Empowering healthier decisions: the impact of consumer innovativeness on linking perceived benefits with protective health behaviors through digital marketing in the health-care sector

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, in December 2019, marking the beginning of a global health crisis (Norazryana et al., 2021). The novel virus rapidly spread across borders, leading the World Health Organization (WHO) to declare it a global pandemic on March 11, 2020 (Cucinotta and Vanelli, 2020). The impact of the pandemic has been profound, resulting in millions of infections and thousands of deaths worldwide, as reported by the COVID-19 dashboard from Johns Hopkins University (Dong et al., 2020). Beyond the immediate health consequences, the pandemic has strained health-care systems and triggered significant financial turmoil globally, revealing vulnerabilities in public health infrastructure and economic stability (Norazryana et al., 2021).

In response to the crisis, nonpharmaceutical interventions (NPIs) emerged as the primary strategies to mitigate the spread of SARS-CoV-2, particularly in the absence of effective vaccines or antiviral treatments at the pandemic’s onset (Qualls et al., 2017). NPIs included measures such as social distancing, mask-wearing and extensive public health campaigns to inform and educate the public. Social media platforms and mobile applications became vital tools during the period, facilitating communication and engagement with the public regarding pandemic guidelines and updates (Norazryana et al., 2021; Yasir A et al., 2020).

The proliferation of social media in recent years has transformed the landscape of communication, providing an unprecedented reach to over three billion users worldwide. The unique characteristic positions social media as an effective medium for promoting awareness and encouraging adherence to health-protective behaviors and preventive measures during the pandemic (Norazryana et al., 2021; United Nations, 2020).

As health-care providers and organizations turned to these platforms to disseminate critical information, understanding the dynamics of social media engagement became essential in evaluating its effectiveness in public health responses. Research has shown that perceived benefits, the subjective value that consumers associate with a product or service, play a crucial role in influencing customer behavior. The concept has gained attention in various studies, highlighting that perceived benefits can significantly accelerate customer decision-making processes (Redhita et al., 2022; Iwan et al., 2022a, 2022b; Alfons Karl et al., 2022; Axelsen and Swan, 2010; Joowon Choi et al., 2013).

Furthermore, it has been established that perceived benefits significantly impact behavioral intentions (Siegel et al., 2015), demonstrating the importance of the construct in shaping consumer actions. In the context of private health care, perceived benefits influence patients’ engagement through social media, reflecting their intentions to seek information and adopt recommended health behaviors (Redhita et al., 2022; Iwan et al., 2022a, 2022b; Alfons Karl et al., 2022; Jarvenpaa et al., 2000).

The research questions for the study are to understand the connection between perceived benefits and social media engagement in private health care during the pandemic. Specifically, the study seeks to answer:

The study aims to identify gaps in the current literature regarding these dynamics, providing insights that can help health-care providers and policymakers enhance public health communication strategies and optimize their digital outreach efforts. The existing literature highlights several important aspects of health and consumer behavior. Aydin et al. (2024) examine health-seeking behavior and e-health literacy in older adults, but their study focuses primarily on aging populations without exploring broader demographic implications or digital engagement patterns. Similarly, Ghali et al. (2024) delve into firm and customer innovativeness in cocreating value but lack emphasis on the psychological and behavioral dynamics specific to e-health adoption.

Sahoo et al. (2024) address the perceived risks and benefits of e-health consultations, yet their study overlooks the nuanced role of digital literacy and trust in influencing user intentions. These gaps underscore the need for a comprehensive investigation into the intersection of consumer innovativeness, e-health literacy and trust, particularly in fostering engagement across diverse populations.

The research aims to explore the intricate relationship between perceived benefits and social media engagement, particularly within the context of private health care during the pandemic. Understanding how perceived benefits influence consumer interactions on social media can provide insights into improving public health communication strategies.

Additionally, the study seeks to identify gaps in the existing literature regarding the role of perceived benefits in driving engagement and adherence to health guidelines on social media platforms. By examining these dynamics, the study informs health-care providers and policymakers on optimizing their digital outreach and enhancing community engagement.

The novelty of the study lies in its focus on the intersection of perceived benefits, social media engagement and private health care in the context of a global health crisis. While previous studies have explored each of these elements separately, there remains a need to understand their combined effect during unprecedented events like the pandemic. By synthesizing existing research and providing a comprehensive analysis of these interconnections, this study aims to contribute to the growing body of knowledge in the fields of marketing, consumer behavior and public health. It emphasizes the importance of perceived benefits as a determinant of effective engagement strategies in digital health communication, particularly during times of crisis when clear and accurate information is crucial for public compliance and health outcomes.

As the world continues to navigate the aftermath of the pandemic, the insights gained from examining the role of perceived benefits in social media engagement will be invaluable. The study aspires to shed light on how these dynamics can enhance consumer interactions, ultimately improving adherence to health guidelines and fostering healthier communities in the long run. Understanding these relationships will not only aid in future public health responses but also inform ongoing strategies for leveraging social media as a tool for health promotion and consumer engagement in various contexts.

Perceived benefits play a pivotal role in shaping consumer intentions and behaviors, particularly in the context of health-care marketing and social media engagement. They reflect a consumer’s subjective assessment of the value gained from a product or service, often outweighing perceived costs (Ghali et al., 2024). The increasing influence of social media on decision-making underscores the importance of understanding these benefits in private health-care settings.

