Empowering maternal health through digital platforms in China: Pregnant women’s online reproductive health product consumption

Han Chen, Songyu Jiang, Jie Gao, Miao Shi, Zhang Pengfei

Abstract

This study examines the digital consumption of reproductive health products by women, linking it to sustainable development goals. The main objective was to develop and test an online purchase decision-making model for pregnant Chinese women on social media platforms. Data were collected through an online survey of 728 pregnant women with online shopping experience and was analysed using structural equation modelling. The findings revealed that factors such as perceived usefulness, perceived ease of use, and influencer attractiveness directly enhance online purchase intention. Furthermore, influencer attractiveness serves as an affective mechanism mediating the relationship between technological perceptions and purchase intention. Another key finding indicated that para-social relationships positively strengthen the link between attractiveness and purchase intention. We conclude that by extending the Technology Acceptance Model through integrating affective and relational components, this study provides practical insights for stakeholders to collaborate effectively with influencers and support pregnant women in making informed and responsible choices in reproductive health

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References

World Health Organization. Critical Considerations and Actions for Achieving Universal Access to Sexual and Reproductive Health in the Context of Universal Health Coverage Through a Primary Health Care Approach. World Health Organization; 2022.

He Y, Chen L, Wang Y, Li X. Exploring nurse and patient perspectives on WeChat-based prenatal education in Chinese public hospitals: a qualitative inquiry. BMC Nurs. 2025;24(1):459.

Macheka T, Quaye ES, Ligaraba N. The effect of online customer reviews and celebrity endorsement on young female consumers’ purchase intentions. Young Consum. 2024;25(4):462-482.

Agustian K, Sari NP, Putra A, Wijaya S. The influence of influencer marketing in increasing brand awareness and sales for SMEs. Technol Soc Perspect (TACIT). 2023;1(2):68-78.

Dahana WD, Miwa Y, Morisada M. Linking lifestyle to customer lifetime value: An exploratory study in an online fashion retail market. J Bus Res. 2019;99:319-331.

Ma B, Zhang J, Liu S, Zhou Y. How do consumers’ fashion

lifestyles differentiate their logistics preferences for fashion products? J Retail Consum Serv. 2024;79:103798.

Wang Y, Torbica A. Investigating the relationship between health and gender equality: What role do maternal, reproductive, and sexual health services play? Health Policy. 2024;149:105171.

Liang M, Li J, Zhao K, Zhang H. Accelerating progress in women’s sexual and reproductive health and rights decision-making: trends in 32 low-and middle-income countries and future perspectives. Glob Health Sci Pract. 2024;12(6).

Yáñez-Valdés C, Arias-Ramírez A, Ibáñez MJ. ‘Apptivism’: Women’s activism through digital applications to solve invisibilized needs. Tec Empresarial. 2025;19(3):120-140.

Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989;13(3):319-340.

Venkatesh V, Davis FD. A theoretical extension of the technology acceptance model: Four longitudinal field studies. Manage Sci. 2000;46(2):186-204.

Kurniawan A, Al Farabi M. Technology acceptance model (TAM) of telescreening innovation for the prevention of mortality of high-risk pregnant women in Jayapura Regency, Papua. Sci Midwifery. 2024;12(3):1200-1205.

Wu S, Cui B, Yu X. Willingness to use smart fetal heart rate monitoring devices among pregnant women: an extension of the technology acceptance model. Front Psychol. 2024;15:1400720.

Rouidi M, Elouadi A, Hamdoune A. Acceptance and use of telemedicine technology by health professionals: Development of a conceptual model. Digit Health. 2022;8:20552076221081693.

Dhagarra D, Goswami M, Kumar G. Impact of trust and privacy concerns on technology acceptance in healthcare: an Indian perspective. Int J Med Inform. 2020;141:104164.

Liu C, Zhang W, Li M, Zhao P. Exploring the influence of Chinese online patient trust on telemedicine behavior: insights into perceived risk and behavior intention. Front Public Health. 2024;12:1415889.

BC Publication. Effectiveness of live-streaming influencers on consumers: Evidence from Douyin. Bus Manag J. 2023;14(3):45–59.

Yang G, Chaiyasoonthorn W, Chaveesuk S. Exploring the influence of live streaming on consumer purchase intention: A structural equation modeling approach in the Chinese E-commerce sector. Acta Psychol (Amst). 2024;249:104415.

Balaban DC, Szambolics J, Chirică M. Parasocial relations and social media influencers' persuasive power.

Exploring the moderating role of product involvement. Acta Psychol (Amst). 2022;230:103731.

Du Y, Rui JR, Yu N. How parasocial relationship and influencer-product congruence shape audience’s attitude towards product placement in online videos: The mediation role of reactance. Psychol Res Behav Manag. 2023;16:1315-1329.

