Abstract: It is known that health belief and health literacy are closely related to health behavior. But, we do not know explicitly how health belief and health literacy interact with each other and determine health behavior change under public health emergencies (PHE). Through the integration of constructs from health belief model (perceived susceptibility, severity, benefits, barriers, and self-efficacy) and diverse dimensions of health literacy (functional, interactive and critical), a research framework is proposed to examine the underlying mechanism of health behavior change during PHE. Structural equation modeling (SEM) was used to analyze 386 questionnaire data collected from Chinese university students for the research framework. The analysis results show that (1) both health belief and health literacy have significant impacts on health behavior change during PHE. However, health belief plays a mediating role which affects the health literacy’s impact on health behavior; (2) while the increase of perceived severity of disease and self-efficacy promote the health behavior change, the effectiveness of perceived susceptibility on health behavior depends on the increase of perceived severity; and (3) the enhancement of interactive health literacy effectively promotes health behavior change, while functional and critical health literacy reduces the blind change. The results throw lights on health education services and provide references and factors in understanding and encouraging health behavior changes to relevant stakeholders including social media operators, practitioners, social service providers, and policy makers.

Keywords: public health emergency, health behavior, health belief, health literacy, norovirus