Existing studies highlight positive correlations between perceived benefits and consumer actions, suggesting enhanced purchase intentions and health-protective behaviors (Aydin et al., 2024; Sahoo et al., 2024). This research delves into how perceived benefits influence consumer engagement on social media, bridging gaps in the literature and offering insights into psychological drivers during critical periods, such as pandemics.

The relationships explored in this study are underpinned by the theory of planned behavior (TPB) and diffusion of innovations theory (DIT). The TPB explains how attitudes, subjective norms and perceived behavioral control influence individual intentions and behaviors, such as engaging with health information on social media (Ajzen, 1991). Perceived benefits act as a motivational factor, shaping positive attitudes toward social media engagement in private health care, which, in turn, drives health-protective behaviors (Sahoo et al., 2024). This aligns with the TPB’s assertion that favorable attitudes and perceived control strengthen behavioral intentions, especially when enhanced by e-health literacy (Aydin et al., 2024).

Simultaneously, DIT highlights how consumer innovativeness fosters the adoption of new ideas and technologies, such as leveraging social media for health-care engagement (Rogers, 2003). Innovativeness motivates individuals to explore and use novel digital platforms, amplifying the perceived benefits of accessibility, emotional support and shared experiences in health decision-making (Ghali et al., 2024). Together, these theories illustrate how perceived benefits and innovativeness synergize to influence social media engagement, driving health-protective behaviors in private health-care contexts.

Consumers’ perceived benefits reflect their subjective evaluation of a product or service’s value based on its experiential worth. Defined as a customer’s appraisal of a product’s utility, Perceived benefits hinge on perceived gains versus offerings (Jiang et al., 2018). In marketing, the term encapsulates the consumer’s subjective judgment, balancing losses and gains (Li et al., 2022; Zeithaml, 1988). Woodruff and Gardial (1996) noted that perceived benefits significantly affect purchase intentions. Li et al. (2022) observed that perceived benefits, as a psychological assessment, influence customer purchase intentions via social media engagement. When perceived benefits surpass perceived costs, consumers believe the product will fulfil expectations, driving purchase intention (Khalifa, 2004). Risk propensity also varies among consumers; those perceiving high benefits typically rate companies more favorably, boosting corporate cognitive legitimacy (Jie Li et al., 2022).

Additionally, Li et al. (2022) suggest that high-risk propensity consumers are more likely to try new products, with cognitive validity mediating this relationship. Mashal and Shuhaiber (2018) showed that perceived benefits impact health-protective behaviors, particularly in the adoption of new technologies (Salem et al., 2019). Shuhaiber (2018) further observed that perceived benefits shape customer attitudes toward using technology. Additionally, perceived benefits significantly affect both new technology adoption and purchase intentions (Yu et al., 2017; Salem et al., 2019).

Researchers provide varied perspectives on the perceived benefits of social media in corporate settings. Siddiqui and Singh (2016) stated that perceived benefits allow customers to express opinions, share interests and build connections (Ying et al., 2021). Similarly, Shu and Chuang (2011) found that social media helps customers gain knowledge, broaden their information base and reduce social costs (Ying et al., 2021; Khan and Malik, 2014).

Previous research shows a positive relationship between perceived benefits of social media and customer behaviors (Redhita et al., 2022; Iwan et al., 2022a, 2022b; Rashed Alhaimer, 2022; Alfons Karl et al., 2022; Axelsen and Swan, 2010; Joowon Choi et al., 2013). Moreover, perceived benefits typically accelerate decision-making (Redhita et al., 2022; Iwan et al., 2022a, 2022b; Rashed Alhaimer, 2022; Alfons Karl et al., 2022; Jarvenpaa et al., 2000).

Since previous studies suggest that perceived benefits such as accessible information, enhanced communication and increased connection foster positive behavioral intentions in consumers. In the context of health care, the benefits could encourage proactive health behaviors. Therefore, the following hypothesis is proposed:

Consumer innovativeness plays a crucial role in driving the adoption and diffusion of innovations, particularly through social media engagement. Schumpeter, the pioneer of innovation, defines innovation as the impact of technological changes that combine new and existing features to solve business challenges (Schumpeter, 1982). He identifies five classifications of innovation, including “Fresh Innovation,” which introduces new aspects of products or services that benefit customers and innovation in existing products penetrating new markets (Schumpeter, 1982). Twiss (1989) describes innovation as a process that integrates economics, science, technology and business management for market consumption, while Afuah (1998) emphasizes the integration of new ideas into products and services.

Consumer innovativeness is essential for both literature and business, as it accelerates innovative behavior, fostering the adoption of new goods and services (Thakur and Jasrai, 2018; Kaushik and Rahman, 2016; Kim et al., 2011). In addition, consumer innovativeness is a psychological state that influences individuals’ tendency to adopt innovations (Hwang et al., 2021a, 2021b; Tellis et al., 2009), and it is categorized into fundamental innovations, improvements and fake innovations, each contributing differently to market development (Kogabayev and Maziliauskas, 2017; Kogabayev et al., 2017).

