EPPM).

A 2 × 2 experimental design is used to examine the differential impact of messages communicating threat of financial and physical risk on evoked fear, perceived uncertainty, perceived susceptibility, efficacy and intention to lose weight.

Overall results indicate that response to weight loss advertising varies given the type of threat presented. Results indicate that there is a greater level of uncertainty associated with physical health threats than that with financial threats. Moreover, even though individuals were more fearful of and felt more susceptible to physical threats, when they believed that the recommended behavior was feasible, financial threat was more influential.

To encourage weight loss and intentions to lose weight advertising in practice and advertising research primarily focus on the physical health risks associated with being overweight as a motivating factor. Current research explores the impact of financial threats on attitudes and behavioral intention and finds that financial threats are perceived as more certain than physical threats, and the communication of financial threats is more salient in its effect on weight loss intentions. An opportunity for future research is to further explore the impact of uncertainty in relation to components of EPPM and how threats varying in degrees of uncertainty may impact weight loss intentions.

Health tourism is recognised as a recent new pattern of taking a break while accessing health-care services overseas. Past studies have explored this research area, but few have focussed on the theoretical perspective. Applying an appropriate theoretical model to guide interventions in planning and programme development is crucial, particularly when the focus of the study is on the cognitive mediation processes of change in individual behaviour. This study aims to examine the effectiveness of the protection motivation theory with the influence of threat appraisal and coping appraisal. The purpose is to trigger the behavioural intention to engage in international health tourism.

A total of 299 international tourists participated in the survey. The partial least squares structural equation modelling technique was used to test the research framework. Both the measurement model and the structural model were assessed as adequate.

The empirical results demonstrate that tourists’ high risk perception must be complemented by coping ability to produce a motivational response. Further, the adaptive behaviours of international tourists are focussed more on perceived efficacy than on the perception of threats related to behavioural intentions towards health tourism.

The study presents an effective theoretical model intervention applicable to health tourism. Future studies should conduct a more comprehensive assessment to generate strong decision-making effectiveness from the theoretical model.

共有299名国际游客参加了此次调查。使用偏最小二乘结构方程建模技术来测试研究框架。测量模型和结构模型均被评估为足够。

健康旅游业被公认为是最近在海外获得医疗服务时休息的新模式。过去的研究已经探索了这个研究领域, 但是很少有人关注理论观点。应用适当的理论模型来指导计划和程序开发的干预措施至关重要, 特别是当研究的重点是个人行为改变的认知中介过程时。本研究在威胁评估和应对评估的影响下检验了保护动机理论（PMT）的有效性。目的是激发从事国际健康旅游的行为意图。

实证结果表明, 游客的高风险感知必须通过应对能力来补充, 以产生激励反应。此外, 国际游客的适应行为更多地集中在感知的效能上, 而不是感知与针对健康旅游的行为意图有关的威胁。

该研究提出了一种适用于健康旅游的有效理论模型干预措施。未来的研究应进行更全面的评估, 以从理论模型中产生强大的决策效力。

关键词 健康旅游, 行为意图, 保护动机理论, 国际游客, 马来西亚

文章类型： 研究型论文

Un total de 299 turistas internacionales participaron en la encuesta. Se utilizó la técnica de modelización de ecuaciones estructurales por mínimos cuadrados parciales para probar el marco de investigación. Tanto el modelo de medición como el modelo estructural se consideraron adecuados.

El turismo de salud se reconoce como un nuevo modelo reciente de descanso para acceder a los servicios sanitarios en el extranjero. Estudios anteriores han explorado esta área de investigación, pero pocos se han centrado en la perspectiva teórica. La aplicación de un modelo teórico adecuado para guiar las intervenciones en la planificación y el desarrollo de programas es crucial, especialmente cuando el estudio se centra en los procesos de mediación cognitiva del cambio en el comportamiento individual. Este estudio examina la eficacia de la teoría de la motivación de la protección (PMT) con la influencia de la valoración de la amenaza y la valoración del afrontamiento. El objetivo es activar la intención conductual de realizar turismo sanitario internacional.

Los resultados empíricos demuestran que la percepción de alto riesgo de los turistas debe complementarse con la capacidad de afrontamiento para producir una respuesta motivacional. Además, los comportamientos adaptativos de los turistas internacionales se centran más en la eficacia percibida, que en la percepción de las amenazas relacionadas con las intenciones de comportamiento hacia el turismo de salud.

El estudio presenta un modelo teórico de intervención eficaz aplicable al turismo de salud. Futuros estudios deberían realizar una evaluación más exhaustiva para generar mayor eficacia en la toma de decisiones a partir del modelo teórico.

Turismo de salud; Intención de comportamiento; Teoría de la motivación de la protección; Turistas internacionales; Malasia

Trabajo de investigación

This paper aims that mobile health (mHealth) applications have emerged as a key tool to support public health. However, there are only a few studies examining the influences of health-related ascribes on continuance intention to use mHealth apps and how these influences are contingent on gender in the mHealth app using context.

This study takes the protection motivation theory as a theoretical framework to examine the ordered relationship between threat and coping appraisals and their impacts on continuance intention to use mHealth apps. In addition, this study further extends the literature on gender differences into the mHealth app's context to investigate the moderating role of gender. The suggested hypotheses are confirmed by a structural equation modeling approach and multigroup investigation employing survey data of 345 users of Spring Rain Doctor in China, a typical mHealth app.

