卫生研究

目的 探究成都大学生微信用户健康科普类公众号持续使用意愿的影响因素。方法 采用分层整群随机抽样方法，于2023年6—9月选取成都市10所高校的745名大学生作为研究对象，通过线上匿名问卷收集人口学信息、健康科普类公众号的使用现状和持续使用意愿的影响因素。采用SPSS 26.0软件进行描述性分析，采用AMOS 26.0软件进行结构方程模型的模型拟合、假设检验和中介效应检验。结果 调查对象中男性237人(31.8%),女性508人(68.2%),≤20岁360人(48.3%),21～25岁351人(47.1%),≥26岁34人(4.6%)。结构方程模型的拟合度良好(CMIN/DF=4.106,RMSEA=0.065,NFI=0.898,CFI=0.921)。路径系数检验结果显示，健康信息质量(标准化系数0.54,P<0.001)、社交价值(标准化系数0.177,P<0.001)、感知娱乐价值(标准化系数0.246,P<0.001)正向影响期望确认度，服务质量(标准化系数-0.223,P=0.037)负向影响感知有用性，健康信息质量(标准化系数0.899,P<0.001)和期望确认度(标准化系数0.167,P=0.004)正向影响感知有用性，期望确认度(标准化系数0.988,P<0.001)正向影响满意度，感知有用性(标准化系数0.338,P<0.001)和满意度(标准化系数0.555,P<0.001)正向影响持续使用意愿。中介效应检验结果表明，期望确认度通过满意度间接影响持续使用意愿，间接效应为0.475(95%CI 0.240～0.800);健康信息质量通过感知有用性和期望确认度间接影响持续使用意愿，间接效应分别为0.296(95%CI 0.094～0.768)和0.290(95%CI 0.085～0.897);期望确认度通过感知有用性间接影响持续使用意愿，间接效应为0.049(95%CI 0.004～0.140);社交价值通过期望确认度和感知有用性间接影响持续使用意愿，间接效应为0.008(95%CI 0.000～0.040);社交价值通过期望确认度和满意度间接影响持续使用意愿，间接效应为0.084(95%CI 0.015～0.233);服务质量通过感知有用性影响持续使用意愿的间接效应为-0.080(95%CI-0.138～0.016),该路径不显著；感知娱乐价值通过期望确认度和感知有用性间接影响持续使用意愿，间接效应为0.012(95%CI 0.000～0.052);感知娱乐价值通过期望确认度和满意度间接影响持续使用意愿，间接效应为0.117(95%CI 0.030～0.298)。结论 期望确认度、健康信息质量、感知娱乐价值、感知有用性和满意度是成都大学生持续使用意愿的影响因素；期望确认度、健康信息质量和感知娱乐价值通过感知有用性和满意度间接影响大学生的持续使用意愿。

OBJECTIVE Exploring factors influencing the continued use intention of health science popularization WeChat accounts among university students in Chengdu.METHODS Stratified cluster random sampling was employed to select students from 10 universities in Chengdu in 2023 as research subjects, with data collected via a questionnaire. The questionnaire encompassed demographic information, usage patterns of health science popularization WeChat accounts, and factors influencing continued use intentions. After designing the questionnaire on the Wenjuanxing website, teachers or tutors distributed the survey link or QR code to students, who voluntarily completed the questionnaire anonymously. Descriptive analysis was conducted using SPSS 26.0, while structural equation model fitting, path coefficient testing, and mediation effect testing were performed using AMOS 26.0.RESULTS After excluding invalid questionnaires, a total of 745 valid responses were included. The structural equation model demonstrated good fit(CMIN/DF=4.106, RMSEA=0.065, NFI=0.898, CFI=0.921). Path coefficient analysis revealed positive impacts of health information quality(standardized coefficient 0.54, P<0.001), social value(standardized coefficient 0.177, P<0.001), and perceived entertainment value(standardized coefficient 0.246, P<0.001) on expectation confirmation. Service quality negatively influenced perceived usefulness(standardized coefficient-0.223, P=0.037). Health information quality(standardized coefficient 0.899, P<0.001) and expectation confirmation(standardized coefficient 0.167, P=0.004) positively influenced perceived usefulness, which along with satisfaction(standardized coefficient 0.988, P<0.001) positively influenced continued use intention. The mediation effect analysis revealed that expectation confirmation indirectly affects continued use intentions through satisfaction, with an indirect effect of 0.475(95%CI 0.240-0.800). Health information quality indirectly influences continued use intentions through perceived usefulness and expectation confirmation, with indirect effects of 0.296(95%CI 0.094-0.768) and 0.290(0.085-0.897), respectively. Expectation confirmation also indirectly influences continued use intentions through perceived usefulness, with an indirect effect of 0.049(95%CI 0.004-0.140). Social value indirectly affects continued use intentions through expectation confirmation and perceived usefulness, with an indirect effect of 0.008(95%CI 0.000-0.040), and through expectation confirmation and satisfaction, with an indirect effect of 0.084(95%CI 0.015-0.233). The indirect effect of service quality on continued use intentions through perceived usefulness was-0.080(95%CI-0.138-0.016), which was not significant. Perceived entertainment value indirectly influences continued use intentions through expectation confirmation and perceived usefulness, with an indirect effect of 0.012(95%CI 0.000-0.052), and through expectation confirmation and satisfaction, with an indirect effect of 0.117(95%CI 0.030-0.298).CONCLUSION Expectation confirmation, health information quality, perceived entertainment value, perceived usefulness, and satisfaction are factors influencing users' continued usage intentions. Expectation confirmation, health information quality, and perceived entertainment value indirectly affect users' continued usage intentions through perceived usefulness and satisfaction.