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Health-driven mechanism of organic food consumption: A structural equation

modelling approach

Article in Heliyon · February 2024

DOI: 10.1016/j.heliyon.2024.e27144

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Health-driven mechanism of organic food consumption: A structural equation

modelling approach

Changxu Wang, Jinyong Guo, Wenbin Huang, Yonghong Tang, Rita Yi Man Li,
Xiaoguang Yue
PII: S2405-8440(24)03175-X
DOI: https://doi.org/10.1016/j.heliyon.2024.e27144
Reference: HLY 27144

To appear in: HELIYON

Received Date: 3 June 2023

Revised Date: 13 February 2024
Accepted Date: 25 February 2024

Please cite this article as: , Health-driven mechanism of organic food consumption: A structural equation
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 Health-Driven Mechanism of Organic Food
Consumption: a Structural Equation Modelling
Approach
Changxu Wang1, Jinyong Guo1*,Wenbin Huang1, Yonghong Tang2, Rita Yi Man Li3,
Xiaoguang Yue4

1
College of Economics and Management, Jiangxi Agricultural University, Nanchang 330000, China
2
College of Foreign Languages, Jiangxi Agricultural University;Nanchang 330000, China
3
Sustainable Real Estate Research Center/Department of Economics and Finance, Hong Kong Shue Yan University, Hong Kong,
China
4
Department of Computer Science and Engineering, School of Sciences, European University Cyprus, Nicosia, Cyprus
* Correspondence: Email: gjytyh40@sohu.com; Tel.: +86-139-7008-6543

Abstract: The COVID-19 pandemic seriously threatened human survival and development. It has also highlighted

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the significant correlation between ecological and public health. After three years of the COVID pandemic, Chinese

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consumers have become more aware of the importance of health. Especially in the Internet era, consumers’
purchasing methods and health awareness have been changed. Consumers can buy nutritious and organic foods. To
understand the impact of consumer psychology and health beliefs on the willingness to purchase organic food in the

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post-pandemic period, this study uses organic beef as an example and extracts key variables from three basic theories.
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The three basic theories include the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the
Norm Activation Model (NAM), respectively. Specifically, perceived susceptibility and severity are combined to
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form a health belief variable that can drive organic food purchasing. In contrast, perceived benefit, moral norms,
self-efficiency, and controllability are introduced as mediating variables to construct the health driving factors of
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organic beef purchasing. Structural equation modeling (SEM) and mediation effect tests are used to analyse 539
samples. Meanwhile, paths and mechanisms between health concern and other variables are explored. The results
show that health concern is an important driving factor. Health concern can significantly promote the formation of
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willingness to purchase organic beef. Mediation effect tests suggest that health concern can indirectly affect the
willingness to purchase organic beef through perceived benefit, moral norms, and controllability, but the mediation
effect of self-efficiency is not significant. This study provides important references for government regulation and
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certification of organic foods as well as for enterprises’organic food marketing strategies.

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Keywords: Internet era; Organic food; Health belief model; Theory of planned behavior

1. Introduction
2500 years ago, the ancient Chinese philosopher Lao Tzu suggested protecting the ecosystem,
prohibiting over-exploitation and severe ecological destruction of natural resources [1]. However,
the past century has witnessed increasing exploitation of natural resources. Environmental problems
such as energy crises, climate changes, and greenhouse effects have negatively affected human life
and development [2,3]. There has been a rising concern regarding how to solve environmental
pollution, and use natural resources reasonably and search for a sustainable, green, and low-carbon
consumption model for long-term development [4,5].
From the consumer perspectives, the first significant change is the food supply and demand
requirement. That is mainly because the global food system is the “main contributor” to greenhouse
gas emissions, responsible for 23-42% of the total emissions [6,7]. Over the past 30 years,
greenhouse gas emissions from global agriculture and food production have increased by 17% [8].
To ensure the food supply for 8 billion people worldwide and to complete the green and sustainable
transformation of the agricultural system, it is essential to alleviate human-caused environmental
pollution and build a sound ecosystem.
Yet, environmental problems have already caused human concerns about food quality. Water
pollution, toxic elements in soil, and other threats have endangered human food safety. The public is
worried about the food they buy, so they purchase products with trusted labels. These labels help
them determine whether the food they buy is safe and reliable. Organic food is a good choice for the
public to address environmental worries and health problems [9,10]. Some scholars have raised
questions about whether organic food is healthier. They are wondering whether mycotoxin levels
are increasing due to the absence of pesticides in organic food production. On the contrary, some
scholars think that organic food is safer, since it does not use chemically synthesized pesticides,
fertilizers, growth regulators, and growth hormones in its production process [11]. Different from
traditional food, organic food is strictly tested by organic certification agencies, and an annual
inspection is required for organic food labeling certification [12]. If failing to pass the audit,
organic food is not allowed to use the organic certification. Thereby, organic food is globally
acknowledged for its stringent safety and quality standards, earning greater consumer trust. For
instance, organic rice cultivation imposes elevated requirements on soil and water quality during the
planting process. Besides, this production and processing process requires biological fertilizers,
farmhouse fertilizers, and physical weeding methods instead of artificially synthesized substances
such as pesticides, fertilizers, and hormones. Given this, some scholars hold the opinion that
organic rice is healthier and safer compared to ordinary rice [13].
With the acceleration of urbanisation, China’s food consumption structure has been upgraded.
Chinese have a growing demand for agricultural products, particularly meat and dairy products
[14]. According to statistics from the Food and Agriculture Organization (FAO) of the United
Nations, the largest source of greenhouse gas emissions in agriculture comes from methane

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produced during livestock digestion, with enteric fermentation, manure, and manure management

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accounting for 72% of agricultural carbon emissions. Livestock has become the primary source of
agricultural greenhouse gas emissions [15]. In addition, among all animal-based foods, beef and
milk production are the primary sources of carbon emissions in livestock farming, taking up 41%

