ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Education and Promotion
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1661328
Who Do We Follow Online? An Experimental Study on Source Clarity and Social Proximity in Digital Health Communication
Provisionally accepted
Junhui Li*
Chunsheng Shi- Harbin Institute of Technology, Harbin, China
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Public health communication increasingly relies on digital channels where advice is encountered from diverse sources that vary in source clarity (whether the sender is perceived as clearly identifiable) and social proximity (whether the sender is perceived as relationally close). To examine how these sources shape compliance with health advice, we conducted a randomized controlled online experiment (N = 810) simulating a social media environment in which each participant viewed one weight-management post attributed to one of eight sources: parents, friends, colleagues, doctors, health influencers, news agencies, Wikipedia, or AI chatbots. We measured intended compliance and four cognitive responses: perceived credibility, psychological reactance, attention, and comprehension. Messages from single specified sources (parents, friends, colleagues, doctors, influencers, news agencies) increased intended compliance by 13–17 percentage points compared with composite diffuse sources (AI chatbots, Wikipedia). Within specified senders, significant others (parents, friends, colleagues) outperformed professional experts (doctors, influencers, news agencies) by 11–16 points. Mediation analyses showed that source clarity operated primarily through enhanced credibility, while social proximity operated through higher credibility and lower reactance; attention and comprehension did not mediate these effects. Subgroup analyses indicated stronger effects among participants with chronic conditions, higher health literacy, or behaviorally aligned daily routines. These findings suggest that, in a networked digital environment, compliance with health advice is influenced less by professional authority or aggregated information, and more by identifiable and socially close sources. The study provides evidence-based guidance for selecting sources and designing messages in public health promotion.
Keywords: public health promotion, digital health communication, Information sources, Source Clarity, Social proximity, Health Advice Compliance, randomized controlled trial
Received: 07 Jul 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Li and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Junhui Li, antheajh.li@stu.hit.edu.cn
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