The findings suggest that the impact of perceived disease threat on user's continuance intention is mediated entirely by coping appraisals. Furthermore, the three coping appraisals' impacts are contingent upon gender. Specifically, response efficacy is more crucial for male users in forecasting continuance intention, whereas self-efficacy and response cost have a more salient influence on continuance intention for female users.

This study examines the ordered influences of threat and coping appraisal, moderated by gender, on continuance intention on use mHealth apps. These findings could contribute to relevant theoretical and practical implications.

This study aims to study the mechanisms and conditions of users' intention to continue to use online health platforms from an information technology (IT) affordance perspective.

b This research proposes that a critical affordance effect on an online health platform, users' intention to continue the use of the platform, is affected by five platform affordances via two actualized affordances (i.e. perceived benefits (PBs) and online engagement (OE)). Perceived health threat moderates the effect generated by affordance actualization. A dataset involving 409 users from the “Ping An Health” platform was collected through an online survey and analyzed to validate the research hypotheses.

The data analysis results confirm that the proposed online health platform affordances affect users' PBs and OE, which influence users' intentions to continue using the platform. Perceived threats (perceived vulnerability (PVU) and perceived severity (PSE)) moderate the relationship between PBs and continuance intention (CI) and between OE and CI.

The research provides important recommendations for online health platform designers to develop IT affordances that can support users' needs for healthcare services.

Limited studies investigated why users continue participating in online diagnosis and treatment. This study provides a new perspective to expand the affordance framework by combining technology features and user health behavior. The study also emphasizes the importance of perceived threats in IT use.

Shifting to mobile-based banking transactions from physical banking transactions can be considered as a social distancing mechanism, which helps to prevent the spread of Covid-19 virus. As the spread of Covid-19 is expected to continue for long, the continued usage of mobile-based payment services as a strategy to maintain social distancing has to prevail. Hence, this study aims to propose an integrated framework of mobile payments adoption and its continuance intention by integrating health belief model (HBM) and expectation confirmation model (ECM) of information system continuance.

The subject of the study constitutes new adopters of mobile payments. A total of 654 respondents participated in the survey. The conceptual model was empirically validated using structural equation modeling and serial mediation analysis.

The study found that the HBM constructs, namely, perceived severity, perceived susceptibility and self-efficacy significantly influenced adoption/confirmation of mobile-based payment services. The continuance intention was significantly predicted by perceived usefulness and perceived satisfaction. Furthermore, the perceived health threat (comprising perceived severity and perceived susceptibility) indirectly affects continuance intention through confirmation, perceived usefulness and satisfaction.

There are short-term and long-term implications for the study. Short-term implications include triggering the HBM at policy levels, to adopt mobile payments/banking as a means of social distancing in the wake of the increasing threat of Covid-19 in India. Long-term implication for service providers is to convert adopters into loyal consumers by enhancing usefulness and satisfaction.

The study proposes a novel attempt to explain the adoption and continuance of mobile-based payment as a preventive health behavior to contain the spread of Covid-19 outbreak. The study proposes an integrated framework of HBM and ECM to explain pre-adoption and post-adoption behavior of consumers with respect to mobile-based payment services during Covid-19 context.

Drawing on the Health Belief Model (HBM), this study aims to investigate the roles of health beliefs (i.e. perceived susceptibility, perceived severity, perceived benefits, perceived barriers, health self-efficacy and cues to action) in promoting college students’ smartphone avoidance intention.

Empirical data were collected through a cross-sectional survey questionnaire administered to 4,670 student smartphone users at a large university located in Central China. Further, a two-step Structural Equation Modeling was conducted using AMOS 22.0 software to test the hypothesized relationships in the research model.

Analytical results indicate that (1) perceived susceptibility, perceived severity, perceived benefits and health self-efficacy positively influence users’ smartphone avoidance intention; (2) perceived barriers negatively influence smartphone avoidance intention, while (3) cues to action reinforce the relationships between perceived susceptibility/perceived benefits and smartphone avoidance intention, but attenuate the relationships between perceived barriers/health self-efficacy and smartphone avoidance intention.

This study demonstrates that HBM is invaluable in explaining and promoting users’ smartphone avoidance intention, thereby extending extant literature on both HBM and smartphone avoidance.

Research on smartphone avoidance is still in a nascent stage. This study contributes to the field by offering a fresh theoretical lens for pursuing this line of inquiry together with robust empirical evidence.

This research aims to develop and test a model of digital health communication media (DHCM) use for healthy food information – DHCM usage – during the Covid-19 pandemic. More specifically, this research investigated the simultaneous effects of perceived threat of Covid-19, e-health literacy, attitude toward DHCM usage, knowledge toward DHCM usage, facilitating conditions and information quality on the DHCM usage.

The empirical data were collected through a survey. The respondents of the survey are 192 DHCM users who lived in Tangerang Regency. Structural equation modelling (SEM) analysis was performed.

The DHCM usage during the Covid-19 pandemic is significantly affected by the attitude towards the DHCM usage and the facilitating conditions. However, the DHCM usage during the Covid-19 pandemic is not significantly affected by the perceived threat of Covid-19, e-health literacy, information quality and knowledge of the DHCM usage.

This research was conducted only in Tangerang Regency and employed a purposive sampling technique. Future research should be conducted in other contexts to examine the stability of the research findings.

In order to improve DHCM usage for healthy food information, it is important for building a positive attitude towards DHCM usage and ensuring the availability of the facilitating conditions.

This paper is the first that develops and tests a model of DHCM usage for healthy food information during the Covid-19 pandemic.