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and 20% of the total livestock emissions [16], respectively. This is mainly because cows are
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ruminants that feed on fibrous plants. Meanwhile, microbes in their stomachs produce large
amounts of carbon dioxide while helping them digest the plant. With the spike in Chinese demand
for meat, eggs, and dairy products, greenhouse gas emissions are also increasing. This has pressured
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China to achieve carbon peak and carbon neutrality in the livestock industry. Existing studies have
shown that compared with the traditional animal husbandry model, organic animal husbandry can
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use modern agricultural technology to improve feed utilization, reduce the production of excreta,
and realize the resource utilization of livestock manure and other wastes, thus reducing carbon
emissions [17]. This also means that the “organic and green” transformation of livestock products is
urgent, but Chinese consumers have not yet had a strong awareness of buying organic and green
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livestock products. Additionally, the demand of Chinese residents for organic food is still
insufficient. This has brought more difficulty to China’s transition from traditional agriculture to
organic agriculture.
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Nevertheless, the outbreak of the COVID-19 pandemic in 2019 significantly changed Chinese
consumers’ attitudes towards organic food. There has been an increasing demand for healthier,
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safer, and more nutritious food among Chinese consumers. This probably indicates new
opportunities for developing the organic food industry in China. It was not until December 2022 that
China officially announced the lifting of its lockdown on the pandemic. This marked the end of the
three-year COVID-19 pandemic. At the same time, the Chinese government also proposed the
slogan – “Everyone is responsible for their health”. According to this slogan, Chinese residents
should sharpen their health awareness. Consumers have significantly been panicked and concerned,
from the moral condemnation of human consumption of wild animals at the beginning of the
COVID-19 outbreak to the numerous food safety incidents during the pandemic. Chinese
consumers now prioritize trustworthy, green, sustainable, and healthy food due to increased
awareness of the adverse health impact of harmful food [18,19]. The production and consumption of
organic food are believed to be green and safe, environmentally friendly, and linked to health,
environmental protection, and low carbon. Organic food is gradually becoming known and adopted
by consumers. These external factors have greatly stimulated the rise of Chinese consumers’
health beliefs. Chinese have been striving to find healthier organic food.
Extensive research has been conducted on the influencing factors of organic food purchases.
Research of this kind mainly focuses on “personal characteristics [20], product perception [21],
risk awareness, attitude [22], and product labelling [23]. Studies by Briz and Ward on Spanish
consumers found that demographic characteristics such as gender, age, and income can affect
consumers’ perception and purchasing behavior towards green products [24]. There is a lack of
studies discussing organic food purchase intentions from the health perspective. Among the
current psychological theories explaining health and organic food consumption, the one closely
related to health is the health belief theory [25]. Previous scholars mostly explained that health
beliefs could promote the occurrence of healthy behaviors through the use of health belief theory.
For instance, individuals with strong health beliefs are more active in engaging in physical
exercise [26]. However, there are few studies paying attention to the impact of health beliefs on
the willingness to purchase organic food from the perspective of health belief theory. Only a small
number of scholars have proposed two important factors influencing consumers’ selection of
organic food, including health benefits and environmental benefits [27], but health benefits are
only regarded as part of perceived benefits. For example, in accordance with the analysis by using
attribution theory, Yao Wen found that consumers’ perception of the health attributes and
environmental protection effects of green agricultural products can significantly influence their
willingness to buy green agricultural products [28]. Consequently, few specialized studies have
been found to use health beliefs as a driving factor to examine consumers’ purchasing willingness
towards organic food. Furthermore, despite the exploration of the direct relationship between
various variables proposed in the health belief theory and purchase intention by the existing
literature [29], it fails to take health belief as a pre-variable to discuss the relationship between
health belief and other variables. On the other hand, it’s necessary to verify the mechanism
relationship between health beliefs and organic food’s purchase intention.
To make up for the shortcomings of existing research, the discussion on the determinants of
consumers’ organic food purchasing decisions is conducted from the perspective of health belief.
Additionally, the relationship between health beliefs and other variables, as well as the mechanism

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between health beliefs and organic food purchase intentions, are explored.

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The remainder of the paper is split into five parts: In the second part, an overview of the
theoretical background is conducted, and the research hypotheses are formed. This helps establish
a theoretical framework for the organic food health-driven purchase intention model. In the third

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part, the material sources and research methods are introduced. In the fourth part, the introduction
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to the research results is carried out. In the fifth part, beyond the discussion of the research results,
theoretical implications and practical implications are also emphasized. In the sixth part, the
conclusions are drawn, limitations and recommendations for future research are also elaborated.
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2. Theoretical background and research hypotheses
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2.1 Theoretical background

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2.1.1 Health belief theory

The health belief theory refers to an individual’s beliefs and concepts about preventing
diseases, maintaining health, and striving for optimal well-being. Individuals with beliefs related to
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diseases and health are more likely to adopt healthy behaviours and change risky behaviours [30].
The health belief theory mainly comprises perceived threat variables and behaviour evaluation
variables. Perceived threat primarily arises from individuals’ feelings of insecurity. It consists of
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perceived susceptibility and severity of the problem. Behaviour evaluation variables include
perceived benefits, barriers, and self-efficiency. Previous research has confirmed the solid
predictive role of various variables in the health belief model on healthy eating behaviours [31].
However, existing research lacks an exploration of the correlations among the variables in the health
belief model. Therefore, this study adopts Yixiang et al’s health belief variables [32], including
perceived susceptibility and severity. On this basis, the correlation between health belief and
perceived benefits, perceived barriers and self-efficiency is investigated for a better understanding
of the impact of health belief on consumers’ willingness to purchase organic food.

