How Social Media Exposure to Health Information Influence Chinese People’s Health Protective Behavior during Air Pollution? A Theory of Planned Behavior Perspective

“Under the Dome” (穹顶之下), a self-financed documentary made by Jing Chai in 2015, a famous Chinese journalist and host, attracted 1.3 million views on Youku after being published for 19 hours. That the video went viral indicates not only the severity of the haze (a term used to describe the air pollution problem in China), but also the public’s concern about its health risks. Due to its rapidly expanding economic and industrial developments, China is one of the countries with the highest particulate matter levels in the world and suffering serious air pollution (e.g., Chen, Ebenstein, Greenstone, & Li, 2013). In January 2013, a hazardous haze due to heavy air pollution covered 1.4 million km2 of China and affected more than 800 million people. Since December 2013, more than 100 cities in China were threatened by haze, which endangered more than one billion people’s health, and was referred to as “airpocalypse” by media. The statistics of China Climate Bulletin showed that there were 8 times large and persistent haze events across the country in 2016, with three yellow warnings of heavy pollution in Beijing from October 1st to October 25th (Niu, 2017). The haze permeating indoor and outdoor spaces reaches the pollution level of 40 times what the WHO considers safe.

Harm to public health caused by air pollution should not be underestimated. WHO (2014) reported that air pollution, one of the planet’s most dangerous environmental carcinogens, rose to a leading cause of cancer and a major hazard factor for multiple health conditions including respiratory infections, heart disease, and lung cancer. Recent studies also indicated that the exposure levels of air pollution have increased significantly in some areas, especially in rapidly industrializing countries with large populations, such as China and India (International Agency for Research on Cancer [IARC], 2013). Moreover, the haze crisis goes beyond a problem of air pollution per se, but interferes economic, political, and societal benefits of Chinese people in general. Davies and colleagues (2016) pointed out that the environmental pollution including air pollution has challenged not only public health but economic development of China.

So how do Chinese people perceive and respond to such environmental crisis? Despite the severity of haze in China, there is still dearth of research conducted in this arena from communication and behavioral perspectives. Previous content-analytic study (Yang, Yang, & Zhou, 2015) found significant differences across governmental organizations, non-governmental organizations, and corporations in presenting haze-related messages on Sina Weibo under the Health Belief Model. Xu and colleagues (2015) applied HBM in predicting protective (e.g., wearing masks, curtailing outdoor activities) and mitigating behaviors (e.g., car driving reduce). However, no study so far has ever investigated the effects of media exposure on Chinese people’s perceptions and behaviors towards haze.

To fill the gap in the literature, Dr. Qinghua Yang, a postdoctoral research fellow at the UPenn Annenberg School for Communication, and Dr. Shiwen Wu, an associate professor at the Wuhan Univeristy, conducted the research project “Clean Air and Clear Vision: Understanding the Effects of Social Media Exposure on Chinese People’s Perceptions of Air Pollution” under the grant support from the UPenn Center for the Study of Contemporary China, aiming to generate better understanding of how Chinese people’s use of Weibo and WeChat for health information influence their perceptions of and protective behavior (i.e., wearing PM2.5 mask) in response to haze. Given the prevalence of social media (SM), with Weibo and WeChat being the leading platforms in China, SM become one of the major channels for people to obtain health information and to form perceptions, beliefs, and attitudes (e.g., Livingston, Cianfrone, Korf-Uzan, & Coniglio, 2014).

To investigate how Chinese people’s exposure to health information on SM influences their health protective behaviors in response to haze, particularly wearing PM2.5 anti-haze mask, Yang and Wu conducted a longitudinal web-based survey of Chinese people residing in Mainland China from October 2016 to January 2017, with 210 respondents who completed a baseline and follow-up survey one month later. The results from the structural equation modeling showed that a) attitude and descriptive norm positively mediated the relationships between using Weibo for health information and behavioral intention while descriptive norm negatively mediated the relationship between using WeChat for health information and intention, and that b) attitude, descriptive and injunctive norms significantly predicted behavioral intention and wearing mask, but perceived behavior control did not. Using the Theory of Planned Behavior (TPB; Ajzen, 1991) as the framework, the study also shed theoretical lights to TPB, which has long been criticized as being “westernized” and lacking the applicability to other cultures (Airhihenbuwa & Obregon, 2000), from a non-westernized perceptive by taking social contexts into consideration. Practically, the results will inform health decisions makers and professionals in designing campaigns or interventions using Weibo and WeChat to disseminate haze-related scientific health information and educate the public of effective protective behaviors.

The research paper titled “How Social Media Exposure to Health Information Influences Chinese People’s Health Protective Behavior during Air Pollution? A Theory of Planned Behavior Perspective” (Yang & Wu, 2017) submitted to the National Communication Association 103rd annual conference was accepted for presentation in Dallas on Nov. 17th, and won the top paper award of Association for Chinese Communication Studies.



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