In the context of Chinese society, offspring's avoidance of health information shared by their parents reflects both cognitive evaluation-central to the Information Adoption Model (IAM)-and relational regulation, as explained by Family Communication Patterns (FCPs). A single theoretical framework is insufficient to fully explain the complexity of this behavior. Therefore, this study integrates the Information Adoption Model (IAM) and the Family Communication Patterns (FCPs) Theory to construct a dual-pathway framework that explains HIA from both informational and relational perspectives. The IAM emphasizes that individuals decide whether to adopt or reject information based on their evaluation of its quality and the credibility of the source (26–28). Offspring in contemporary Chinese families often question the scientific validity or usefulness of health information forwarded by their parents, regardless of the medium through which it is shared. This skepticism is rooted in generational differences in health literacy and perceived credibility of the information source (9). As a result, they may engage in health information avoidance, reflecting a rational, content-based rejection shaped by relational and informational dynamics.

However, the IAM alone cannot explain why offspring who recognize flawed information often choose not to directly correct or confront their parents, but instead remain silent or respond passively. This behavior is deeply shaped by the relational norms within Chinese families, where values such as filial piety and deference to elders play a central role in shaping intergenerational communication (5, 29). The FCPs theory offers a structural approach to understanding these dynamics, distinguishing between “conformity-oriented” and “conversation-oriented” communication styles (30, 31). In conformity-oriented families, offspring are expected to comply with parental guidance and minimize dissent. As a result, they may cognitively reject the health information but behaviorally avoid direct resistance—leading to HIA as a relational coping mechanism. In contrast, conversation-oriented families allow for more open discussion, potentially reducing avoidance behaviors. By integrating IAM and FCPs, this study seeks to capture the dual mechanisms—cognitive rejection and relational suppression—that jointly drive HIA. This theoretical integration enriches the understanding of health information behavior and enhances the applicability of the model within the Chinese socio-cultural context.

Sussman and Siegal (26) proposed the Information Acceptance Model (IAM), which explains how individuals adopt or reject information based on their evaluations of information quality, source credibility, and perceived usefulness. Source credibility refers to the extent to which individuals believe the information source is reliable and trustworthy (32). Information quality involves subjective judgments about the completeness, accuracy, and relevance of information in a specific context (33). Perceived usefulness refers to people's recognition of the actual value of the health information provided (34). These three dimensions together determine whether information is considered worth accepting or engaging with. To date, IAM has been widely employed to explore information behaviors, such as the acceptance, processing, and rejection of information (35–37). While IAM was initially developed in organizational and digital environments, its theoretical logic—rooted in dual-process models of information processing—has broad applicability to interpersonal and health-related contexts, including family communication (38).

In the context of intergenerational family communication, particularly between parents and offspring, information acceptance is not a purely rational act but a complex interplay between cognitive assessment and relational dynamics. Offspring do not passively receive health information from parents; rather, they engage in active evaluation—assessing not only the factual reliability of the content (information quality), but also the credibility of the source (i.e., the parent), and the personal relevance or utility of the message (perceived usefulness) (39). While these three dimensions are core constructs of the IAM model, their relevance alone does not justify its use in family settings. The IAM framework is particularly appropriate for analyzing HIA behavior in intergenerational family contexts because it accounts for how individuals cognitively process and evaluate information based on perceived credibility and relevance. In families, where emotional bonds, hierarchical dynamics, and cultural values like filial piety influence information reception, IAM provides a useful lens to understand why offspring may choose to accept or avoid health advice shared by their parents. In Chinese families, where communication is often shaped by filial piety and respect for authority, the source (parent) holds a dual role: a transmitter of information and a figure of relational obligation. This amplifies the role of source credibility and introduces emotional complexity into the cognitive decision to accept or avoid information.