2.1.2 Theory of Planned Behavior

The Theory of Planned Behavior (TPB) is one of the most influential theories in health
psychology. This theory has been widely applied to healthy eating and consumer behaviour.
Developed by Ajzen, TPB consists of three components: attitude, subjective norm, and perceived
behavioural control. However, some scholars have pointed out that TPB, while having solid
explanatory power in healthy eating behaviour, lacks a motivational drive for action and fails to
consider the evaluation of perceived risks. Due to these two defects, TPB cannot help scholars
understand the impact of negative information evaluation on purchase intention related to health
[33,34]. Additionally, TPB has been criticised for not considering human beings’ moral and
emotional factors. Therefore, some scholars have proposed improvements and expansions to TPB
by introducing moral norms and self-identity. Their efforts have significantly enhanced the
effectiveness and applicability of TPB [35].
Inspired by existing literature, this study replaces and expands the traditional variables of TPB
to improve the model’s explanatory power. First, the health belief variables of perceived
susceptibility and perceived severity provide an assessment of health risks. These variables can
effectively address the lack of motivational factors and help evaluate perceived risks in TPB.
Second, we have modified TPB. Some scholars have suggested that in case of food safety incidents,
information asymmetry may lead to the influence of behavioural attitude on consumer behaviour
being weaker than perceived benefit. So we have replaced the attitude component of TPB with
perceived benefit from the HBM [25]. The meaning expressed by perceived behavioural control in
TPB and perceived barriers in HBM contradict each other. Besides, perceived behavioural control
has more enriched connotations. Therefore, we have replaced perceived barriers with perceived
behavioural control. Finally, Urbig’s empirical test of perceived behavioural control has confirmed
the existence of a two-factor structure. The empirical test also pointed out that perceived
behavioural control could be classified into self-efficiency and controllability. Moreover, the
two-factor structure is more persuasive than a single factor. Hence, this study takes a closer look into
the impact of self-efficiency and controllability on organic beef purchase intention and verifies the
path correlation of health belief with self-efficiency and controllability, respectively.

2.1.3 Norm activation theory

The norm activation theory, developed by Schwartz in 1977, is fundamental in environmental
behaviour. It has found wide applications in various social behaviours, such as low-carbon energy

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consumption and green consumption [36,37]. Generally, this theory consists of four latent variables:

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consequence awareness, responsibility attribution, moral norms, and behavioural intention. Among
them, moral norms mediate the effects of consequence awareness, responsibility attribution, and
behavioural intention. Consequence awareness refers to individuals recognising the consequences

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of not performing a specific behaviour. Some studies have verified that environmental consequence
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awareness significantly affects the willingness to purchase organic food [38].
In this study, consequence awareness is replaced with health belief, which refers to
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consumers’concerns about the harm to health caused by purchasing beef that may be contaminated
with diseases or containing pesticide residues. In organic food consumption, the health belief
variable is similar to the consequence awareness variable. In the purchasing behaviour of organic
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beef, health and consequence consciousness are concerned about the damage to one’s health caused
by buying infected or unhealthy beef. Hence, we replace consequence awareness with health belief.
Moral norms are individuals’moral obligations to fulfil or avoid certain behaviours [39].
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Consuming organic beef undoubtedly can be considered a moral behaviour, as it benefits the
environment and animal welfare by not using antibiotics, hormones, feed additives, or genetic
engineering techniques in the production process. Moreover, moral norms differ fundamentally
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from subjective norms in TPB. The former is mainly driven by social group pressures such as
threats of sanctions or promises of rewards [40]. In addition, moral norms emphasise individual
internal emotional factors and attempt to guide individuals’environmental behaviour from a
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moral-emotional perspective.
In COVID-19 pandemic, many scholars demonstrated that subjective norms can significantly
promote the formation of willingness to purchase organic food. Consumers may also be influenced
by the government or social groups [41]. However, there have been limited discussions on moral
norms in existing studies. Research has shown that moral norms are more enduring and stable than
subjective norms. Moral norms are related to an individual’s beliefs. Once beliefs are formed, they
will be long-lasting and stable [42,43]. Therefore, internalised moral norms are more meaningful
than subjective norms in practice.
The analysis above reveals similarities and differences between the three models involved in
this research. Combining them can complement each other in explaining and predicting organic
food consumption. This can reinforce the explanatory power of the model. Figure 1. Conceptual
model. illustrates the theoretical framework of this study. It first constructs the risk perception
assessment of the indicator, namely health belief. As shown in Figure 1. Conceptual model. health
belief have two antecedent variables, including perceived susceptibility and perceived severity. This
study integrates variables from health belief theory, the theory of planned behaviour, and norm
activation theory. These variables include health beliefs, perceived benefits, subjective norms,
self-efficiency, and controllability. Then, a health-driven model of organic beef purchase intention is
proposed based on the logical correlations among these variables. To sum up, this study follows the
research path below: first, health belief is taken as the antecedent driving factor of organic beef
purchase intention, and perceived benefits, subjective norm, self-efficiency, and controllability as
mediating variables to examine the correlations and mechanisms among health belief and these
variables.
 Figure 1. Conceptual model.

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2.2 Research Hypotheses

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2.2.1 Health belief
Health belief is a conscious behavioural tendency formed on a specific cognitive basis. It

