The mediating role of health literacy between information overload, risk perception, and health information avoidance

This study examines how external stimuli (e.g., information overload, risk perception) interact with internal emotional states (e.g., health information anxiety and sadness) to trigger health information avoidance (behavioral outcomes/response), with health literacy as a mediator. The study attempts to develop and test a seven-factor measurement model based on the expanded Stimulus-Organism-Response (S-O-R) framework. The findings confirmed that information overload and risk perception significantly increase both health information anxiety and avoidance, and that avoidance directly predicts poor health outcomes. It demonstrates that sadness, often overlooked in favor of anxiety, plays a significant role in driving avoidance. It also identifies health literacy as a critical mediator, suggesting that improving literacy reduces avoidance not directly but by buffering emotional distress. Our study carries several important contributions, for example, it extends prior work by incorporating sadness (beyond anxiety/fear) as a response to overload/risk; it incorporates health literacy as a mediator between stimuli (information overload/risk perception) and organism (information anxiety/sadness). The findings offer actionable insights for university-based interventions aimed at breaking the cycle of information overload, emotional distress, and avoidance.