In addition, IAM has been enriched by the inclusion of new explanatory variables. One such variable is “attitude toward information,” which has gained increasing attention in recent studies. Attitude refers to an individual's evaluative disposition—positive or negative—toward the information being received, which encompasses both cognitive judgment and emotional reaction (40). In the context of HIA, offspring may cognitively recognize the value of health information shared by parents, yet still avoid engaging with it due to a negative emotional attitude—such as perceiving the information as annoying, intrusive, or threatening to autonomy. This disconnect between perceived usefulness and behavioral response highlights the mediating role of attitude in decision-making processes. Several studies support the inclusion of attitude in extended IAM frameworks. Park (41) found that individuals' attitudes—whether they view information as annoying, emotionally burdensome, or personally relevant—significantly influence their likelihood of accepting or avoiding it. Le (42) further demonstrated that negative attitudes toward health messages were strong predictors of information avoidance behavior. Given that HIA behavior often occurs in emotionally charged interpersonal contexts, such as parent-offspring communication, the inclusion of attitude provides a more nuanced understanding of the decision to engage with or avoid information. These findings suggest that without considering attitude, the IAM framework may underestimate the emotional and motivational aspects of information processing—particularly in family environments where relational dynamics play a central role. Therefore, this study incorporates “attitude toward information” as a fourth key variable in the IAM framework. Therefore, this study builds upon the IAM framework by incorporating four key variables: information quality, source credibility, perceived usefulness, and attitude. This extended model not only identifies critical antecedents of offspring's HIA behavior but also enhances our understanding of the complex emotional and cognitive processes involved in family health information exchange.

The FCPs model was proposed by McLeod and Chaffee (43) and refers to the ways in which family members, particularly parents and offspring, interact and communicate with each other. The FCPs model was originally developed to examine how family members—especially parents and children—communicate in the context of media use and political socialization. Ritchie and Fitzpatrick (30) further enriched and deepened the FCPs model by dividing it into two dimensions: conversation orientation and conformity orientation. Conversation orientation refers to the extent to which family members share their views, feelings, and beliefs with one another. Families with a high Conversation orientation encourage extensive and unrestricted communication among all members, where family members are relatively equal and the frequency of communication is high (3). Conformity orientation refers to the clear hierarchical relationships among family members, where emphasis is placed on the obedience of offspring to parents (44). In a family with a high conformity orientation, there is limited open discussion on topics, and the frequency of interaction is relatively low (45). Over time, this model has been extended to other interpersonal communication domains, including health communication within families. A large number of empirical studies have shown that the FCPs significantly affects family members' behaviors in obtaining, sharing, and adopting health information (46–49). For instance, Hovick et al. (48) demonstrated that a family communication model that emphasizes consistency and authority may inhibit individuals' willingness to actively seek key information, while a conversation-oriented pattern that encourages free expression and open discussion facilitates smoother information exchange and communication.

In addition, the applicability of FCPs to the Chinese intergenerational context is evident in the model's emphasis on authority and dialogue. These dimensions align well with traditional Chinese family communication norms shaped by Confucian values such as filial piety and respect for hierarchy. In families where obedience to elders is culturally expected, conformity-oriented communication may dominate, while in more modernized families, conversation orientation has been gradually increasing (3, 50). Several empirical studies in East Asia have confirmed the cultural relevance of FCPs in parent-offspring interactions (51–53). For example, Kang et al. (51) and Xie (53) applied FCPs in Korean and Chinese family settings respectively, demonstrating that family communication orientation significantly affects adolescents' openness and information engagement. Moreover, Gong et al. (49) who found that in conversation-oriented Chinese families, middle-aged and older adults expressed less negative emotions in response to infectious disease prevention and control. These studies suggest that FCPs demonstrates strong explanatory power in collectivist and hierarchy-oriented social contexts.

Therefore, FCPs is not only a crucial theoretical tool for understanding the exchange of health information within the family, but also a significant factor in predicting and explaining the health behaviors of family members. This study took the conversation orientation and conformity orientation of FCPs as two core variables at the family factor level to reveal how different FCPs affect offspring's behaviors toward health information shared by their parents.