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serves as a fundamental driver for decision-making. In this study, following the approach of
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previous scholars, we combine perceived susceptibility and perceived severity in the health belief
theory into a single variable, health belief [32]. Consumers with higher perceived susceptibility may
pay more attention to information related to the benefits of organic food, corporate production
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control, and government monitoring and regulation of food quality and safety. Being more aware of
food safety issues and concerned about purchasing unhealthy food, these consumers want to
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mitigate food safety risks and satisfy their psychological needs to buy safe food [44]. For consumers
with higher perceived severity, scholars argue that behaviour change only occurs when they realise
that their current behaviour harms their health and that changing their behaviour can reduce their
food risks [45].
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During the COVID-19 pandemic, food safety incidents often happened to meat and poultry
products. Consumers are worried that the food might be contaminated with the virus, which lead to
contracting a disease [46]. Therefore, consumers with a higher awareness of health beliefs are
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expected to have a significantly higher perceived value of organic food compared to those who do
not prioritise health [47]. At the same time, a stronger awareness of health is likely to evoke a sense
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of moral responsibility in consumers and a willingness to pay a higher consumption cost for organic
beef. Meanwhile, a stronger health awareness can overcome barriers such as convenience and
availability [48], and can ultimately increase organic beef consumption. Thus, this study proposed
the following hypotheses:
H1: Health belief has a positive promoting effect on perceived benefit.
H2: Health belief has a positive promoting effect on moral norms.
H3: Health belief has a positive promoting effect on self-efficiency.
H4: Health belief has a positive promoting effect on controllability.
H5: Health belief has a positive promoting effect on willingness to purchase organic beef.
2.2.2 Perceived benefit
Perceived benefit refers to the perceived effectiveness and evaluation of specific attributes and
performance of a product in helping consumers achieve their goals or intentions in particular
consumption contexts. Consumers often perceive organic food as a reputable product that is
produced using natural ingredients, so organic food is pollution-free and safe. Studies by Akter and
others suggest that consumers perceive organic food as healthier and more nutritious than
conventional food, as organic production does not involve harmful chemical fertilisers [49]. Further
research by Guanqi and Husnain Mudassir indicates a significant association between perceived
benefit and willingness to engage in green consumption, with health concerns being an essential
driving factor for positive attitudes and intentions towards organic food consumption [50].
Therefore, consumers expect to consume more nutritious, healthy, and pesticide free food to reduce
the potential food safety risks. From the perspective of behavioural evaluation, if consumers
perceive a substantial benefit in consuming organic food, they will believe that it is beneficial to
their health. Consequently, they are more likely to increase their purchase intention towards organic
beef. Hence, this study proposes the following hypotheses:
H6: Perceived benefit has a positive promoting effect on organic beef purchase intention.
H6a: Health belief indirectly influences organic beef purchase intention through perceived
benefit.
2.2.3 Moral norm
Moral norms refer to the expectations of individuals regarding their behaviour in specific
situations under society’s unwritten rules. Once moral norms are activated, individuals feel
obligated to engage in environmentally-friendly behaviour. In the context of organic beef
consumption, moral norms refer to consumers’ moral emotions and sense of responsibility and
obligation to purchase organic beef that is environmentally and animal friendly. Consumers with
strong moral norms feel guilty when consuming uncertified conventional beef. They might consider
eating beef harmful to animal rights [51], but consuming certified organic beef bring them
emotional well-being and moral values. Research has shown that moral norms positively influence
behavioural intentions. For example, Mørk et al. found that moral norms positively impact
consumers’ willingness to purchase organic food [43]. Consequence awareness is another variable
in the NAM model. In this study, it is defined as health belief, referring to consumers’ awareness of
the health risks and environmental damages associated with not consuming organic beef. Because
health belief is closely related to consequence awareness, we use health belief as a substitute for

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consequence awareness. Research has confirmed that individuals aware of the severity of
environmental damage and health risks caused by waste disposal are more likely to moral obligation
and responsibility for the consequences of risk. Meanwhile, these consumers are also more inclined
to engage in waste sorting to promote resource recycling and reduce human health risks. Therefore,

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we propose the following hypotheses: -p
H7: Moral norms positively influence consumers’ willingness to purchase organic beef.
H7a: Health belief indirectly affects consumers’ willingness to buy organic beef through moral
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norms
2.2.4 Self-efficiency
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Self-efficiency is an individual’s subjective judgment of whether they can successfully

perform a behaviour. It reflects the individual’s confidence level and determines whether they will
take action. The stronger consumers’ confidence in their ability to perform a behaviour, the lower
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the perceived risks and the stronger their willingness to purchase. In the face of unfamiliar new
products, consumers’ willingness to purchase is more likely to be influenced by their beliefs about
the perceived difficulty or ease of the task Such perception of difficulty can come from internal
measurement (self-efficiency) or external measurement (Controllability). Referring to viewpoints
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of multiple scholars, this study divides perceived behavioral control into self-efficiency and
controllability.
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Ashraf et al. confirmed that high self-efficiency increases trust and personal willingness to
purchase [52]. Son and Lee also found that self-efficiency is a key factor influencing online
purchase intention and behaviour [53]. Therefore, when individuals have sufficient confidence in
certain behaviours, their motivation to take action will be stronger. Specifically, when consumers
have higher self-efficiency, they are more confident in purchasing green products and demonstrate
stronger will to overcome difficulties during the purchasing process. All in all, they will show a
stronger willingness and behaviour to buy green products. In addition, self-efficiency strongly
influences organic food purchases, which helps optimize the cognitive process. Rich experience in
organic food purchase help understand the nutrition and health value of organic food and promote
the formation of consumers’ organic food purchase behaviour. Health belief is the basis of organic
food buying behaviour and an important link in the development of nutrition and health cognition
and behaviour. As Bandura pointed out, a person who is certain that an action will have a positive
outcome will have a stronger sense of self-efficiency, which affects the behaviour. Thus, health
beliefs can indirectly promote organic food purchase by influencing self-efficiency. Based on the
above discussions, the following hypotheses are proposed:
H8: Self-efficiency has a positive promotion effect on organic beef purchase intention.
H8a: Health belief indirectly influences organic beef purchase intention through
self-efficiency.

2.2.5 Controllability
Controllability refers to the perceived degree of control over external conditions, including
time, money, and accessibility, necessary for individuals to engage in certain behaviours. When
individuals perceive a higher control over external conditions, their willingness to purchase will
also be stronger. People are more inclined to engage in behaviours when they have the necessary
resources. On the other hand, when individuals do not have sufficient conditions to complete a
specific behaviour, their intention to engage in that behaviour decreases. Chiciudean et al. found
that controllability is essential to Chinese consumer behaviour [54]. Sultan and Tarafder argued that
price and convenience are essential factors constraining consumer purchasing of organic food [55].
Beniwal suggested that the availability of organic food is a significant factor influencing household
purchasing behaviour; that is, an adequate supply of organic food in the market can increase
likelihood of purchase intention. Controllability also changes an individual behaviour [56]. When
consumers have sufficient resources and can control their behaviour, they will have enough
confidence, and their intention and action to purchase organic food will be stronger.
If consumers perceive significant barriers, such as the belief that engaging in healthy behaviour
requires expensive costs in terms of time and money, the likelihood of taking beneficial actions
decreases. When consumers believe they can purchase a particular product for food safety and
perceive a few or no barriers during the purchasing process, their controllability will be more robust,
and they will be more willing to purchase green products [57]. When consumers perceive that the
purchased food and its functions do not meet their expectations or may incur losses, they will
actively cope with potential losses and seek external help to overcome purchasing barriers and
purchase organic food. Based on these findings, we hypothesise the following:

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Hypothesis 8: Controllability positively promotes the intention to purchase organic beef.

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Hypothesis 8a: Health belief indirectly influences the intention to purchase organic beef
through controllability.

