How Digital Media Usage Predicts Chinese Children’s Intention to Consume Unhealthy Food: Mediated by Accessibility and Moderated by Digital Media Engagement

Childhood overweight and obesity has become a severe public health concern worldwide including in China. Previous research has found that exposure to food-related information via digital media may predict unhealthy food consumption through one's attitudes and perceived social norms. However, food choice can also be a process of automaticity. Drawing upon cultivation theory, theory of normative social behavior, and the notion of accessibility, the present study explicated the process by which exposure to food-related information via digital media predicted Chinese adolescents' intention to consume unhealthy food. A cross-sectional survey (N = 1749) was conducted at 21 schools in 14 places in China. The relationship between exposure and intention was sequentially mediated by descriptive norm accessibility and attitude accessibility. In addition, the relationship between descriptive norm accessibility and attitude accessibility was enhanced by user engagements with food-related information. This study highlights the role that accessibility plays in the process by which media affect unhealthy eating and possibly other health behaviors. Thus, media may shape health behaviors by turning relevant media-shaped perceptions into automatic reactions.