The two dimensions of FCPs—conversation orientation and conformity orientation—have been extensively applied in studies examining health behavior and intergenerational information exchange (49, 54). Conversation orientation encourages open dialogue, mutual understanding, and emotional sharing among family members. In such environments, offspring are more likely to express their opinions and critically engage with health-related topics. For example, Moss et al. (55) found that individuals from high conversation-oriented homes were significantly more willing to discuss COVID-19 vaccination with their parents. Similarly, Scheinfeld (54) demonstrated that conversation orientation positively mediated both the willingness to disclose health concerns to parents and to third parties. These findings indicate that a high level of conversation orientation fosters open, supportive dialogue, which in turn helps reduce communicative barriers and emotional resistance. As a result, it may significantly decrease the likelihood of HIA in family contexts. Conformity orientation, on the other hand, emphasizes family hierarchy, obedience, and the suppression of dissent. In such families, offspring may avoid challenging or rejecting parental information to preserve relational harmony. Hesse and Rauscher (47) found that conformity orientation negatively influenced vaccine intentions. Moreover, Bakhtiari (56) showed that conformity-oriented communication styles predicted increased psychological distress and behavioral withdrawal among students, including anxiety, low self-esteem, and avoidance behavior. For example, Zhou et al. (6) found that individuals often avoid certain health-related topics with close family members to reduce anxiety and maintain relational harmony. This suggests that in conformity-oriented families, HIA may serve as a strategy for passive resistance or emotional protection. Based on the theoretical and empirical evidence above, the following hypotheses are proposed:

In the IAM, perceived usefulness is conceptualized as a key mediator in determining whether individuals will accept or avoid certain information (26). Information quality refers to the accuracy, clarity, and relevance of the content, while source credibility reflects the extent to which the sender is viewed as trustworthy and knowledgeable. Both of these factors shape how useful the information appears to the recipient.

High information quality enhances perceived usefulness by providing clear, reliable, and actionable content, thereby increasing the likelihood that users will find the information worth engaging with. Komendantova et al. (57) demonstrated this effect in their study on Instagram, showing that higher-quality information significantly increased users' willingness to adopt content related to renewable energy. In a health communication context, clear and evidence-based health messages are more likely to be viewed as beneficial, especially by younger individuals facing information overload. Source credibility, although more relational in nature, also plays a critical cognitive role. A message from a trusted source is more likely to be processed positively, especially in close relationships such as family. Prior research shows that when the sender is perceived as credible—emotionally invested, knowledgeable, or morally authoritative—the recipient is more inclined to consider the information useful (58, 59). This relationship is particularly important in intergenerational communication, where authority and emotional ties are deeply intertwined (9).

In the IAM framework, perceived usefulness refers to the extent to which individuals believe that health information is valuable, relevant, and beneficial to their decision-making (26). This perception not only increases the likelihood of accepting information but also influences the individual's emotional and cognitive attitude toward it. The link between perceived usefulness and attitude has been well-documented. Peng et al. (60) found that when patients perceive medical information as useful, they tend to form more favorable attitudes toward sharing it. Similarly, Tan et al. (61) demonstrated that usefulness of the system positively and significantly influences students' favorable attitudes toward hybrid learning. This suggests that the more useful the information is perceived to be, the more positively it is received on an attitudinal level. Attitude, in turn, plays a central role in the decision to engage with or avoid health information. According to behavioral theories such as the Theory of Planned Behavior (40), attitudes toward a behavior significantly predict behavioral intentions and actions. Zhang and Jiang (62) found that individuals who evaluated cancer-related health content negatively were more likely to ignore or avoid it. Moreover, Foust and Taber (63) demonstrated that attitude has a negative effect on information avoidance behavior. Arghashi and Yuksel (64) illustrated a positive relationship between consumers' attitudes toward AR applications and their engagement behaviors. Thus, following the cognitive-affective-behavioral model, perceived usefulness influences attitude, which in turn affects HIA behavior. Based on these findings, the following hypotheses are proposed:

In behavioral science, a mediating variable transmits the effect of an independent variable to a dependent variable, thereby clarifying the internal psychological mechanism between them (65). Within the Information Acceptance Model (IAM) and related behavioral frameworks, attitude has been widely recognized as a key mediator between perceived usefulness and behavioral outcomes (66). This mediating effect reflects how individuals' evaluations of usefulness shape their emotional and motivational readiness to act. For instance, Atinafu et al. (67) found that in the context of prenatal mental health care, women's attitudes partially mediated the relationship between perceived usefulness of mobile support tools and their intention to use them. Jum'a et al. (68) further confirmed this mechanism in the context of blockchain use in supply chain management. Foust and Taber (63) also demonstrated that attitudes have a significant negative impact on information avoidance, suggesting that favorable attitudes decrease the likelihood of avoiding health messages. In family-based health communication, offspring may cognitively acknowledge the usefulness of information shared by parents, but their emotional response—captured as “attitude”—plays a key role in determining whether they will engage with or avoid the information. This indicates that attitude not only affects behavior directly, but also functions as a mediator between perceived usefulness and HIA. Based on these theoretical and empirical findings, the following hypotheses are proposed:

Information quality and source credibility are widely recognized as core factors influencing individuals' information acceptance and avoidance behaviors (26, 35, 69). High-quality information—defined by accuracy, clarity, and relevance—can directly shape users' cognitive evaluation of its usefulness. The quality of information on social media platforms directly enhances users' perceived usefulness of the information, while source credibility indirectly increases perceived usefulness by altering users' attitudes (57). This highlights a dual-path mechanism in which cognition (usefulness) and affect (attitude) interact. As a mediating variable, perceived usefulness plays a crucial role in the pathway by which information quality and source credibility influence HIA behavior. Perceived usefulness not only serves as a cognitive filter for evaluating information, but also initiates affective responses such as acceptance or avoidance. Madli et al. (37) suggested that when individuals perceive information as having high practical value, they are more likely to develop a positive attitude, thereby reducing HIA behavior. This supports the cognitive-affective-behavioral model in which perceived usefulness shapes attitude, which in turn predicts behavioral outcomes. Zhang and Jiang (62) found that the impact of perceived usefulness on information avoidance behavior is further amplified through the mediating variable of attitude. Therefore, the following hypotheses are proposed:

The whole hypothesized model of this study is illustrated in Figure 1.

The questionnaire consists of three main sections: the first section briefly introduces the purpose and content of this study and obtains informed consent from the respondents. The second section inquires about the respondents' demographic information, such as gender, age, and education level, as well as information about their parents, including age, education level, health status, medical conditions, and lifestyle habits. The third section contains measurement scales for seven variables: information quality, source credibility, perceived usefulness, attitude, HIA behavior, conversation orientation, and conformity orientation.

The measurement scales used in this study were adapted from previously validated instruments. Specifically, items measuring information quality, source credibility, attitude, and health information avoidance behavior were adapted to better align with the research context, with particular emphasis on phrasing relevant to health information. A back-translation procedure was employed to ensure linguistic accuracy and conceptual equivalence across English and Chinese versions. These scales have been tested in prior studies and have demonstrated good reliability and validity, thereby providing a robust foundation for the current research. Additionally, to enhance data quality in a large-scale survey context, one attention check item was embedded in the questionnaire. Respondents were asked a simple arithmetic question (“What is 1 + 3?”), and only those who selected the correct answer were retained for analysis. This approach aimed to filter out inattentive or careless responses caused by fatigue, lack of engagement, or misunderstanding of the survey content. A total of 29 items were included in the final questionnaire (See Appendix 1). All items were measured using a 5-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree).

The current study was approved by the Ethics Committee of Guangxi University on January 1, 2024 (Resolution No.GXU-2024-065), as it does not involve biomedical research on humans. Oral informed consent was given by all participants.

The study created the questionnaire through the most popular and professional online survey platform Wenjuanxing (www.wjx.com) in China (75). In order to ensure the scientificity and rigor of the survey, a preliminary survey was conducted before distributing the formal questionnaire. Through the reliability and validity test of 227 pre-survey questionnaires, some items that may have been ambiguous, duplicated other items, or failed to effectively measure the target variable were adjusted and deleted. After these adjustments, another small-scale test of the revised questionnaire was conducted to ensure that all modifications achieved the expected results and to further verify the reliability and validity of the questionnaire. Finally, the formal questionnaires were randomly distributed through social media such as WeChat groups, QQ groups, Weibo, and Douban from January to May 2024.