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3. Materials and methods

3.1 Data Collection and the Sample

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Using a quantitative design, the study was conducted through an online survey in China from
July to November 2022. China’s largest questionnaire survey platform was adopted for data
collection (www.wenjuan.com; accessed in July 2022). After a preliminary survey of 100
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consumers, the questions were revised to enhance readability. Having attached importance to the
investigation of consumers’ willingness to purchase organic food, organic meat, and organic rice,
previous studies did not specifically study the purchase intention of organic beef [58,59]. Therefore,
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the questionnaire survey method was used in this dissertation and organic beef consumption was
taken as an example to investigate consumers’ willingness to purchase organic beef. The target
group of this survey is consumers who have previously purchased beef, as only consumers who
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have purchased beef can perceive the characteristics of organic beef. Therefore, we set a screening
question, “Have you ever bought beef?”. The survey will continue only after the respondents have
bought beef. A total of 621 people participated in our survey. After deleting incomplete and
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unreliable questionnaires, a valid sample of 539 respondents was obtained, with a questionnaire
efficiency of 86.79%. According to Kline’s research [60]. The minimum sample size for empirical
surveys is 10 times that of measurement items. There were 20 measurement items in our study, so
539 effective sample sizes were acceptable.

3.2 Measures
Previous studies have focused on developed cities. This article surveyed Jiangxi Province in
central China to find out about organic food consumption in less developed areas. Based on
previous studies and discussed by three academic experts, this study modified the scale to adapt to
the consumption of organic beef in the Chinese environment. The scale include not only the
respondents’ perception of their own threatened health, but also iperceived benefit, moral norms,
self-efficiency, controllability and purchase intention of organic beef. The 5-point Likert scale was
used for all scales except demographic questions. The questionnaire items and their sources of
adoption are illustrated in Table 1.

Table 1. Questionnaire items and their source of adoption

Variables Items Measurement Items Adopted From
health belief Perceived The novel coronavirus has been detected in beef,I Huang and
(HB) susceptibility worried about buying infected beef Zhang [32]
Due to food safety issues, I concerned about purchasing
beef with veterinary drug residues
I worried that consuming infected beef poses a threat to
health
Perceived I concerned that eating problematic beef may threaten
severity life and health
Do you think that damage to family health due to
long-term consumption of problematic beef?
perceived PB1 Eating organic beef will make me healthier Teixeira et
benefit PB2 Organic beef gives me a greater sense of security than al.[61]
(PB) other beef

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PB3 Organic beef can enhance the nutrition and health of

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family members
moral norms MN1 In my opinion, Organic beef farming does not use Hossain et

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(MN) growth hormones al.[62]
MN2
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Organic beef production is less damaging to the
ecological environment
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MN3 Organic beef production is more in line with human
moral emotions
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self-efficiency SE1 I have sufficient experience to ensure that I can Sharma and
(SE) purchase safe organic beef Dayal[63]
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SE2 I have a good understanding of the nutritional value of

the organic beef purchased
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Controllability C1 I can easily and quickly purchase the organic beef I Han et al.[64]
(C) need
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C2 The price of organic beef is reasonable

C3 Organic beef can be purchased through many channels
and is convenient to buy
C4 I have enough time and money to buy organic beef
purchase BI1 In the future, I will buy organic beef Yazdanpanah
intention BI2 I prefer to buy organic beef over uncertified beef and Forouzani
(PI) BI3 I am willing to pay more for organic beef [65]

3.3 research method

Traditional multivariate statistical methods can only test the single relationship
between independent variables and dependent variables, while structural equation model
(SEM) can integrate regression analysis, factor analysis, path analysis and other methods,
and change the test of variable relations from exploratory analysis to confirmatory
analysis while dealing with multiple interrelationships of variables [66]. Structural
equation model allow for measurement errors in independent and dependent variables,
and the results are more accurate than traditional regression analysis. Data analysis in this
study is divided into three steps. First, the reliability and validity of the variables were tested using
SPSS26.0 and AMOS24.0 to ensure the goodness of fit of the structural model. Secondly,
AMOS24.0 was used to verify the hypothetical relationship among six variables: health beliefs,
moral morals, self-efficiency, controllability, purchase intention. The structural equation model
(SEM) includes dominant, potential, and error variables. The model formula is as follows:
Measurement model：X=Λxξ+δ (1)
Y=Λyη+ε (2)
Structural model：η=Bη+Γξ+ζ (3)

4. Results

4.1. Descriptive Statistics Analysis

As shown in Table 2, the number of females (63.6%) is significantly more than that of male
(36.4%). This may be because women are the major food buyers in Chinese households.
Respondents aged 26-35 account for the most significant proportion (41.1%), followed by those
aged 36-45 (18.4%), indicating that younger consumers are more willing to buy organic beef. In
addition, most respondents were in excellent physical health (78.5%). More than half of consumers
have a bachelor’s degree or above (56.5%). Regarding personal income, respondents with a
monthly income of 3,000-5,001 yuan topped on the list, accounting for 31.3%. In general, the
survey samples in this study are more consistent with the actual situation of organic consumption in

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China, which can be further analysed.
Table 2. Demographic characteristics of the samples (n = 539).

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Variables Frequency Percentage
Gender -p
male
female
196
343
36.4
63.6
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Age (years) 18-25 88 16.3
26-35 221 41.1
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36-45 99 18.4
46-55 97 18.1
over55 34 6.5
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Health condition Very unhealthy 5 0.9

Not very healthy 18 3.3
Good 93 17.3
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Relatively healthy 250 46.4

Very healthy 173 32.1
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Education Primary school and below 42 7.8

Junior high school 67 12.4
Technical secondary school or high school 49 9.1
Junior college 82 15.2
Undergraduate 241 44.7
Postgraduate 58 10.8
Income 0-3000¥ 109 20.5
3001-5000¥ 167 31.3
5001-8000¥ 148 27.5
over8000¥ 115 21.5
 4.2 Reliability and Validity Test

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According to the measured results of the model in Table 3, the standardised factor loading of

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each project is greater than the critical value of 0.50, and Cronbach’s α values were greater than the
threshold value of 0.7 [67]. Secondly, the composite reliability (CR) value was used to test the
reliability of the questionnaire. CR values are greater than 0.7, indicating that the indicators of each