Liu Y, Wang W. Discipline and resistance in the representation of motherhood: Postpartum recovery discussion on Xiaohongshu. Fem Media Stud. 2023;23(5):2286-2302.

Zhu C, Zeng R, Zhang M, Liu X. Pregnancy-related information seeking and sharing in the social media era among expectant mothers: qualitative study. J Med Internet Res. 2019;21(12):e13694.

Davis FD. Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology. MIS Q. 1989;13(3):319-340.

Riaz MU, Ali M, Khan MS, Ahmed W. Consumers’ purchase intention and decision-making process through social networking sites: a social commerce construct. Behav Inf Technol. 2021;40(1):99-115.

Jiang G, Li S, Li M, Wang L. Effects of information quality on information adoption on social media review platforms: moderating role of perceived risk. Data Sci Manag. 2021;1(1):13-22.

Gefen D, Karahanna E, Straub DW. Trust and TAM in Online Shopping: An Integrated Model. MIS Q. 2003;27(1):51-90.

Ayeh JK, Au N, Law R. Predicting the intention to use consumer-generated media for travel planning. Tour Manag. 2013;35:132-143.

Yang L, Xu M, Xing L. Exploring the core factors of online purchase decisions by building an E-Commerce network evolution model. J Retail Consum Serv. 2022;64:102784.

Wu IL. The antecedents of customer satisfaction and its link to complaint intentions in online shopping: An integration of justice, technology, and trust. Int J Inf Manage. 2013;33(1):166-176.

Lucas GA, Lunardi GL, Dolci DB. From e-commerce to m-commerce: An analysis of the user’s experience with different access platforms. Electron Commer Res Appl. 2023;58:101240.

Sun J, Chi T. Key factors influencing the adoption of apparel mobile commerce: an empirical study of Chinese consumers. J Text Inst. 2018;109(6):785-797.

Delbaere M, Michael B, Phillips BJ. Social media influencers: A route to brand engagement for their followers. Psychol Mark. 2021;38(1):101-112.

Li Y, Jiang S. A study on the influencing factors of tourists’

travel intentions: a configurational analysis based on fsQCA. J Hosp Tour Insights. 2025; [Epub ahead of print].

Pornpitakpan C, Li Q, Fu SFI. A gender-focused review of the effect of message source attractiveness on persuasion: Implications for marketers and advertisers. Commun. 2017;42(2):195-237.

Pornpitakpan C. The persuasiveness of source credibility: A critical review of five decades' evidence. J Appl Soc Psychol. 2004;34(2):243-281.

Meng LM, Duan S, Zhao Y, Lü K, Chen S. The impact of online celebrity in livestreaming E-commerce on purchase intention from the perspective of emotional contagion. J Retail Consum Serv. 2021;63:102733.

Song H, Jiang S. Determinants of Purchase Intention in Virtual Reality Commerce Platform for Tourism Products: Y-Generation Consumers’ Perspective. J Qual Assur Hosp Tour. [Epub ahead of print]:1-36.

Pereira MJdS, Costa RG, Moreira AC, Gonçalves R. Digital influencers’ attributes and perceived characterizations and their impact on purchase intentions. Sustainability. 2023;15(17):12750.

Chen H, Ren J. Can Influencer Persona Increase the Effectiveness of Social Media Video Ads? The Mediating Effect of Consumer Perceptions of Self. J Theor Appl Electron Commer Res. 2024;19(3):2451-2475.

Yuan J, Li X, Wang Y, Zhang K. User behaviour in sustainable technology: an exploration of endorsement strategy. Technol Anal Strateg Manage. 2024; [Epub ahead of print]:1-16.

Ohanian R. The impact of celebrity spokespersons’ perceived image on consumers’ intention to purchase. J Advert Res. 1991;31(1):46-54.

Till BD, Busler M. The match-up hypothesis: Physical attractiveness, expertise, and the role of fit on brand attitude, purchase intent and brand beliefs. J Advert. 2000;29(3):1-13.

Kapoor S, Fernandes S, Punia S. 'Natural'Label Halo Effect on Consumer Buying Behavior, Purchase Intention and Willingness to Pay for Skincare Products. Cardiometry. 2022;(23):741-755.

Han S, Zhang Y, Wang J, Li M. Beauty is in the eye of the beholder: The halo effect and generalization effect in the facial attractiveness evaluation. Acta Psychol Sin. 2018;50(4):363.

De Veirman M, Cauberghe V, Hudders L. Marketing through Instagram influencers: the impact of number of followers and product divergence on brand attitude. Int J Advert. 2017;36(5):798-828.

Li L, Wang F, Zhang Z, Li Y. The impact of social presence and facilitation factors on online consumers' impulse

buying in live shopping–celebrity endorsement as a moderating

factor. Inf Technol People. 2023;36(6):2611-2631.