A total of 1,990 questionnaires were collected. Then, a rigorous data cleaning and preprocessing process were done. In this study, this study applied a minimum response time of 2 s per item (76–78). Given that the questionnaire contains 39 items, any questionnaire completed in <78 s was considered invalid and manually removed from the dataset. Moreover, questionnaires with highly repetitive answer patterns, or failure to pass the attention check were manually excluded to ensure data validity and quality. Finally, a total of 485 invalid questionnaires were eliminated, and 1,505 valid questionnaires were analyzed by SPSS 26.0 and AMOS 28.0.

Reliability and validity tests were conducted to ensure the quality of the measurement instruments. Cronbach's α was used to assess internal consistency, with all constructs exceeding the recommended threshold of 0.70, indicating good reliability (79). Confirmatory factor analysis (CFA) was performed to evaluate construct validity, including convergent validity and discriminant validity. Convergent validity was confirmed through acceptable values of composite reliability (CR > 0.70) and average variance extracted (AVE > 0.50).

Table 1 shows that the reliability values for the seven constructs are 0.787, 0.742, 0.805, 0.804, 0.846, 0.812, and 0.799, respectively. Each of these values exceeds the threshold of 0.7 (79), indicating that the questionnaire exhibits high reliability and stability. In the assessment of convergent validity, this study follows the recommendations of Hair for validity evaluation (80). Specifically, the absolute value of factor loadings should be at least 0.5, the Average Variance Extracted (AVE) should be above 0.5, and the Composite Reliability (CR) should exceed 0.7, indicating that the questionnaire possesses good convergent validity. Based on the data in Table 1, the factor loadings for each item range between 0.734 and 0.877, all of which are >0.5. The CR values for the seven variables all exceed 0.8, and the AVE values are >0.5. This indicates that the questionnaire has good convergent validity. In addition, in terms of the mean values in Table 1, all constructs fall within a moderate range (~2.95 to 3.32), indicating that the responses are well-distributed without extreme skewness or ceiling/floor effects. This suggests that the scale has good discriminative power. The standard deviations range from 0.80 to 0.97, reflecting moderate variability among respondents. This level of dispersion suggests that the scale captures individual differences effectively, without overly clustered or random responses. Taken together, the distribution and variability of the scale scores support the conclusion that the questionnaire data are valid and of good quality, making them suitable for further statistical analysis.

Table 2 presents the means, standard deviations, correlation coefficients, and the square roots of the AVE for the seven variables. This study follows the method proposed by Fornell and Larcker (81), assessing discriminant validity by determining whether the square root of the AVE is greater than the correlation coefficients between the two variables. The square roots of the AVE for the seven variables are 0.840, 0.813, 0.797, 0.794, 0.787, 0.756, and 0.746, all of which are greater than their corresponding correlation coefficients. This indicates that the questionnaire possesses good discriminant validity.

Common method bias (CMB) occurs when the covariance between independent and dependent variables is artificially induced due to consistent data sources or raters, identical measurement environments, item context, or the characteristics of the items themselves (82). This artificial covariance between latent variables can lead to misleading research results and conclusions. CMB can undermine the validity of research results and conclusions, making it essential to test for and control this bias in order to ensure the reliability of the study's findings. Therefore, following the recommendation of Zhou and Long (83), this study uses Harman's single-factor test to assess common method bias. In the exploratory factor analysis, all items of the study variables were loaded onto a single factor. The unrotated factor analysis results showed that the variance explained by the first factor was 25.844%, which is below the 40% threshold (84), indicating that there is no significant common method bias in this study.