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dimension have sufficient reliability and internal consistency [68]. The convergent and discriminant
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validity are used to measure the validity. The convergent validity is mainly reflected in factor load
and average variance extracted (AVE). The results show that the factor loading is greater than 0.6,
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and the average variance extraction (AVE) is greater than 0.5. This indicates that the scale has high
convergence validity [69].
Meanwhile, Table 4 shows the results of the discriminant validity test. The correlation
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coefficient between any two variables is less than the square root of AVE in each variable; the scale
has good discriminant validity [70]. Therefore, through confirmatory factor analysis（CFA）, the
model has sufficient reliability and validity.
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Table 3. Measurement model: reliability and validity

Construct Item code Loading CA CR AVE
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HB HB1 0.872 0.808 0.961 0.832

HB2 0.945
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HB3 0.988
HB4 0.894
HB5 0.855
PB PB1 0.777 0.73 0.769 0.528
PB2 0.644
PB3 0.753
MN SN1 0.745 0.786 0.788 0.554
SN2 0.774
SN3 0.713
SE SE1 0.859 0.764 0.856 0.749
SE2 0.872
C C1 0.756 0.749 0.819 0.532
C2 0.744
C3 0.724
C4 0.693
BI BI1 0.837 0.889 0.894 0.738
BI2 0.916
 BI3 0.822
Note: BI, behavioural intention; HB, health belief ; PB, perceived benefit; MN, moral norms; SE, self-efficiency; C,
Controllability.
Table 4. Discriminant validity
AVE HB PB MN SE C BI
HB 0.832 0.912
PB 0.528 0.340 0.727
MN 0.554 0.329 0.471 0.744
SE 0.749 0.224 0.289 0.492 0.865
C 0.532 0.264 0.389 0.601 0.605 0.729
BI 0.738 0.457 0.556 0.432 0.334 0.454 0.859
Note: The items on the diagonal represent the square roots of the AVE; off-diagonal elements are the correlation
estimates.

4.3 Model fitness test

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We further tested the fit of the measurement model using confirmatory factor analysis (CFA).
The results indicate that the proposed theoretical framework has good model fit（χ 2/df = 3.364，
GFI = 0.916，IFI = 0.926，TLI = 0.908，CFI = 0.925，RMSEA = 0.066). Table 5 shows the

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calculated indicator values for fitting the measurement model. All indicators meet the recommended
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standards: R2 is 0.57, meaning that the model can explain 57% of the total variance in this study.
Table 5. Summary of fit indices from confirmatory factor analysis.
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Fit Indices Model Recommended Value Results
CMIN/DF 3.364 >1 and <5 Satisfactory
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GFI 0.916 ≥0.9 Satisfactory

IFI 0.926 ≥0.9 Satisfactory
TLI 0.908 ≥0.9 Satisfactory
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CFI 0.925 ≥0.9 Satisfactory

RMSEA 0.066 ≤0.08 Satisfactory
R2 0.57
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Note: GFI, goodness-of-fit index; TLI, Tucker-Lewis index; CFI, comparative fit index; IFI, incremental fit index;
RMSEA, root mean square error approximation.
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4.4 Test of the Measurement Model

As expected, health beliefs can significantly promote perceived benefits（β= 0.351, p<0.001),
moral norm（β= 0.338, p<0.001), self-efficiency（β= 0.256, p<0.001), controllability（β= 0.277,
p<0.001) and purchase intention（β= 0.242,p < 0.001）.Therefore, the research hypotheses H1, H2,
H3, H4, and H5 are supported. In addition, perceived benefits positively promote the formation of
willingness to purchase organic beef（β= 0.366, p<0.001）. Moral norms positively promote the
formation of willingness to purchase organic beef （ β= 0.103,p<0.05 ） . The stronger the
controllability of consumers, the more likely they are to buy organic beef（β= 0.209，p<0.001）.
Therefore, the research hypotheses H6, H7 and H9 are supported. However, self-efficiency did not
significantly affect organic beef purchase intention (β=0.072, p>0.05). The research hypothesis H8
could not be confirmed. Table 6 shows the hypothesis testing results of the structural equation
model.
Table 6. Results of the hypothesis test.
Hypothesised Path Estimate S.E. T Results
HB→PB 0.351 0.217 4.659 ***
Supported
HB→MN 0.338 0.217 4.608 ***
Supported
HB→SE 0.256 0.171 3.291 ***
Supported
HB→C 0.277 0.162 4.115*** Supported
 HB→BI 0.242 0.21 3.854*** Supported
PB→BI 0.366 0.061 6.986 ***
Supported
MN→BI 0.103 0.052 2.241 *
Supported
SE→BI 0.072 0.074 1.485 Not Supported
C→BI 0.209 0.066 4.444*** Supported

4.5 Mediation effect test

Next is the evaluation of the mediation model. The bootstrap method proposed by Hayes et al.
(2009) was used to test the mediation effect. According to previous studies, the mediation effect test
is conducted in AMOS. In 95% confidence intervals, the existence of indirect effects depends on
whether 0 is included between the upper and lower limits. When the main effect is significant, if the
lower limit and upper limit contain 0, the mediation effect does not exist. If 0 is not included, there is
a mediation effect [71,72]. In AMOS, We set the sample size at 5000 with 95% confidence. The
results are shown in Table 7. Confidence intervals for perceived benefit (β = 0.43, p = 0.05), moral
norm (β = 0.117, p < 0.05) and controllability(β = 0.194, p < 0.05) do not contain 0, so the direct
effect is significant. Therefore, health beliefs can indirectly affect organic beef purchase intention

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through perceived benefits, subjective norms and controllability. This also suggests the existence of

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partial mediation effect. This can provide solid evidence for H6a, H7a and H9a. However,
self-efficiency contains 0 between the upper and lower limits at the 95% confidence
interval(β=0.062, p>0.05). So the main effect is not significant, meaning that H8a fails the test.

