Lived Efficacy and Chinese Medicine: Post-COVID-19 Self-Health Management in Chinese Mainland

While a growing body of research has emphasized the role of state-granted legitimacy in shaping public acceptance of complementary and alternative medicine (CAM), less is known about why public views of CAM may remain heterogeneous even when it receives official endorsement. We address this question by highlighting the importance of user experience, using Chinese mainland as a case study. Chinese medicine (CM) is a well-known form of CAM that is deeply embedded in China’s healthcare system, supported by extensive infrastructure and strong policy backing. Drawing on in-depth interviews about people’s use of CM for self-treatment and rehabilitation after COVID-19, we find that “lived efficacy”, a subjective evaluation of effectiveness grounded in personal experience, plays a salient role in health-related decision-making. Individuals with positive prior experiences of CM tend to rely less on external information and often differentiate among various forms of CM, including state-endorsed products and folk practices. By contrast, those without such lived efficacy are more likely to adopt state-endorsed CM remedies based on trusted health information sources, such as government messaging. This study contributes to the literature by showing that the effects of state-granted legitimacy and institutional trust on CAM adoption are conditional and mediated by a multidimensional decision-making process. Lived efficacy and information trust constitute two key mechanisms through which respondents interpret the efficacy-based legitimacy of CM.