Table 3 presents the distribution characteristics of demographic variables for the respondents (offspring) and their parents. The demographic characteristics of the offspring and parental generations exhibit significant differences in several aspects. According to the Seventh National Population Census of China, males account for 51.24% and females for 48.76% of the population. In this study, 44.05% of participants are male and 55.95% are female, a distribution that closely approximates the national gender ratio, indicating good demographic representativeness in terms of gender and providing reference value. In terms of educational attainment, the offspring group exhibits a relatively high level of education, with more than half holding a bachelor's degree or higher (~53.16% in total). This higher educational level likely gives the offspring an advantage in acquiring and processing information, particularly health-related information. Moreover, we limited the study subjects to under 30 years of age: under 18 years (17.34%), 18–25 years (47.38%) and 26–30 years (35.28%). A large proportion of 18–25 year olds, who are basically in college or just entering the workplace, usually have a strong learning ability and a high ability to accept new health information, and they often communicate more closely with their parents. As reported by China Youth Daily (85) in a survey of 1,001 young respondents, 74.6% said that they have placed greater importance on parent-child relationships in recent years and communicate more frequently with their parents.

In contrast, the age distribution of the parental generation is primarily concentrated in the middle-aged and older adults, with 39.80% aged 50–59 and 32.16% aged 60–69. This indicates that they are in the later stages of life and may be more concerned with health issues and the management of chronic diseases, which can also be reflected by the health status, health conditions and healthy lifestyle habits of their parents. The educational level of them is generally lower than that of the offspring, with the majority having only completed middle school or below (33.16%) and high school/technical school/vocational education (37.41%), which may contribute to their susceptibility to believing incorrect or misleading health information. The parental generation predominantly resides in fourth-tier and below cities or county/town areas (23.46%) and rural areas (20.13%). This indicates that they largely live in regions where medical resources are relatively scarce, which may limit their access to comprehensive healthcare services and up-to-date health information.

This study employs Structural Equation Modeling (SEM) for hypothesis testing. SEM is a statistical method that analyzes relationships between variables based on the covariance matrix, integrating factor analysis, multiple regression analysis, and path analysis (86). Therefore, using SEM for the empirical research in this study is highly appropriate. The model estimation in SEM is conducted using the Maximum Likelihood method. This study utilizes AMOS 28.0 software to construct the Structural Equation Modeling (SEM). The 1,505 questionnaires collected meet the suggestion of Nunnally and Bernstein that the minimum sample size for SEM analysis should be at least 10 times the number of construct items (87).

The SEM results indicate that conversation orientation negatively impacts offspring's HIA behavior, while a conformity-oriented FCP positively influences it. This finding is consistent with the research of Mullen and Hamilton (94), which suggests that the higher the level of parental control in the parent-child relationship, the more difficult it is for offspring to adopt parental advice and develop viral knowledge (95). Moreover, an important finding is that the absolute value of the standardized coefficient for conformity orientation (0.574) is greater than that for conversation orientation (0.128), indicating that traditional authoritarian communication still holds greater influence in Chinese families. Traditionally, Chinese families place great importance on authority and the hierarchy between elders and younger members. Parents often hold a dominant position within the family, and offspring are generally expected to comply with their parents' wishes without easily opposing or questioning them (3). From a psychological perspective, offspring's avoidance of parental health information may reflect an implicit form of resistance. In conformity-oriented families, where hierarchical expectations are strongly enforced, offspring may lack the space for open negotiation and instead resort to silence or disengagement to protect their autonomy. According to Foucault's theory of discourse and power (96, 97), everyday communication is not neutral, but a medium through which power is exercised and maintained. Health advice, while seemingly benign, can function as a form of discursive control that reinforces parental authority. Therefore, information avoidance may serve as a subtle act of defiance—an attempt by offspring to resist being governed under the guise of care or tradition. This outcome reflects the cultural emphasis on harmony and hierarchy in Chinese families, but also exposes underlying generational tensions rooted in unequal communicative power. As such, HIA behavior should not only be understood as a passive communication failure, but also as an active psychological strategy shaped by relational and cultural dynamics.

Conversation orientation has a negative impact on offspring's HIA behavior. Although its effect is relatively modest, it suggests that offspring in families with more open and egalitarian communication structures are more likely to engage in meaningful dialogue with their parents. As offspring increasingly grow up in environments that emphasize respect, mutual understanding, and emotional support, they tend to feel safer expressing their views and are less inclined to avoid health-related discussions (98). In such conversation-oriented families, offspring are more willing to participate in health information exchanges because they believe their perspectives will be acknowledged and valued.

