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.

Health knowledge plays an important role in health education and promotion, in providing critical services to the global population and helping them live healthier lives and make informed health decisions. This study explores what determines health knowledge adoption in the context of Chinese social media, and attempts to explain why there is a gap between health knowledge adoption intention and behavior. Based on the ELM (elaboration likelihood method) and EPPM (extended parallel process model), this paper proposes four processes of health knowledge adoption to construct an explanatory framework, and examines it from the intention-behavior gap perspective, highlighting the mediating effect of trust. Data collected from 355 Chinese respondents was tested using a partial least squares (PLS) approach. The results indicate that perceived threat has a positive effect on health knowledge adoption via the mediator, fear; perceived efficacy has a positive direct effect on health knowledge adoption; and perceived knowledge quality and perceived source credibility both have a positive effect on health knowledge adoption via the mediator, trust. Trust and fear have different impacts on health knowledge adoption intention and behavior, which explains why there is sometimes a gap between them. Theoretical and practical contributions are discussed.

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Abstract:The communication of health knowledge in social media plays an important role in public health literacy and health behavior promotion. But with the accumulation of user-generated health information in social media, more and more misleading health information, health gossip and health rumors are inhibiting the communication of health knowledge and breaking the balance of information ecology in social media. This study focuses on the information ecology in social media and contributes to the communication of health knowledge in social media ecology, highlighting the characteristics of health knowledge and the special Chinese culture. A communication explanatory framework was constructed and 319 samples were tested leveraging PLS. The results indicate that fear communication and trust communication both act as effective communication forms contributing to the communication of health knowledge; face communication acts as a barrier constraining the trust communication while no effect on fear communication.