Understanding consumer innovativeness is key to ensuring that new products and services meet the needs of consumers (Ceyda Tanrikulu, 2022; Solomon, 2020). Based on these insights, the following hypothesis is proposed:

As discussed earlier, adopting social media in health care offers several benefits, including easy access to information about diseases, treatment procedures and medications. Emotional support can also be obtained by connecting with others who have the same illness and the sharing of updates about the latest treatments is facilitated (Nisar and Shafiq, 2019). Furthermore, communication is enhanced between patients, and the connection and relationship between patients and health-care providers are also improved.

Social media can aid in comparing various service providers within a reachable area, which helps in terms of cost, location of proper facilities and treatment quality (Nisar and Shafiq, 2019). Online patient communities and Google health groups have emerged as valuable resources for patients, their families and physicians seeking information about various ailments (Nisar and Shafiq, 2019). Consequently, integrating social networking sites in the health-care industry holds tremendous potential. These platforms can aid patients in obtaining health-related information, social support and making informed treatment decisions (Nisar and Shafiq, 2019).

Previous studies indicate that social networks can influence how patients access health-care information. Many individuals turn to the internet and social media to obtain medical-related information (Nisar and Shafiq, 2019). The results suggest that social media have the potential to provide patients with more knowledge and, thus, increase their empowerment (Nisar and Shafiq, 2019). Customers engage with products and services to fulfil their needs and satisfaction. The previous researchers found that consumer innovativeness and perceived benefit are interrelated in the online purchase platform.

The perceived benefit increases customer’s intention to purchase. In addition, this proofs that online purchase platform needs to be innovative and creative in producing features of online purchase that consider and take in consumer innovativeness and perceived benefit to increase the possibility of customers purchasing online (Alfons et al., 2022; Alhaimer, 2022; Ramdan et al., 2022). Joo et al. (2019) highlighted that perceived benefits and satisfaction positively and directly impact intentions to continue using social media engagement.

According to Al-Jundi et al. (2019), customers are becoming more rational and willing to purchase new products. They will be innovative when seeking attractiveness and novel experiences in their new product selection. They use the internet and social media platforms to gather information about new trends and technologies to evaluate the performance and features of new products (Al-Jundi et al., 2019). The psychological element of perceived benefits significantly influences consumer innovativeness (Uke et al., 2018). In sum, it was reported that perceived benefits positively and significantly influenced consumer innovativeness. Hence, the following hypothesis is proposed:

It is critical in mitigating the spread of infectious diseases, particularly in the context of the pandemic, which has been described as the most severe global public health crisis since the founding of the WHO. By March 16, 2021, there had been over 120 million cases and 2.66 million deaths globally (Kou and Zhang, 2022; Johns Hopkins University and Medicine, 2020). One of the most effective strategies to curb the transmission of SARS-CoV-2 is the widespread adoption of health-protective behaviors, including practices such as thorough handwashing, wearing face masks in public spaces and maintaining social distancing. These measures have been especially vital during the pandemic, given the delays in the availability and distribution of effective vaccines (Kou and Zhang, 2022; Michie et al., 2020; Ramirez-Valles et al., 2020).

Practicing health-protective behaviours as recommended by public health experts is essential in preventing the spread of infection, particularly as the virus continues to affect populations around the world. However, promoting the adoption of health-protective behaviours during pandemics is not without its challenges. Research suggests that changing individual behaviors, especially during times of widespread infectious disease, is a complex task (Kou and Zhang, 2022; Puterman et al., 2009; Rubin et al., 2010; Vartti et al., 2009). The difficulty lies in influencing ingrained habits and attitudes, as well as addressing public resistance or confusion about the necessity of such behaviors.

Factors such as misinformation, psychological reactance and perceived barriers to compliance can hinder the effective implementation of health-protective behaviours, thus delaying the broader public health response. Therefore, understanding the psychological and social dynamics of health behavior change is crucial in improving adherence to protective measures and ensuring effective prevention during future pandemics.

During the pandemic, people’s decisions to adopt protective measures against the disease are usually considered either exogenous or overlooked (Martin-Lapoirie et al., 2023). The risk of infection has been examined through the prism of population density and movement, ignoring the impact of social and health practices, despite the crucial role that interpersonal connections play in either raising or decreasing the transmission of respiratory infectious diseases (Martin-Lapoirie et al., 2023). Given the pandemic situation and the potential for even more severe pandemics, it is essential to evaluate the importance and usefulness of health-protective behaviors (Martin-Lapoirie et al., 2023).

The mediating effect of consumer innovativeness on the relationship between perceived benefits on health-protective behaviors has not been well established in the past. The mediating effect of consumer innovativeness seems not sufficiently explored, where the researcher has considered the mediating effect of consumer innovativeness on health-protective behaviors. However, in the past, other variables were used to examine the mediating influence of consumer innovativeness. Consumer innovativeness is found to impact the use of new products and services.

Psychological aspects of perceived benefits significantly influence consumer adoption of innovation, with consumer innovativeness acting as a mediating variable (Uke et al., 2018). Consumer innovativeness is found to affect the interconnections in customers’ adoption intentions. According to Ali (2019), consumer innovativeness refers to a consistent disposition that shapes an individual’s perception and response to innovations, with an important level of innovativeness leading to a more positive response.

