Background: women's health WeChat public accounts play a crucial role in enhancing health literacy and fostering the development of healthy behaviors among women by disseminating women's health knowledge. Improving users' continuous usage behavior and retention rates for the women's health WeChat public account is vital for influencing the overall effectiveness of health communication on WeChat.
Objective: This study aimed to construct a comprehensive model, delving into the key factors influencing women's continuance intention of the women's health public accounts from the perspectives of perceived health threats, individual abilities, and technological perceptions. The goal is to provide valuable insights for enhancing user stickiness and the effectiveness of health communication on WeChat public accounts.
Method: An online survey was conducted among women receiving gynecological care at a certain hospital to gage their willingness for sustained use of the women's health WeChat public accounts. Through structural equation modeling, the study investigated the influencing factors on women's sustained intention to use the women's health WeChat public accounts.
Results: The study included a total of 853 adult women. Among them, 241 (28.3%) women had followed women's health official accounts in the past but do not currently follow them, 240 (28.1%) women had followed women's health official accounts in the past and are still following them, and 372 (43.6%) women had never followed women's health official accounts. Currently, 240 women are still browsing women's health public accounts, 52 of whom read women's health public accounts every day, and most of them read women's health public accounts for 10-20���min at a time (100, 11.7%). The results of the structural equation model revealed that performance expectancy, social influence, hedonic motivation, habit, and e-health literacy had significantly positive effects on women's sustained intention to use public accounts (performance expectancy: ���=���0.341, <���0.001; social influence: ���=���0.087, ���=���0.047; hedonic motivation: ���=���0.119, ���=���0.048; habit: ���=���0.102, <���0.001; e-health literacy: ���=���0.158, <���0.001). E-health literacy and self-efficacy indirectly influence sustained intention by affecting performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic motivation, and habit. The effect sizes of e-health literacy on performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic motivation, and habit were 0.244 ( <���0.001), 0.316 ( <���0.001), 0.188 ( <���0.001), 0.226( <���0.001), 0.154 ( <���0.001), and 0.073 (���=���0.046). The effect sizes of self-efficacy on performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic motivation, and habit were 0.502 ( <���0.001), 0.559 ( <���0.001), 0.454 ( <���0.001), 0.662 ( <���0.001), 0.707 ( <���0.001), and 0.682 ( <���0.001). Additionally, perceived severity and perceived susceptibility indirectly affected sustained intention by influencing performance expectancy and social influence. The effect sizes of perceived severity on performance expectancy and social influence were 0.223 ( <���0.001) and 0.146 ( <���0.001). The effect size of perceived susceptibility to social influence was 0.069 (���=���0.042).
Conclusion: Users' e-health literacy, self-efficacy, perception of disease threat, and users' technological perceptions of the WeChat public accounts are critical factors influencing women's continuance intention of using the WeChat public accounts. Therefore, for female users, attention should be given to improving user experience and enhancing the professionalism and credibility of health information in public account design and promotion. Simultaneously, efforts should be made to strengthen users' health awareness and cultivate e-health literacy, ultimately promoting sustained attention and usage behavior among women toward health-focused public accounts.
