Development and Validation of a Scale for Perceived Health Information Fog Among Social Media Users from the Perspective of Information Ecology

The phenomenon of health information fog on social media has become increasingly prevalent, posing significant challenges to users’ health literacy, decision-making, and the sustainable development of social media information ecosystems. This study aims to develop a robust and effective scale to measure users’ perception of health information fog and to uncover its underlying mechanisms. Grounded in information ecology theory, the initial scale was developed through a literature review, semi-structured interviews, and grounded theory. A pilot survey involving 155 respondents was conducted, followed by a formal survey with 561 participants. Exploratory and confirmatory factor analyses were employed to validate and refine the scale, resulting in a final version comprising 46 items across eight dimensions: health information overload, low-quality information, unclear information sources, group blind following, cognitive conflict, anxiety, group polarization, and urgent demand for health information. A normative model was further constructed to categorize users into five levels of perception intensity: low, relatively low, moderate, relatively high, and high. This study provides targeted intervention strategies for stakeholders and offers a scientific foundation for optimizing information dissemination while promoting the sustainable development of social media ecosystems.