Kim H, Park M. Virtual influencers’ attractiveness effect on purchase intention: A moderated mediation model of the Product–Endorser fit with the brand. Comput Hum Behav. 2023;143:107703.

Hugh Wilkie DC, Lee SH, Chen T, Farrell A. Influencer marketing effectiveness: the mechanisms that matter. Eur J Mark. 2022;56(12):3485-3515.

Chen N, Yang Y. The role of influencers in live streaming e-commerce: influencer trust, attachment, and consumer purchase intention. J Theor Appl Electron Commer Res. 2023;18(3):1601-1618.

Yee LS, Tan GW, Ooi KB, Dwivedi YK. Analyzing the Impact of Social Media Advertising on Consumer Interactions, Trust, and Purchase Intentions in the Cosmetics and Personal Care Sector. J Appl Data Sci. 2025;6(3):1708-1722.

Ahmed S, Islam T, Ghaffar A. Shaping brand loyalty through social media influencers: The mediating role of follower engagement and social attractiveness. Sage Open. 2024;14(2):21582440241242928.

Schlütz D, Hedder I. Aural parasocial relations: Host–listener relationships in podcasts. J Radio Audio Media. 2022;29(2):457-474.

Nadroo ZM, Islam JU, Naqshbandi MA. Parasocial Interaction in Marketing Domain: Offering Insights Through a Systematic Literature Review. Int J Consum Stud. 2025;49(4):e70079.

Ballantine PW, Martin BA. Forming parasocial relationships in online communities. Adv Consum Res. 2005;32:197.

Hwang K, Zhang Q. Influence of parasocial relationship between digital celebrities and their followers on followers’ purchase and electronic word-of-mouth intentions, and persuasion knowledge. Comput Hum Behav. 2018;87:155-173.

Du Y, Rui JR, Yu N. How Parasocial Relationship and Influencer-Product Congruence Shape Audience’s Attitude Towards Product Placement in Online Videos: The Mediation Role of Reactance. Psychol Res Behav Manag. 2023;16:1315-1329.

Hoo WC, Lim WM, Tan GW, Ooi KB. Factors influencing customer behavior in impulse buying of cosmetics on live shopping platforms in Malaysia. Humanit Soc Sci Lett. 2025;13(1):270-284.

Dodds WB, Monroe KB, Grewal D. Effects of price, brand, and store information on buyers’ product evaluations. J Mark Res. 1991;28(3):307-319.

Wen I. An empirical study of an online travel purchase intention model. J Travel Tour Mark. 2012;29(1):18-39.

Labrecque LI. Fostering Consumer–Brand Relationships in Social Media Environments: The Role of Parasocial

Interaction. J Interact Mark. 2014;28(2):134-148.

Dancer LS. Scale Development: Theory and Applications. J Am Stat Assoc. 1994;89(428):1550.

Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. J Mark Res. 1981;18(1):39-50.

Bagozzi RP, Yi Y. On the evaluation of structural equation models. J Acad Mark Sci. 1988;16(1):74-94.

Hoe SL. Issues and procedures in adopting structural equation modelling technique. J Quant Methods. 2008;3(1):76.

Syamsudin N, Hoo WC, Kassani PL, Munir Z. Are job satisfaction and role breadth self-efficacy the links to proactive work behavior? Heliyon. 2022;8(1).

MacKinnon JG. Bootstrap Hypothesis Testing. In: Handbook of Computational Econometrics. 2009:183-213.

Atinafu WT, Taye GM, Tadese M, Molla A. Intention to use a mobile phone to receive mental health support and its predicting factors among women attending antenatal care at public health facilities in Ambo town, West Shoa zone, Ethiopia 2022. BMC Health Serv Res. 2023;23(1):1368.

De Jans S, Van de Sompel D, Hudders L, Cauberghe V. Digital food marketing to children: How an influencer's lifestyle can stimulate healthy food choices among children. Appetite. 2021;162:105182.

Joo E, Yang J. How perceived interactivity affects consumers' shopping intentions in live stream commerce: roles of immersion, user gratification and product involvement. J Res Interact Mark. 2023;17(5):754-772.

Sun Y, Shao X, Li X, Guo Y, Nie K. How technical features of virtual live shopping platforms affect purchase intention: Based on the theory of interactive media effects. Decis Support Syst. 2024;180:114189.

Lu Y, Wu Y, Liu X, Li J. Pregnancy-related information seeking in online health communities: A qualitative study. In: International Conference on Information. Springer; 2021.

SayakhotP, Carolan-Olah M. Internet use by pregnant women seeking pregnancy-related information: a systematic review. BMC Pregnancy Childbirth. 2016;16(1):65.

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