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Table 7. Results of mediating effect test.
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Parameter Estimate Lower Upper P Results
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HB→PB→BI 0.43 0.228 0.821 0.001 Accepted
HB→MN→BI 0.117 0.112 0.317 0.005 Accepted
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HB→SE→BI 0.062 -0.032 0.204 0.167 Rejected

HB→C→BI 0.194 0.077 0.409 0.002 Accepted
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5. Discussions and Implications

5.1 Discussions of findings
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This study takes health belief theory, theory of planned behaviour, and norm activation theory
as theoretical foundations. Then, key variables are extracted from these three theories. The health
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belief is adopted as the driving factor of the model. Perceived benefits, moral norms, self-efficacy,
and controllability are used as mediating variables to explore the driving mechanism of health on
organic food purchasing. Thereafter, we discuss the empirical results based on the current situation
of organic food consumption in China.
First, health belief is a perceived risk evaluation variable. It can significantly promote other
variables in the health-driven mechanism model. Meanwhile, it can effectively predict consumers’
willingness to purchase organic beef. Furthermore, the structural equation model validates
correlations among the variables in the health belief model. Consumers with stronger health beliefs
perceive higher risks in food. These consumers are more concerned about buying beef that may be
infected with diseases and threaten their health. This conclusion is consistent with the study by Chai
and Wang [44, 45]. They found that food safety concerns and attitudes of consumers can promote
organic food consumption intentions, and that health-conscious consumers also increase their
organic food purchases.
Therefore, these consumers are more likely to perceive organic beef as safer and of higher
quality. At the same time, consumers with a stronger awareness of health consequences have more
apprehensions about environmental protection and animal welfare. This can lead to the formation of
personal moral norms and a positive influence on moral norms. This is consistent with the study of
Czudec, A et al [51]. In other words, due to the abuse of hormones in the meat production process,
breeding methods do not conform to the natural growth laws of animals. As a result, individuals
with strong health consciousness realize the importance of the coordinated development of human
health and ecological health. This proposition is confirmed in this study. This will stimulate their
formation of personal moral norms. Consumers with stronger health beliefs also significantly
promote self-efficiency and increase their confidence in purchasing organic beef. They are also
willing to overcome barriers such as cost and convenience to buy organic beef [52,53]. Food safety
incidents as external shocks have disrupted consumers’ original purchasing patterns, increased
consumers’ perception of risks in traditional food, and decreased consumers’ willingness to
purchase. On the contrary, the COVID-19 pandemic has raised consumers’ concerns on their health.
Their demand for healthier, safer, and more nutritious food increases [55,56]. This means
consumers are willing to break through barriers, change their original consumption concepts and
habits, and accept healthier organic food.
Second, this study demonstrates that consumers’ perception of the health benefits of organic
beef can positively influence their purchase intention. For every unit increase in perceived benefits
of organic beef, consumers’ purchase intention will increase by 36.6%. Additionally, stronger moral
norms awareness among consumers can promote their purchase intention towards organic beef,
with a 10.3% increase for every unit increase in moral norms. This finding is consistent with
previous conclusions [34]. Furthermore, controllability also significantly promotes consumers’
purchase intention towards organic beef, with a 20.9% increase for every unit increase in
controllability. When consumers believe they have sufficient control over resources such as money,
time, and effort, their purchase intention towards organic food will be enhanced. However,
consumers’ self-efficiency is not significantly associated with their purchase intention towards
organic beef. This inconsistency in findings may be explained by the unstable predictive ability of

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self-efficiency in different contexts. Some scholars argue that self-efficiency varies across other

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activity domains due to differences in required abilities and skills, This result supports Jiao and
Hale, which holds a similar conclusion [73,74]. Organic food, which relies on government
certification and corporate production regulation, tends to establish its position in consumers’ minds

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through certification and information disclosure [75], while consumers’ self-efficiency represents
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their confidence in purchasing. On the one hand, organic awareness has not yet deeply penetrated
the public consciousness, and consumers cannot judge the quality of organic food based on their
purchasing experience [76]. On the other hand, the characteristics of organic food, which are
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described by the production and supply side to consumers, belong to external information [77].
Nevertheless, affected by information asymmetry, consumers are sceptical about the benefits
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of organic food. Therefore, self-efficiency does not play a significant role in forming purchase
intention, which is contrary to the study conducted by Ashraf [78], His research suggests that high
levels of self-efficacy among consumers can promote organic food consumption. In addition,
consumers’ belief in pursuing health cannot influence the formation of purchase intention through
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their confidence in purchasing organic food. A main cause of this is that their affirmation of organic
food is not internalised. Under the overlapping impact of the COVID-19 pandemic and food safety
risks, consumers’ confidence in purchasing organic beef varies greatly. Some consumers have a
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good understanding of the health and nutritional status of organic beef. They believe that they will
purchase organic beef. But are some consumers have concerns about buying organic beef, because
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of a lack of purchase channels.

Third, research findings indicate that health beliefs can indirectly influence consumers’
willingness to purchase organic beef through perceived benefits, moral norms, and controllability.
During the COVID-19 pandemic, consumers with A higher awareness of food safety care more
about the safety and quality of food. This is because the virus was found in beef during the
COVID-19 outbreak in China. For example, in November 2022, China found the novel coronavirus
in a batch of imported Argentine beef. It was highly possible to contract the virus from eating
ordinary beef that had not been tested. These consumers better understand the benefits and
significance of organic food for health and environmental protection, which increases their
willingness to purchase organic beef. This result is in line with the study conducted by Guanqi, Z.;
Husnain, M. et al [50]. Similarly, consumers with a stronger health belief exhibit a higher sense of
moral responsibility and are more likely to overcome barriers such as convenience in purchasing
organic food [43,57]. These consumers also have a stronger intention to buy organic beef. However,
the health belief model does not indirectly affect willingness to purchase organic beef through
self-efficiency.
5.2 Theoretical Implications
The results of this research provide various theoretical meanings for organic food
consumption. First, to our knowledge, no previous studies have combined the HBM, TPB, and
NAM theories to explain Chinese consumers’ purchasing behaviour toward organic food
[31,34,35]. On the contrary, this study establishes an updated model of organic food purchasing
intention driven by health. Second, in previous studies, when research was carried out with health
belief theory as its theoretical basis, the focus was usually on examining the willingness to
consume by using variables such as perceived susceptibility, perceived severity, perceived benefit,
perceived barriers, and self-efficacy [32], but the correlation among variables involved in health
belief theory were left unexplored. Third, some scholars believe that the theory of planned
behaviour provides prerequisites for action implementation through the variables of attitude,
subjective norm, and perceived behavioural control, but it does not provide motivational driving
force for action. Therefore, we have introduced health belief variables, including perceived
susceptibility and perceived severity, as the driving factors for the entire model. This study is
helpful to enrich the theoretical connotation of the study of organic food purchase intention. It has
reference significance for subsequent research.
5.3 Practical Implications
Some scholars have proposed that with the continuous improvement of Chinese residents’
living standards, Chinese residents’ food consumption continues to upgrade. This has increased
the level of meat consumption, thus posing a major challenge to sustainable development [79].
Compared to conventional meat, organic meat can reduce greenhouse gas emissions and overuse
of natural resources during production. Therefore, the results of this study can help marketers,
policymakers and environmental groups better understand the various needs and motivations of
consumers for organic meat consumption, such as health needs and emotional appeals, and adjust
marketing strategies accordingly to promote consumers’ organic meat consumption.
In keeping with recommendations by other researchers, the findings of this study can help the