Although frequently studied in the context of the diffusion of innovation, particularly regarding consumers’ willingness to adopt new products and openness to external knowledge, this study takes a broader approach to investigate further on consumer innovativeness. It considers how it affects an individual’s perception and reaction to innovative ideas, inventions and ways of doing things, as well as their ability to generate original ideas, improvise and accept challenges in adopting social media. The approach enables a thorough exploration of the relationship between consumer innovativeness, psychological factors and health-protective behaviors. Therefore, a hypothesis is proposed in the research:

Both perceived benefits and consumer innovativeness are distinct yet interrelated concepts in the realm of marketing and consumer behavior. Perceived benefits refer to the subjective value that consumers attribute to products or services, primarily based on their evaluations of the advantages relative to the costs involved. The concept emphasizes how consumers assess the utility of offerings and how these evaluations influence their purchase intentions and behaviors, particularly in the context of social media engagement.

In contrast, consumer innovativeness encompasses the propensity of consumers to embrace new ideas, products or services, reflecting their willingness to adopt innovations and their openness to experimenting with novel experiences. The psychological state drives the adoption and diffusion of new products within the marketplace, playing a crucial role in the overall innovation process. While perceived benefits highlight the evaluative criteria that consumers use when making purchasing decisions, consumer innovativeness captures the behavioral tendencies that lead to the acceptance of these innovations, indicating that both concepts are essential for understanding consumer behavior in dynamic environments.

The present study investigates social media engagement in private health care, focusing on how perceived benefits, consumer innovativeness and health-protective behaviors are interrelated. The quantitative study involved 400 participants who were either local or foreign residents of Klang Valley and used private health-care services. Due to pandemic restrictions, the researcher used nonprobability sampling, specifically purposive sampling, to target individuals directly involved with private health care. The methods used for data collection, measurement instruments and statistical analysis are discussed in detail below.

A quantitative research design was chosen to objectively measure and analyze the relationships among perceived benefits, consumer innovativeness and health-protective behaviors. The design is suitable for quantifying social media engagement’s impact within the health-care context, facilitating an analysis of statistical correlations and patterns across large groups. Given the challenges of the pandemic, a nonprobability purposive sampling approach was adopted.

Nonprobability sampling does not require every member of a population to have an equal chance of selection; instead, it allows researchers to select participants based on specific criteria relevant to the study. Purposive sampling, a subset of nonprobability sampling, was particularly suitable here because it allowed the researcher to target individuals within the health-care ecosystem, such as health-care customers, patients, insurance agents and clinic staff, whose experience would directly contribute to understanding social media engagement’s impact.

The study’s sample size of 400 participants was carefully selected to ensure sufficient statistical power for detecting meaningful relationships among the variables. Participants were chosen from a diverse demographic, including both local and foreign residents of Klang Valley, thereby enhancing the generalizability of findings within Malaysia’s private health-care context.

Data collection was conducted through online survey questionnaires distributed via Google Forms. The approach enabled the researcher to reach participants despite pandemic restrictions, which limited face-to-face data collection. Survey links were disseminated to private health-care users through various channels, including private health-care management, insurance agents, third-party administrators, insurance companies, general practitioners, medical officers and specialist and private clinics. Additionally, vaccine recipients were also included, as they had relevant recent interactions with the health-care system. The survey was specifically designed to gauge respondents’ engagement with social media in the context of health care.

Google Forms allowed the researcher to easily distribute the survey and gather responses in a secure and efficient manner (Wright, 2025). To gather bias-free responses during data collection via purposive sampling, it is essential to use a structured questionnaire that includes diverse and representative demographic questions to capture a broad spectrum of respondents. Conducting anonymous surveys can further encourage honest responses and mitigate social desirability bias.

Additionally, triangulating data sources by integrating feedback from multiple stakeholders, such as community leaders and public health experts, can validate findings and ensure that insights accurately reflect the attitudes and behaviors of the target population. The comprehensive approach ultimately enhances the credibility of the study and the reliability of its outcomes.

The survey used three main instruments to assess the variables of interest: perceived benefits, consumer innovativeness and health-protective behaviors. The scales used in the study were validated by previous research, ensuring their reliability and applicability in the current health-care setting (Redhita et al., 2022; Iwan et al., 2022a, 2022b; Rashed Alhaimer, 2022; Alfons Karl et al., 2022; Shirley Man et al., 2022; Nusrat et al., 2020).

A five-point Likert scale, originally developed by Rensis Likert in 1932, was used to capture participants’ responses across all three scales (Sullivan and Artino, 2013). The Likert scale is well-suited for measuring attitudes and perceptions, with five points providing a balanced scale for agreement and disagreement.

Respondents rated each item (Table 1) on a continuum from (1) Strongly disagree to (5) Strongly agree, allowing for nuanced responses that reflect varying levels of agreement. The scale’s psychometric properties make it ideal for assessing subjective perceptions in a quantifiable manner, thus providing reliable data on participants’ engagement with social media in the health-care sector.

