Objective: Despite the proliferation of health apps that facilitate users’ healthy lifestyles, little empirical research examines the relationship between health app use and actual health behaviors among international students who reside in non-Western countries. Previous literature suggests that educational migration may affect international students’ health behaviors (Tunc, Bilgin, & Cerit, 2021). This study aims to examine international students’ health app use and the factors related to their intention to participate in health behaviors, employing the theory of planned behavior in China.

Procedures and Methods: International students from Malaysia (n = 322) and Korea (n = 179) participated in the anonymous online survey. The 24-item survey measured the international students’ demographics (e.g., age, sex, nationality, and education), frequency of health app use, attitudes toward performing health behaviors (e.g., doing a workout, no smoking or drinking, and eating a healthy diet), subjective norms of participating in health behaviors, perceived behavioral control, behavioral intention, and frequency of performing health behaviors (Ho, 2015; Park & Yang, 2012; Yang & Wu, 2019). Structural equation modeling (SEM) analyses were performed to examine the associations among the key variables.

Results: Results of SEM analyses indicated that respondents’ health app use exerted indirect effects on their participation in health behaviors. Attitudes (β = .049, CI [0.025-0.085]), subjective norms (β = .014, CI [0.014-0.033]), and perceived behavioral control (β = .022, CI [0.007-0.042]) positively mediated the associations between health app use and behavioral intention. Attitudes, subjective norms, and perceived behavioral control significantly predicted behavioral intention and actual health behaviors. Our results further showed that the positive associations between health app use and attitudes or subjective norms were moderated by respondents’ nationality. Health app use induced more positive attitudes and stronger subjective norms among Malaysian students than Korean ones.

Theoretical and practical implications: This study examines the relationship between health app use and health behavior participation among international students in the context of China. Such examinations go beyond prior work on local university students or work mainly conducted in Western countries. International students who utilized the health apps of the host country where they live and study more frequently were more likely to engage in a series of health behaviors. In addition, the influence of health app use on attitudes or perceived behavioral control was contingent on respondents’ nationality. These findings have supported the applicability of the theory of planned behavior in the digital era and in a non-Western culture, highlighted the importance of smart technologies in promoting international students’ health behaviors, and enlightened educators on how to design interventions and campaigns to improve international migrants’ healthy lifestyle behaviors.