Although adhering to a specific health message may seem like a personal choice, this adherence is associated with a combination of internal factors and external influences. This study, conducted through an online survey experiment with 364 Chinese adults, explores how self-construal related to the role of social norms in message adherence, with perceived information diagnosticity as a mediator. The results show that descriptive norms correlate with higher health message adherence compared to injunctive norms. Specifically, among individuals with an interdependent self-construal, descriptive norms are associated with significantly greater adherence compared to injunctive norms. In contrast, among those with independent self-construal, adherence differences between norm types are non-significant. Furthermore, the interaction between social norms and self-construal is indirectly linked to adherence through perceived information diagnosticity. These findings enrich our understanding of social norm theory and provide practical strategic suggestions for improving the effectiveness of health communication.
AakerJL (2000) Accessibility or diagnosticity? Disentangling the influence of culture on persuasion processes and attitudes. Journal of Consumer Research26(4): 340–357.
2.
AakerJLLeeAY (2001) “I” seek pleasures and “we” avoid pains: The role of self-regulatory goals in information processing and persuasion. Journal of Consumer Research28(1): 33–49.
3.
AndrighettoGVriensE (2022) A research agenda for the study of social norm change. Philosophical Transactions Series A: Mathematical, Physical and Engineering Sciences380(2227): 20200411.
4.
BoothARNormanPHarrisPR, et al. (2014) Using the theory of planned behaviour and self-identity to explain chlamydia testing intentions in young people living in deprived areas. British Journal of Health Psychology19(1): 101–112.
5.
BurgerJMSheltonM (2011) Changing everyday health behaviors through descriptive norm manipulations. Social Influence6(2): 69–77.
6.
ChengYLiuRWFoersterTA (2021) Predicting intentions to practice COVID-19 preventative behaviors in the United States: A test of the risk perception attitude framework and the theory of normative social behavior. Journal of Health Psychology27(12): 2744–2762.
7.
CialdiniRBRenoRRKallgrenCA (1990) A focus theory of normative conduct: Recycling the concept of norms to reduce littering in public places. Journal of Personality and Social Psychology58(6): 1015–1026.
8.
CrăciunICTodorovaIBăbanA (2018) “Taking responsibility for my health”: Health system barriers and women’s attitudes toward cervical cancer screening in Romania and Bulgaria. Journal of Health Psychology25(13–14): 2151–2163.
9.
CrossSEBaconPLMorrisML (2000) The relational-interdependent self-construal and relationships. Journal of Personality and Social Psychology78(4): 791–808.
10.
DavisJMTuttleBM (2013) A heuristic–systematic model of end-user information processing when encountering IS exceptions. Information and Management50(2–3): 125–133.
11.
DillardJPTianXCruzSM, et al. (2021) Persuasive messages, social norms, and reactance: A study of masking behavior during a COVID-19 campus health campaign. Health Communication38: 1338–1348.
12.
DingXZhongXKangT, et al. (2023) Individualism vs. collectivism: Influences on attitudes in China toward the search for meaning in life. Current Psychology43(16): 14738–14750.
13.
FeldmanJMLynchJG (1988) Self-generated validity and other effects of measurement on belief, attitude, intention, and behavior. Journal of Applied Psychology73(3): 421–435.
14.
FinsetABosworthHButowP, et al. (2020) Effective health communication: A key factor in fighting the COVID-19 pandemic. Patient Education and Counseling103(5): 873–876.
15.
GermarMMojzischA (2019) Learning of social norms can lead to a persistent perceptual bias: A diffusion model approach. Journal of Experimental Social Psychology84: 103801.
16.
InmanJJPeterACRaghubirP (1997) Framing the deal: The role of restrictions in accentuating deal value. Journal of Consumer Research24(1): 68–79.
17.
JacobsonRPMortensenCRCialdiniRB (2011) Bodies obliged and unbound: Differentiated response tendencies for injunctive and descriptive social norms. Journal of Personality and Social Psychology100(3): 433–448.
18.
KempfDSSmithRE (1998) Consumer processing of product trial and the influence of prior advertising: A structural modeling approach. Journal of Marketing Research35(3): 325.
19.
KimTKimJ (2021) How spatial distance and message strategy in cause-related marketing ads influence consumers’ ad believability and attitudes. Sustainability13(12): 6775.
20.
KramerTYoonSO (2007) Approach–avoidance motivation and the use of affect as information. Journal of Consumer Psychology17(2): 128–138.
21.
LapinskiMKAndersonJShugartA, et al. (2014) Social influence in child care centers: A test of the theory of normative social behavior. Health Communication29(3): 219–232.
22.
LeeSGoodallCEgbertN, et al. (2021) The moderating role of self-construal in culturally reflected fear appeals. Journal of Health Communication26(2): 65–75.
23.