Perceived benefits were assessed using a scale designed to measure participants’ beliefs about the positive outcomes of engaging with social media in private health care (Redhita et al., 2022; Iwan et al., 2022a, 2022b; Rashed Alhaimer, 2022; Alfons Karl et al., 2022; Shirley Man et al., 2022; Nusrat et al., 2020). The scale captured respondents’ attitudes toward how social media engagement provided them with emotional satisfaction, social connections and personal growth in the health-care context. Six items were included in this section, each measured on a five-point Likert scale, which ranged from (1) “Strongly disagree” to (5) “Strongly agree.”

Consumer innovativeness was assessed using items adapted from Goldsmith and Hofacker (1991), focusing on participants’ openness to adopting new trends in social media within the health-care field. The scale evaluates the extent to which participants are early adopters or innovators in a product area, such as health-care information. Like the perceived benefits scale, the consumer innovativeness scale also used a five-point Likert scale.

Health-protective behaviors were measured using items adapted from Norazryana et al. (2021), focusing on individuals’ engagement in actions that promote health and wellness. The scale assesses how social media influences participants’ health-related attitudes and protective behaviors, with specific attention to private health care.

Statistical analysis was conducted using the partial least squares structural equation modeling (PLS-SEM). PLS-SEM facilitates structural equation modeling to test the hypothesized relationships among perceived benefits, consumer innovativeness and health-protective behaviors. PLS-SEM was chosen as the primary method for hypothesis testing, given its suitability for complex models with multiple latent variables (Hair et al., 2017).

The technique allowed the researcher to test the direct and indirect effects of perceived benefits on health-protective behaviors, with consumer innovativeness as a mediating variable. Path coefficients and significance levels were calculated to determine the strength of relationships between variables, and bootstrapping with 5,000 samples was used to assess the robustness of these findings.

The reliability of each scale was tested using Cronbach’s alpha to ensure internal consistency. A Cronbach’s alpha score of 0.70 or higher was considered acceptable, indicating that the scales were reliable for measuring their respective constructs (Hair et al., 2017). Construct validity was also assessed using factor loadings and composite reliability scores, ensuring that each item adequately measured its intended variable.

The study was conducted with careful adherence to ethical standards. Participants were informed about the research objectives, the confidentiality of their responses and their voluntary participation. Informed consent was obtained, and anonymity was maintained throughout data collection and analysis.

In sum, the quantitative study used purposive sampling, a five-point Likert scale and reliable measurement instruments to assess the influence of social media engagement on perceived benefits, consumer innovativeness and health-protective behaviors in the private health-care sector. Through rigorous statistical analysis, the study contributes to a deeper understanding of social media’s role in influencing health behavior in the health-care sector.

Demographic profile of respondents associated with information such as nationality, gender, marital status, age, family monthly income, education level, social media tools use the most for health and wellness purposes, how often to use social media for health and wellness purposes, when to use social media for health and wellness purposes normally and main reasons for using social media in health and wellness.

Demographic data in Table 2 illustrates that all 400 respondents are private health-care customers, with a high proportion (89.5%) being Malaysian nationals. Other nationalities include Indian (5%), Indonesian (3.75%) and a small percentage of Vietnamese and others. Gender distribution shows a female majority at 60.3%, with males at 39.8%. Most respondents are married (63.8%), while 35% are single. In terms of age, 35% are between 35 and 44 years, followed by those under 25 (31.8%).

A significant share (45.3%) has a monthly income between RM 5,001 and RM 10,000, and a third holds a bachelor’s degree. The professional field is prevalent in occupations (36.3%), with notable representation from business (29.3%) and administrative roles (16%). The demographic profile suggests a diverse sample, primarily middle-aged, middle-income and well-educated individuals, providing insights into private health-care customers in Klang Valley.

Table 3 shows the social media engagement and its behavior in private health care. Table 2 presents the social media engagement patterns for health and wellness in private health-care settings. The most popular platforms are WhatsApp (100%), Facebook (387 users), Instagram (371 users) and YouTube (368 users). Twitter, TikTok, LinkedIn, Telegram and WeChat also show moderate usage, while Snapchat and “Others” are not used at all for this purpose.

Nearly all respondents (99.3%) use social media for health and wellness daily, primarily during free time (96.8%). The main reasons for using social media include increasing knowledge about diseases (100%), seeking advice from health-care professionals (199 users) and finding answers to specific health questions (350 users). Notably, 224 users engage in buying or selling health-related products, indicating a strong commercial interest. Few users use social media to express emotions, share experiences or help others, suggesting a more informational than social or supportive engagement in this sector.

Part 2: Data investigation deals with the research instrument such as normality, validity and reliability. In the other words, all the structural equation modeling assumption are being confirmed to make sure all the circumstances of proceeding with SEM are being fulfilled.

Table 4 evaluates the convergent validity and reliability of the reflective measurement models used in the study, focusing on three key constructs: perceived benefits, consumer innovativeness and health-protective behaviors. The loadings for items under each construct are robust, indicating strong relationships between the items and their respective constructs. For Perceived Benefits, the loadings range from 0.794 to 0.897, with an impressive Cronbach’s alpha of 0.933, composite reliability of 0.947 and an AVE of 0.750. These values suggest that the construct is both reliable and valid.

