Integrating public health advertising and the health belief model to predict diabetes prevention intention: evidence from Indonesian young generations

Purpose This study aims to develop and empirically examine an integrative framework combining public health advertising, health literacy, and the Health Belief Model (HBM) to explain diabetes prevention intention among Indonesian young generations. The study specifically investigates how exposure to social media health advertising and government public health advertising influences health literacy, perceived susceptibility, perceived severity and health consciousness in shaping diabetes prevention intention. Design/methodology/approach A quantitative cross-sectional survey was conducted among 500 Indonesian Millennials and Generation Z respondents. Data were collected through an online questionnaire and analyzed using partial least squares structural equation modeling. The study assessed direct and indirect relationships among public health advertising exposure, health literacy, HBM constructs and diabetes prevention intention. Findings The findings reveal that both social media health advertising and government public health advertising positively influence health literacy, with social media exposure demonstrating a stronger effect. Health literacy significantly enhances perceived susceptibility, perceived severity and health consciousness. Health consciousness emerged as the strongest predictor of diabetes prevention intention, followed by perceived susceptibility, while perceived severity showed no significant direct effect. Furthermore, health literacy significantly mediates the relationship between both forms of health advertising exposure and diabetes prevention intention through health consciousness. Research limitations/implications This study contributes to the health behavior and health communication literature by demonstrating that public health advertising influences diabetes prevention intention primarily through health literacy and health consciousness. The findings extend the HBM by incorporating communication exposure as an antecedent of cognitive and motivational processes underlying preventive intention. Furthermore, the study highlights health consciousness as a more influential predictor than perceived severity among younger populations, suggesting that future diabetes prevention research should emphasize lifestyle-oriented psychological mechanisms and digital health communication strategies. These insights provide a foundation for advancing integrated models of chronic disease prevention in emerging economies. Originality/value This study extends the HBM by integrating public health advertising and health literacy into a unified predictive framework for diabetes prevention intention. The study provides novel evidence from an emerging economy context and highlights health consciousness as the primary psychological mechanism linking health communication and preventive intention among younger generations.