How Health-Related Social Media Use Affects Health Behaviors: Mediated by Self-Efficacy and Self-Regulation, Moderated by Gender

Health-related social media use (HRSMU) has the potential to facilitate fruit and vegetable intake (FVI) and physical activity (PA). Based on self-efficacy theory and self-regulation theory within the Social Cognitive Theory (SCT) framework, this study examines whether health self-efficacy (HSE) and the use of health information technology (HIT) for self-regulation mediate the relationship between HRSMU and health behaviors among Chinese adults. Data were extracted from a national survey conducted in China between January and September 2023, involving 7018 adults. A moderated mediation model was employed to examine a sequential chain of mediation through HSE and HIT use for self-regulation. Results revealed that HRSMU was positively associated with FVI, both directly (bp = .140, se = .010, p < .001) and indirectly (bp = .001, se = .0002, 95% CI [.0005, .001]), with HSE and the use of HIT for self-regulation serving as sequential mediating mechanisms. Additionally, a moderating effect of gender was observed in the relationship between HSE and FVI (bp = -.048 se = .018, p = .008), with men showing a stronger association than women. Although HRSMU is not related to PA directly, it is associated with PA indirectly through HSE and the use of HIT for self-regulation (bp = .0003, se = .0001, 95% CI [.0002, .0004]). These findings highlight the association between HRSMU and health behaviors, as well as the need for gender-tailored interventions to strengthen cognitive factors during health behavior change.