Consumer Innovativeness also demonstrates good reliability, with loadings from 0.688 to 0.839, a Cronbach’s alpha of 0.910 and a composite reliability of 0.931, yielding an AVE of 0.692. Although the lowest loading (0.688) may indicate a slight weakness in one item, the overall construct remains strong. Meanwhile, health-protective behaviors present the highest reliability among the constructs, with loadings from 0.826 to 0.867, a Cronbach’s alpha of 0.961 and composite reliability of 0.967, along with an AVE of 0.764. These metrics collectively affirm the robustness of the measurement model.

Overall, the high Cronbach’s alpha values across all constructs exceed the 0.7 threshold, confirming excellent internal consistency, while the AVE values indicate adequate convergent validity. Thus, the measurement model is well-suited for further analysis in the study.

Part 3: Analyse the causal impact of perceived benefits and consumer innovativeness on health-protective behavior using SEM via Smart-PLS 3.0. In addition, path coefficient is assessed to evaluate the hypothesized relationships between constructs in a study. The coefficients of the significant path, t-values and standard error are assessed through the bootstrapping procedure. The bootstrapping technique ensures that measures are calculated better (Mooney and Hunt, 1996). This is done by repetitively calculating resamples of 5,000 cases using bootstrapping (Hair et al., 2012). The 5,000 bootstrapping samples used are to ensure that a proxy is given to the distribution of the empirical standard error of the model (Hair et al., 2012). The path coefficients were determined using t-statistics from the bootstrapping standard error procedure (Hair et al., 2013).

Table 5 presents the direct effects of various constructs on health-protective behaviors and consumer innovativeness. The results reveal that perceived benefits positively influence health-protective behaviors, with an original sample coefficient of 0.116, a T-statistic of 2.261 and a p-value of 0.025. This indicates that higher perceived benefits are significantly associated with an increase in health-protective behaviors, suggesting that when individuals recognize the advantages of these behaviors, they are more likely to engage in them.

Consumer innovativeness also shows a positive relationship with health-protective behaviors, indicated by a coefficient of 0.131, a T-statistic of 2.335 and a p-value of 0.019. This implies that individuals who are more innovative in their consumption tend to adopt health-protective behaviors more readily, emphasizing the role of innovative thinking in health-related decision-making. Furthermore, the perceived benefits construct has a strong positive effect on consumer innovativeness, with a coefficient of 0.174, a T-statistic of 3.293 and a p-value of 0.001. This strong significance suggests that when individuals perceive greater benefits associated with health initiatives or products, they are more likely to exhibit innovative behavior as consumers.

Overall, the data underscores the interconnectedness of perceived benefits, consumer innovativeness and health-protective behaviors, highlighting the importance of enhancing perceived benefits to foster both innovative consumer behavior and health-oriented actions.

Part 4: Table 6 examines the mediation effect of consumer innovativeness on the relationship between perceived benefits and health-protective behaviors. The results indicate an original sample coefficient of 0.023 for the indirect effect, accompanied by a T-statistic of 1.682 and a p-value of 0.040. This suggests that the mediation effect is statistically significant, although the T-statistic is on the lower end, indicating a moderate level of mediation. The direct effect of perceived benefits on health-protective behaviors stands at 0.023, showing that perceived benefits directly influence these behaviors without mediation.

The variance accounted for (VAF) is reported at 48.74%, indicating that nearly half of the effect of perceived benefits on health-protective behaviors is mediated through consumer innovativeness. This substantial VAF suggests that consumer innovativeness plays a significant role in explaining how perceived benefits translate into health-protective behaviors. The findings classify the mediation type as partial mediation, meaning that while consumer innovativeness does facilitate some of the impact of perceived benefits on health-protective behaviors, it does not entirely mediate the relationship.

Therefore, enhancing perceived benefits can improve health-protective behaviors both directly and indirectly through fostering consumer innovativeness. This underscores the importance of promoting perceived benefits as a strategy to encourage health-protective behaviors, leveraging the innovative capacities of consumers to amplify this effect. Overall, the mediation analysis highlights the complexity of these relationships and the critical role of consumer behavior in health promotion initiatives.

Table 7 presents the acceptance and rejection of four hypotheses exploring the impact of perceived benefits, consumer innovativeness and social media engagement on health-protective behaviors in private health care. Each hypothesis examines specific relationships, with beta coefficients, t-values and p-values indicating the strength, significance and acceptance or rejection of the hypothesized relationships:

• H1: The hypothesis posits that perceived benefits positively influence attitudes toward health-protective behaviors via social media engagement in private health care. With a beta coefficient of 0.116, a t-value of 2.272 and a p-value of 0.010, the results show a statistically significant positive relationship, leading to hypothesis acceptance. The positive beta coefficient implies that as perceived benefits increase, so does the likelihood of positive attitudes toward health behaviors among consumers. The significant p-value (p < 0.05) and adequate t-value further reinforce the relationship, indicating that individuals engaging with health-related content on social media perceive greater benefits and develop favorable attitudes toward adopting health-protective behaviors.

• H2: Hypothesis 2 explores the role of consumer innovativeness in health-protective behaviors through social media engagement. The hypothesis has a beta coefficient of 0.131, a t-value of 2.298 and a p-value of 0.009. The significant p-value demonstrates a meaningful association, leading to hypothesis acceptance. The positive beta coefficient suggests that individuals with higher consumer innovativeness are more likely to engage in health-protective behaviors when influenced by social media. This result highlights that innovative consumers, likely more open to new information and trends, are also more inclined toward proactive health behaviors when exposed to engaging social media content related to health care.