LiangYJiangJOuW, et al. (2018) Effect of community screening on the demographic makeup and clinical severity of glaucoma patients receiving care in urban China. American Journal of Ophthalmology195: 1–7.
24.
LiuRWChengYBarbatiJL, et al. (2023) The effectiveness of social norm appeals on promoting COVID-19 prevention behaviors: A multistudy examination. Health Communication39(12): 2698–2706.
25.
LynchJGMarmorsteinHWeigoldMF (1988) Choices from sets including remembered brands: Use of recalled attributes and prior overall evaluations. Journal of Consumer Research15(2): 169.
26.
MarkusHRKitayamaS (1991) Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review98(2): 224–253.
27.
McCaffertySShahMLaulA, et al. (2025) Intraocular pressure correlation to progressive retinal nerve fiber layer loss in primary open angle glaucoma as measured by standard and modified goldmann applanation tonometers. BMC Ophthalmology25(1): 263.
28.
NigburDLyonsEUzzellD (2010) Attitudes, norms, identity and environmental behaviour: Using an expanded theory of planned behaviour to predict participation in a kerbside recycling programme. British Journal of Social Psychology49(2): 259–284.
29.
NolanJMSchultzPWCialdiniRB, et al. (2008) Normative social influence is underdetected. Personality and Social Psychology Bulletin34(7): 913–923.
30.
NguyenLHDrewDAGrahamMS, et al. (2020) Risk of COVID-19 among front-line health-care workers and the general community: A prospective cohort study. The Lancet. Public health5(9): e475–e483. https://doi.org/10.1016/S2468-2667(20)30164-X
31.
PangYWangLChenF (2024) Message framing to enhance consumer compliance with disease detection communication for prevention: The moderating role of age. Journal of Consumer Psychology1(1): 1–11.
32.
PettyRECacioppoJT (1986) The elaboration likelihood model of persuasion. Advances in Experimental Social Psychology19: 123–181.
33.
PhamMTAvnetT (2004) Ideals and oughts and the reliance on affect versus substance in persuasion. Journal of Consumer Research30(4): 503–518.
34.
ReidAEAikenLS (2013) Correcting injunctive norm misperceptions motivates behavior change: A randomized controlled sun protection intervention. Health Psychology32(5): 551–560.
35.
RenoRRCialdiniRBKallgrenCA (1993) The transsituational influence of social norms. Journal of Personality and Social Psychology64: 104–112.
36.
RhodesNShulmanHCMcClaranN (2020) Changing norms: A meta-analytic integration of research on social norms appeals. Human Communication Research46(2–3): 1–31.
37.
RimalRNRealK (2005) How behaviors are influenced by perceived norms. Communication Research32(3): 389–414.
38.
RobinsonEFlemingAHiggsS (2014) Prompting healthier eating: Testing the use of health and social norm based messages. Health Psychology33(9): 1057–1064.
39.
RudertSCJankeS (2021) Following the crowd in times of crisis: Descriptive norms predict physical distancing, stockpiling, and prosocial behavior during the COVID-19 pandemic. Center for Open Science.
40.
SalmivaaraLLombardiniCLankoskiL (2021) Examining social norms among other motives for sustainable food choice: The promise of descriptive norms. Journal of Cleaner Production311: 127508.
41.
SingelisTM (1994) The measurement of independent and interdependent self-construals. Personality and Social Psychology Bulletin20(5): 580–591.
42.
SpencerSJZannaMPFongGT (2005) Establishing a causal chain: Why experiments are often more effective than mediational analyses in examining psychological processes. Journal of Personality and Social Psychology89(6): 845–851.
43.
SunYChenAZouM, et al. (2022) Disease burden of glaucoma in China: Findings from the Global Burden of Disease 2019 Study. Clinical Epidemiology14: 827–834.
44.
SunYWangNShenX, et al. (2019) Bias effects, synergistic effects, and information contingency effects: Developing and testing an extended information adoption model in social Q&A. Journal of the Association for Information Science and Technology70(12): 1368–1382.
45.
TrumboCW (1999) Heuristic-systematic information processing and risk judgment. Risk Analysis19(3): 391–400.
46.
WhiteKSimpsonB (2013) When do (and don’t) normative appeals influence sustainable consumer behaviors?Journal of Marketing77: 78–95.
YangB (2017) The moderating role of close versus distal peer injunctive norms and interdependent self-construal in the effects of descriptive norms on college drinking. Health Communication33(6): 762–770. https://doi.org/10.1080/10410236.2017.1312202
49.
YuNShenF (2012) Benefits for me or risks for others: A cross-culture investigation of the effects of message frames and cultural appeals. Health Communication28(2): 133–145.
50.
YukiMMadduxWWMasudaT (2007) Are the windows to the soul the same in the East and West? Cultural differences in using the eyes and mouth as cues to recognize emotions in Japan and the United States. Journal of Experimental Social Psychology43(2): 303–311.
