Cognitive and Structural Pathways to Preventive Health Behaviours in the Digital Era: A Case of Sierra Leone

Purpose: Despite the increasing use of digital platforms during health emergencies, little is known about the cognitive and structural mechanisms through which social media quality information influences preventive healthcare behaviour, particularly in low-resource settings. Drawing on the integration of the Protection Motivation Theory and Andersen’s Behavioural Model, this study examines how social media quality information shapes preventive healthcare behaviour in Sierra Leone by investigating the mediating role of risk perception and the moderating role of psychological resilience. Methods: A quantitative, cross-sectional survey approach was adopted, and data were collected from social media users in Sierra Leone, Africa, and analysed using IBM SPSS 25 and SmartPLS 4.1 to evaluate the measurement and structural models. Results: The findings disclose that SMQI significantly influences preventive behaviour both directly and indirectly via RP. Furthermore, RES positively and significantly moderates the relationship between risk perception and preventive healthcare behaviour, acting as a catalyst for action, while access to preventive resources (AcPR) serves as a critical enabling factor. Implications: This study advances health behaviour theory by integrating cognitive, psychological, and structural determinants into a cohesive model and establishes resilience as a vital boundary condition for effective crisis response. The findings offer actionable insights for policymakers and health communicators to design high-quality social media interventions that not only inform citizens but also foster the psychological resilience necessary for sustained health compliance.