• H3: Hypothesis 3 examines the relationship between consumer innovativeness and perceived benefits through social media engagement. It records a beta coefficient of 0.174, the highest among the hypotheses, with a t-value of 3.296 and a p-value of 0.000. This strong relationship, indicated by the significant p-value (p < 0.01), suggests that more innovative consumers perceive greater benefits from social media engagement in private health-care settings. The substantial t-value strengthens this finding, suggesting that consumer innovativeness is a key factor in perceiving health-related benefits, which can then influence attitudes and behaviors toward health.

• H4: Hypothesis 4 hypothesizes a complex relationship where consumer innovativeness influences perceived benefits, which, in turn, affects health-protective behaviors through social media engagement. With a beta coefficient of 0.023, a t-value of 1.692 and a p-value of 0.040, the relationship is significant but weaker than the others. While the relationship meets statistical significance (p < 0.05), the smaller beta coefficient indicates a modest effect size. This finding implies that while consumer innovativeness can indirectly impact health-protective behaviors by enhancing perceived benefits, the strength of this pathway is relatively lower. Thus, consumer innovativeness does contribute to health behavior through perceived benefits, but this indirect relationship is weaker compared to direct pathways.

Table 7 provides evidence that both perceived benefits and consumer innovativeness, mediated by social media engagement, significantly influence health-protective behaviors in private health care. Each hypothesis is supported, suggesting that social media engagement can enhance consumer perceptions and attitudes toward health benefits, especially among innovative consumers. The analysis emphasizes the importance of tailored health messages on social media to foster proactive health behaviors in private health-care settings.

The COVID-19 pandemic, triggered by the SARS-CoV-2 virus, has caused a global health crisis, with millions infected and countless deaths worldwide (Cucinotta and Vanelli, 2020). In response, NPIs such as social distancing and mask-wearing were adopted to mitigate the virus’s spread, especially before vaccines and treatments were available (Qualls et al., 2017). Social media platforms played a crucial role during the pandemic, providing vital communication tools for public health updates and fostering social media engagement regarding health guidelines (Norazryana et al., 2021). The role of perceived benefits individuals’ subjective evaluations of value from products or services was critical in driving consumer behavior influencing engagement with health-care information on social media (Redhita et al., 2022; Iwan et al., 2022a, 2022b). These perceived benefits, which include access to critical health information and emotional support, encouraged adherence to health guidelines during the pandemic, reflecting the importance of perceived value in digital health communication (Siegel et al., 2015; Sahoo et al., 2024). However, gaps in the current literature suggest that while consumer innovativeness and e-health literacy are explored separately, the intersection of these factors in driving social media engagement in health-care settings remains underinvestigated (Aydin et al., 2024; Ghali et al., 2024). This research aims to fill this gap by examining the relationship between perceived benefits, consumer innovativeness and social media engagement, specifically in private health care during the pandemic. The study’s novelty lies in analyzing how perceived benefits impact engagement with health-related content on social media, offering insights for enhancing health-care communication strategies (Ajzen, 1991; Rogers, 2003). By synthesizing theories such as the TPB and DIT, the study explores how attitudes, subjective norms and consumer innovativeness drive health-protective behaviors (Aydin et al., 2024; Ghali et al., 2024). Furthermore, it hypothesizes that perceived benefits and consumer innovativeness significantly influence health-protective behaviors through social media engagement in private health care (Li et al., 2022; Salem et al., 2019).

The study investigates the relationships between social media engagement, perceived benefits, consumer innovativeness and health-protective behaviors in private health care. A quantitative research design was used, using purposive sampling to select 400 participants from local and foreign residents of Klang Valley who used private health-care services. Data were collected via online surveys distributed through Google Forms, ensuring efficient outreach despite pandemic restrictions. Measurement instruments included validated scales for perceived benefits, consumer innovativeness and health-protective behaviors, each assessed using a five-point Likert scale. The study analyzed the relationships among these variables using PLS-SEM, chosen for its suitability in testing complex models. Reliability and validity were ensured through Cronbach’s alpha and factor loadings, confirming internal consistency and construct validity. Ethical standards were maintained, with informed consent and confidentiality guaranteed. This research provides valuable insights into the impact of social media engagement on health behaviors in the private health-care sector, contributing to a better understanding of consumer behavior and its implications for health-care practices (Hair et al., 2017; Redhita et al., 2022; Iwan et al., 2022a, 2022b).

