Health information sources and behaviour changes in a community population: a longitudinal study

Accessible and trustworthy health information sources support informed decisions. Longitudinal evidence on how health information sources influence behavioural changes in community-dwelling populations remains limited. Thus, we examined associations between health information sources and behaviour changes in walking time, balanced meal consumption, and smoking cessation.

Baseline (2021) and follow-up (2023) survey questionnaires were distributed to residents randomly selected from the 18 residential areas. Health information sources were classified into five categories: print media, television (TV) and radio, the Internet, family and friends, and professionals. Desirable health behaviours were defined as walking for ≥60 min/day; consuming ≥2 meals per day comprising staple grains, main dishes, and side items (SMS); and smoking cessation. Meeting these criteria was classified as good; not meeting them as poor. Improvement was defined as poor at baseline and good at follow-up. Maintenance was defined as good at both surveys. Improvement analyses included participants with poor baseline conditions. Maintenance analyses included those with good baseline conditions. Associations were analysed using multilevel modified Poisson regression models, accounting for clustering within residential areas and adjusting for covariates. Risk ratios (RRs) and 95% confidence intervals (95% CIs) were calculated.

Of the 12 119 baseline participants, 6620 (54.6%) completed the follow-up. The most common health information sources were TV and radio (68.5%), the Internet (56.8%), and print media (48.9%). Use of family and friends as information sources was associated with improvement in walking time (RR: 1.19; 95% CI: 1.02-1.39), as was use of professionals (RR: 1.15; 95% CI: 1.03-1.28). Professionals showed a marginal association with sustained walking time (RR: 1.07; 95% CI: 0.99-1.15). TV and radio was associated with improvement in SMS meal consumption (RR: 1.13; 95% CI: 1.02-1.26), while print media was associated with maintenance of SMS meal consumption (RR: 1.05; 95% CI: 1.01-1.08). No sources were related to smoking cessation.

Health information sources showed distinct associations with improved and maintained health behaviours. Interpersonal sources were relevant for improving walking time, while mass media were linked to dietary improvement and maintenance. These findings suggest tailoring health communication strategies to specific health behaviours.