Family protection motivation and economic vulnerability: a network analysis of public influenza risk perception, education and mitigation strategies in China.

Background: In the post-pandemic era, influenza and COVID-19 jointly exacerbate global public health burdens, yet persistent biases in risk perception drive declining vaccination rates and health disparities. Conventional linear models fail to capture the complex interactions between risk cognition, family protection motivation, and socioeconomic vulnerability-particularly within collectivist contexts like China. This gap impedes effective interventions targeting critical behavioral nodes in influenza mitigation.

Objective: This study employs network analysis to uncover the core structural features of influenza risk perception among the Chinese public, examining the association between science literacy and risk perception to inform targeted mitigation and intervention strategies.

Design: A multicenter, cross-sectional network analysis study using convenience sampling.

Setting: Fifteen provinces across mainland China, covering eastern, western, southern, northern, and central regions.

Participants: 1,416 individuals aged 18-70, representing diverse occupations, education levels, and income groups.

Results: The public's influenza risk perception network exhibited a "family-knowledge-economy" triadic structure. "Risk of family infection" (M_2) emerged as the central node (strength = 2.165), while "transmissibility knowledge" (F_3) and "socioeconomic loss" (S_2) served as the key knowledge nodes (strength = 1.520) and bridge node (bridge strength = 2.037). Additionally, science literacy moderated risk perception by enhancing perceived control, with the strongest association observed between knowledge level and "temporal controllability" (C_3, edge weight = 0.25). Family-based knowledge-sharing effects were significant (K_1-K_2 edge weight = 0.42). Network stability tests confirmed robustness (centrality stability coefficient CS > 0.5, core node differences  < 0.01).

Conclusion: Network analysis reveals a "family-knowledge-economy" triad governing influenza risk perception, with family infection risk (M_2) as the central driver (strength = 2.165) and socioeconomic loss (S_2) as the pivotal bridge node (bridge strength = 2.037). Science literacy amplifies perceived controllability (C_3-K_1 edge = 0.25) but fails to alleviate economic anxiety, underscoring the need for integrated structural policies. Family-centered interventions-leveraging tiered communication, economic security narratives, and real-time surveillance of network dynamics-are essential to optimize public health strategies in collectivist societies.