The demographic profile of the 400 respondents reveals a predominantly Malaysian (89.5%) sample, with the majority being female (60.3%) and married (63.8%). A significant portion of the respondents are aged between 35 and 44 years (35%) and have a monthly income ranging from RM 5,001 to RM 10,000 (45.3%), with a high proportion holding a bachelor’s degree (33%). Most are professionals (36.3%) or businesspeople (29.3%). Regarding social media usage for health and wellness, WhatsApp, Facebook, Instagram and YouTube are the most popular platforms, with almost all respondents using social media daily, primarily during free time. The key reasons for social media use include gaining knowledge about diseases (100%), seeking advice from health-care professionals (199) and finding answers to health-related questions (350). Engagement in buying or selling health products was reported by 224 users. In terms of data validation, the study confirms robust convergent validity and reliability across constructs like perceived benefits, consumer innovativeness and health-protective behaviors, with Cronbach’s alpha values exceeding 0.9, indicating strong internal consistency. SEM analysis highlights that perceived benefits positively influence health-protective behaviors, with a path coefficient of 0.116 (p = 0.025) and consumer innovativeness also significantly impacts health behaviors (0.131, p = 0.019). Furthermore, perceived benefits have a positive effect on consumer innovativeness (0.174, p = 0.001), emphasizing the interconnectedness of these variables. Mediation analysis shows that consumer innovativeness partially mediates the relationship between perceived benefits and health-protective behaviors, with a significant indirect effect (0.023, p = 0.040), albeit with a moderate level of mediation. This data highlights the importance of perceived benefits in promoting innovative consumer behavior and encouraging health-oriented actions.

• Contribution to health behavior theories.

  The findings of this study contribute to the theoretical understanding of health behaviors in the digital era by integrating multiple frameworks. A key theoretical contribution is the support provided to the TPB, which helps in understanding the influence of attitudes, subjective norms and perceived behavioral control on health-related decisions in a digital context. Aydin et al. (2024) suggest that health-seeking behavior is closely tied to e-health literacy, highlighting that individuals with higher e-health literacy are more likely to engage with health information on social media. This aligns with the TPB’s assertion that perceived control enhances behavioral intentions, further reinforcing the role of control in driving engagement with digital health platforms.

• Perceived benefits and behavioral intentions.

  The study corroborates the work of Sahoo et al. (2024), who emphasize the role of perceived benefits in shaping users’ willingness to adopt e-health consultations. These findings reinforce the TPB’s claim that favorable attitudes and perceived control are critical in strengthening behavioral intentions. This concept can be extended to understanding social media engagement in health care, where the perceived benefits of using social media for health information can drive more significant user involvement.

• Diffusion of DIT.

  The DIT, as discussed by Rogers (2003), is relevant in explaining how consumer innovativeness influences the adoption of new technologies, including e-health platforms. Ghali et al. (2024) support this by highlighting that consumer innovativeness fosters value cocreation and satisfaction. This theory suggests that more innovative individuals are more likely to adopt novel health-care technologies, including social media platforms, for health-related information. The implications of this theory demonstrate the importance of consumer innovation in the diffusion of digital health solutions.

• Enhancing health-protective behaviors through social media.

  The study provides several insights for health-care providers, policymakers and digital health platforms. A key implication is the importance of perceived benefits in driving health-protective behaviors through social media. As Sahoo et al. (2024) suggest, users’ perceptions of the benefits associated with e-health consultations directly influence their intention to adopt such technologies. Health-care providers can leverage these insights to design compelling digital health campaigns that highlight tangible benefits such as emotional support, accessibility and knowledge enhancement. These campaigns can encourage greater engagement with social media platforms in health-care settings.

• Strengthening policy for health and wellness through social media.

  The role of social media in promoting health behaviors, as discussed by Sahoo et al. (2024), highlights the need for policies that regulate the use of social media in private health-care:

  • Governments should collaborate with health-care organizations to establish guidelines for the ethical use of social media to promote health information. This could include developing standards for accurate health communication and ensuring that health-related content adheres to evidence-based practices.

  • Policies should address the potential for misinformation and ensure that platforms used for health-related purposes provide users with accurate, reliable and scientifically backed information.

• Focus on e-health literacy for successful aging.

  Aydin et al. (2024) emphasize the importance of e-health literacy in promoting successful aging. This insight suggests that health-care initiatives targeting older populations should focus on enhancing e-health literacy, which can lead to more effective use of digital health resources. By improving e-health literacy, health-care providers can empower older adults to make informed health decisions and engage more meaningfully with digital health platforms.

• Leveraging consumer innovativeness for health technology adoption.

  Ghali et al. (2024) highlight that firms can use consumer innovativeness as a strategic advantage when designing innovative health-care solutions. By targeting early adopters, health-care providers and digital health platforms can improve customer satisfaction, as innovative consumers are more likely to appreciate and engage with new health technologies. This increased engagement can lead to more effective digital health interventions and higher rates of adoption.

The study faces several limitations, including a restricted sample size limited to Klang Valley, impacting generalizability (Qaisar et al., 2021; Mahmoud S. Alhaddad, 2018). Pandemic restrictions also limited direct interaction, potentially affecting the depth of responses.

Future research should broaden the geographic scope to increase diversity and explore demographic factors, such as age and income, which may differently influence consumer innovativeness. Additionally, incorporating personality traits could enrich the understanding of consumer innovativeness. Expanding social media engagement models with additional variables may clarify nonsignificant findings and address inconsistencies with previous theories, providing a more comprehensive view.

Competing of interests: The author, as the sole and corresponding contributor to the research, declares no competing financial or personal interests that could have influenced the work reported. The research was conducted independently, with no external influences, funding or affiliations that could have impacted the findings or interpretations presented.

Informed consent: All procedures in the study were conducted in accordance with the ethical standards of the institutional research guidelines, and informed consent was obtained from all participants.

Data availability: The data set and further material analyzed during the current study will be available from the corresponding author on reasonable request.