The results show that although conversation orientation helps reduce offspring's HIA, its influence is still weaker than that of conformity orientation. This may reflect the tension Chinese families face in navigating a shift from hierarchical, authority-driven communication—rooted in Confucian traditions—to more egalitarian and dialogic forms of parent-child interaction. While more families are beginning to value openness and emotional expression, authoritarian styles that emphasize parental dominance and filial obedience remain deeply embedded in the cultural and relational fabric (98). As a result, many families are in a transitional state where coexisting and sometimes conflicting communication norms may hinder the effectiveness of health information exchange.

From a macro-level perspective, this finding has important implications for improving health information dissemination within Chinese families. Health authorities and public health institutions should consider how traditional conformity-based family communication styles may hinder intergenerational understanding. When designing health education strategies, special attention should be paid to addressing hierarchical communication norms that suppress open discussion. This supports calls from previous scholars [e.g., (99)]—to localize health policy frameworks to better accommodate culturally embedded communication patterns.

At the micro-level, this study further suggests that families—particularly parents—should be encouraged to adopt more conversation-oriented communication approaches. In doing so, offspring are more likely to feel psychologically safe, heard, and engaged in health-related dialogue, which reduces avoidance behaviors. This aligns with findings from Hovick et al. (48), who emphasized the role of interpersonal openness in family health communication. However, our study expands this literature by confirming that even when openness is encouraged, the influence of conformity orientation remains stronger in Chinese cultural contexts, underscoring the complex interaction between modern communication ideals and traditional family values.

Information factors play a crucial role in influencing offspring's HIA behavior. The SEM results indicate that: first, the quality of health information shared by parents and the credibility of the information source both have a positive impact on offspring's perceived usefulness. However, the standardized coefficient for source credibility (0.632) is greater than that for information quality (0.227), indicating that in intergenerational communication, source credibility has a stronger influence on offspring's perception of the usefulness of the information. This finding is consistent with the research of Petty and Cacioppo (100), Hovick et al. (101), and Nelson and Kim (36). This is primarily because, in China, parents typically play an authoritative role in education, and the family environment tends to be one-way instruction rather than two-way communication (102).

In this growing environment, the offspring's ability to make independent decisions and think independently is inhibited to a certain extent, so they are more likely to be influenced and persuaded by external authorities. When they receive health information, they place greater importance on the credibility of information sources, even if the quality of information is not optimal. Secondly, there is a significant association between offspring's perceived usefulness, attitude, and HIA behavior, with attitude serving as a mediator in the relationship between perceived usefulness and HIA behavior. While perceived usefulness plays a crucial role in shaping the initial attitude of offspring toward the information, it is not the sole factor that determines whether they decide to avoid the information. One possible explanation is that in Chinese families, offspring's attitudes toward their parents often include a mix of respect for parental authority, compliance with family expectations, and consideration for family harmony (3). Therefore, even if offspring find the information useful, they may still choose to avoid it if their attitude toward their parents is not positive enough. In addition, family relationships emphasize harmony, respect, and collectivism in Chinese culture (103). Offspring's attitudes toward their parents not only reflects their evaluation of health information itself but also mirrors their perception of family relationships and their identification with the parental role.

The standardized coefficient of attitude is 0.154, which is significantly larger than that of perceived usefulness (0.049). This indicates that in the context of Chinese families, offspring's attitudes have a greater impact on their HIA behavior than the quality and credibility of the information itself. This may be driven by the desire for personal independence of the offspring or by existing conflicts between generations. Therefore, in the context of health communication of Chinese families, it is more important not only to ensure that the health information shared is of high quality and targeted, but also to strive to cultivate mutual understanding and trust among family members, and to enhance offspring's positive attitudes toward their parents. In this way, a more open and supportive family communication climate can be established, thereby encouraging offspring to be more willing to accept and consider the health information provided by their parents.

