Factors influencing people’s health knowledge adoption in social media. The mediating effect of trust and the moderating effect of health threat
| Pages | 129-151 |
| Published date | 19 March 2018 |
| Date | 19 March 2018 |
| DOI | https://doi.org/10.1108/LHT-04-2017-0074 |
| Author | Chaoguang Huo,Min Zhang,Feicheng Ma |
Factors influencing
people’s health knowledge
adoption in social media
The mediating effect of trust and the
moderating effect of health threat
Chaoguang Huo
Center for Studies of Information Resources, Wuhan University, Wuhan, China
Min Zhang
School of Information Management, Wuhan University, Wuhan, China, and
Feicheng Ma
Center for Studies of Information Resources, Wuhan University, Wuhan, China
Abstract
Purpose –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.
Design/methodology/approach –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.
Findings –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.
Originality/value –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.
Keywords Trust, Social media, Health knowledge adoption, Health threat, Public number, Spondylopathy
Paper type Research paper
1. Introduction
Health knowledgeplays a very important role in the promotion of healthinformation literacy
(HIL) and healthy behavior, helping people build a health knowledge base and make better-
informed health decisions in everyday life (Eriksson-Backa et al., 2012; Yates, 2015).
If people lack knowledge about the health risks and benefits of a behavior, they may be
unmotivated to alter unhealthy habits. Hence, health knowledge can be considered as a
precondition for change (Enwald et al., 2016). If people lack knowledge about evaluating,
understanding,and using health-related information, their ability to make informed decisions
concerning health may be impaired.Hence, health knowledge can be considered a knowledge Library Hi Tech
Vol. 36 No. 1, 2018
pp. 129-151
© Emerald PublishingLimited
0737-8831
DOI 10.1108/LHT-04-2017-0074
Received 11 April 2017
Revised 7 August 2017
Accepted 28 August 2017
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/0737-8831.htm
This paper was supported by the National Natural Science Foundation of China (Grant Nos 71203166;
91646206; 71661167007; 71420107026).
129
People’s health
knowledge
adoption
source to enhance HIL and health literacy (Hirvonen et al., 2016). Health knowledge can
improve patients’understandingabout their health statusand treatment options,assist people
to take responsibility for managing and improving their own health, and help the public live
better (Maasland et al., 2011). Promoting the adoption of health knowledge has always been
the main motive in the process of HIL instruction, health education, and health promotion,
especially in the era of information overload (LaRosa et al., 1999; Mairs et al., 2013).
Besides traditional he alth education channels, su ch as watching TV, reading
newspapers, reading books, and consulting doctors face-to-face, social media have
gradually become an important channel for health education due to the in-time and
technology-based interventions and user-content-generated convenience, which provide a
highway for health knowledge communication and dissemination (Bughin et al., 2012;
Duan, 2013). For instance Facebook, YouTube, and Twitter serve these functions outside
China. In China, WeChat is the most active social medium. According to China’s social media
impact report, 75.9 percent of users used WeChat in 2015 (2016).
Furthermore, “publi c number”has becomethe most popular mediumembedded in WeChat.
Public number is a new and flexible service platform nesting in users’social networking to
push information and provide services. It includes service public number, enterprise public
number, and subscription public number. Service public number provides services for
enterprisesand users, such ashuaweicorp, a public numberaffiliated withHUAWEI company,
where you can purchase products. Enterprise public number provides a mobile application
entrance for businesses and organizations to help enterprises establish connections
among employers, employees, and suppliers. Subscription public number provides a new
way of information dissemination to individuals, suchas health366 and baojiandaifu, two very
popular public numbers pushing healthcare and disease precaution knowledge.
But unlike health knowledge posted by authoritative organizations, such as hospitals,
doctors, and healthcare centers, there is a great deal of misleading user-generated health
information, some of which is no more than rumors or gossip, inhibiting the adoption of real
health knowledge. For example, rumorsabout the H1N1 virus in Japanand the H7N9 virus in
China both led to widespread trust crises with authorities (Shigemura et al., 2015). The 2013
rumor about the hepatitis B vaccine resulted in a serious public health crisis. Misleading
information and rumors, such as “Milk causes cancer,”“Calcium supplements can cause
kidney stones,”and “GM foods kill your grandchildren,”have permeated social media and
confused users who seek health truths (Liu, 2014). In fact, according to a report from Life Tim e,
the first health weekly in China (affiliated with the Global Times), 42.2 percent of social media
users have been affected bymedical deceptions, which will certainly influenceusers’trust and
adoptionof health knowledge in thefuture. On the other hand,users immersed in social media
are in sore needof HIL to avoid the risk of misleading health information, gossip, andrumors.
For users, trust might be a key evaluation dimension about health knowledge in social
media. Therefore, highlighting the role of trust and emphasizing the character of health
knowledge of health threats, this study tries to explore what determines people’health
knowledge adoption in social media. Spondylopathy knowledge posted by WeChat public
numbers was selected as an example in designing the experiment.
2. Theoretical background and research model
2.1 ELM and trust
The elaboration likelihood model (ELM) is a theory arguing that individuals change the ir
attitudes through a dual-route persuasion process that includes central route persuasion and
peripheral route persuasion (Petty et al., 1983). In the central route, the recipient experiences high
levels of elaboration and devotes much cognitive energy to the information to which they are
exposed (Angst and Agarwal, 2009). In peripheral route persuasion, the recipient experiences
low levels of elaboration and may ignore the information content, due in part to his prior
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LHT
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