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China government promote organic food and raise consumer awareness of organic consumption

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effectively [35]. The government can make propaganda in the form of slogans or slogans. In the
longer term, however, the sustainable consumption benefits of organic food should be included in
national education programs to help children develop sustainable consumption attitude and

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behaviour from an early age.
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The study found that consumers have limited awareness of various certification standards and
regulatory systems for organic food. As a result, they tend to be sceptical about organic food. The
outbreak of quality and safety issues in certified organic food has greatly undermined consumer
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confidence in purchasing. For example, the “Sanlu Milk Powder Incident” in China in 2008
caused many infants to suffer from kidney dysfunction or even death. Even to this date, Chinese
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parents are still living in the aftermath of this scandal [80]. They dare not purchase infant formula
produced by Chinese companies. So it is urgent for Chinese government to build a supervisory
and management system for organic food. This supervisory and management system can help
resolve the social trust crisis caused by food safety issues.
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The findings reinforce the idea that health belief promotes organic food purchase intentions.
Food safety incidents have dealt a heavy blow to consumers’ confidence in food safety.
Consumers tend to pay more attention to information on food safety and quality, and prefer to
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purchase healthy organic food [81,82]. Therefore, producers and marketers need to use various
media, such as videos or images, to show consumers the production process of organic food,
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including production, transportation, and sales. Through these media, consumers can better
understand the benefits of organic food for health and the environment.
China was a late starter in organic food development. This can explain the varying
development speeds of different types of organic food. For example, organic vegetables and
organic rice have relatively matured development, while organic animal husbandry still lags
behind Western countries. In the future, with the progress of urbanization in China and the
continuous increase of middle-income population, the demand for animal products will further
increase. Therefore, the government and enterprises need to constantly enrich the supply of
organic animal products and services, and ban animal husbandry practices that harm animal
welfare and pollute the environment [83]. All these measures can help speed up the green
transformation of animal husbandry. In addition, to reduce the psychological distance with
consumers, it is necessary to lower the prices of organic food and narrow the gap with regular
food. The issue of generally high prices of organic food still exists in the Chinese organic food
consumer market. Multiple channel strategies should be adopted to reduce the cost of organic food
[84]. Last but not least, organic food manufacturers should strengthen their technological
innovation, increase production, and reduce production costs, so that consumers can afford healthy
and safe organic food.

6. Conclusions
6.1 Research summary and conclusion
Against the backdrop of the post-pandemic period and food safety incidents, this study
investigates the intention of Chinese consumers to purchase organic beef in the central region of
China. The main objective of this study is to identify factors that can enhance or hinder consumers’
willingness to buy organic beef. The survey results indicate that factors such as health belief (HB),
perceived benefit (PB), moral norms (MN), and controllability (C) play a crucial role in shaping
consumers’ intention to purchase organic food, but self-efficiency (SE) had no significant effect on
consumers’ organic beef purchase intention. In addition, the results also show that consumers’ own
health belief can indirectly affect consumers’ organic beef purchase intention through PB, MN, C,
etc. They can also validate the path relationships and mechanisms between health belief and other
variables. In conclusion, strategic management of the factors that influence organic beef purchase
intentions can increase consumers’ purchase intentions.
6.2 Research limitation and future research direction
This study has the following limitations: We only measure consumers’ purchase intention and
ignore that there is a significant gap between purchase intention and actual behaviour. Although we
have modified and replaced variables based the Theory of Planned Behaviour and Health Belief
Model to propose a new health-driven model for organic food purchase intention, we have not
covered variables like willingness and actual organic beef purchase behaviours based on the above
mentioned theoretical framework. As willingness may not be the same as the actual behaviour [85],
this study can cover actual purchasing behaviour in the future. Besides, many of our perceptions are
affected by culture, and food consumption is no exception. Further research may compare the
differences in organic food consumption per different cultural dimensions [86].

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Author Contributions: Conceptualisation,C.W.;methodology,J.G.; software, C.W.; validation,C.W., W.H. ; formal
analysis,,J.G.,Y.T.; investigation,W.H.; resources, J.G.; data curation, W.H.; writing—original draft preparation,
C.W.; writing—review and editing, C.W., R.L. X.Y.; visualisation, W.H.; supervision, ,J.G.,Y,T.; project

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administration,,J.G.; funding acquisition, J.G.All authors have read and agreed to the published version of the
manuscript.
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Funding: This research was funded by the National Natural Science Foundation of China(project number:
72063017); Jiangxi Modern Cattle and Sheep Technology Industry System Special Fund (Project number:
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JXARS-13-Economic Post); Social Science Fund of Jiangxi Province “Qingma Project” special project(project
number: 23ZXOM61).
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Institutional Review Board Statement: Not applicable.

Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.
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Data Availability Statement: The data are available from the corresponding author on reasonable request.
Acknowledgments: The authors are thankful to the anonymous reviewers and the editor for their
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valuable comments.
Conflicts of Interest: All authors declare that there are no conflict of interest.
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 Declaration of interests

☒ The authors declare that they have no known competing financial interests or personal relationships
that could have appeared to influence the work reported in this paper.

☐ The authors declare the following financial interests/personal relationships which may be considered
as potential competing interests:

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