Finally, information quality and source credibility have a chain effect on offspring's HIA behavior through perceived usefulness and attitude. This effect not only demonstrates the basic laws of information dissemination, but also deeply reveals the particularity of intergenerational communication and health information transmission under the influence of Chinese culture and family values. In Chinese family culture, the dissemination of health information is not just a simple transfer of data; it also carries the deep meaning of trust, respect and emotional interaction among family members (14, 104). The quality of information and the credibility of the source affect offspring's attitude toward information by shaping their perception of the usefulness. This suggests that the attitude is not only a direct response to the content of the information, but also a reflection of offspring's cognition of their parents' roles and family relationships. This reflects the cultural depth of the information dissemination process, in which the transmission of information is not only a logical coherence, but also a form of emotional expression and social.

This study, based on FCPs and the AIM theory, comprehensively examined the factors that affect offspring's avoidance of health information shared by their parents. The study finds that at the family level, conversation orientation had a negative impact on offspring's HIA behavior, while conformity orientation had a positive impact on it. This indicates that communication within the family plays a crucial role in the reception and dissemination of health information. At the information level, perceived usefulness and attitude each have a significant negative impact on offspring's HIA behavior. This indicates that perceived usefulness and attitude are key psychological factors that influence offspring's avoidance of health information. In addition, information quality and source credibility have a chain mediating effect on offspring's HIA behavior through perceived usefulness and attitude. This chain mediating effect emphasizes the synergistic interaction of multiple factors in information dissemination, indicating that improving information quality and enhancing the credibility of information sources can effectively increase offspring's acceptance of health information, thereby reducing HIA behavior.

This study's contribution to theory is mainly reflected in two aspects: first, by incorporating both cognitive and relational variables into the framework, this study contributes to existing theory by bridging the IAM and FCPs models in a non-Western setting. It also clarifies how psychological resistance—expressed as health information avoidance—may be shaped by intergenerational discourse power structures. Second, this study extends the application of the IAM framework to the context of family health communication in China. It specifically examines how offspring process health information shared by their parents. This approach not only enriches existing theories of family health communication but also provides new insights into the psychological mechanisms behind intergenerational information transmission and avoidance. Third, the study offers practical implications for public health interventions and digital health design. Health campaigns targeting younger audiences should not only focus on improving the quality and credibility of content but also consider the relational context in which health messages are received.

Although this study provides valuable findings and insights, there are still some limitations. Firstly, this study employed SEM to analyze and validate various factors and their interrelationships. The advantage of SEM lies in its ability to handle complex variable relationships, providing a comprehensive validation of the research model. However, the model falls short in explaining certain key phenomena. For instance, while the model accounted for a significant portion of the variance in offspring's HIA, it did not fully capture the emotional or contextual factors (105, 106)—such as parent-child relational closeness or digital literacy—that may also influence avoidance behavior. These omitted variables could offer additional explanatory power and deserve further investigation in future research. Moreover, the use of two existing scales to measure FCPs and HIA, though validated in prior research, may not fully capture the complexity or cultural specificity of these constructs in Chinese families. Some culturally nuanced aspects of communication—such as implicit obedience or indirect resistance (107, 108)—may fall outside the scope of standardized instruments. Future research could benefit from using mixed methods or culturally adapted scales to enhance construct validity.

Secondly, although the age limit for the study was under 30 years old, the age span was still large. Therefore, future research could further examine the heterogeneity of this model across different age groups to more precisely identify the unique factors influencing health information avoidance among offspring. On the basis of comparative studies, a more explanatory model of the mechanisms behind HIA in offspring could be constructed, leading to the development of more targeted health intervention strategies for this group.

Finally, although the gender distribution of the sample (male: 44.05%, female: 55.95%) deviates from national census data, this discrepancy primarily affects the representativeness of the sample and may limit the generalizability of the findings. However, since the focus of this study lies in examining the relational patterns among key variables rather than producing population-level estimates, the impact of this gender imbalance on the core analytical logic is minimal. Future research may consider more balanced sampling to enhance external validity.