**Background:** The COVID-19 pandemic significantly altered consumer food purchasing behaviors, with organic food gaining popularity due to its perceived health and safety benefits. The global organic food market grew from $115 billion in 2019 to $136 billion in 2021. In China, the fourth-largest organic market, organic food sales reached $15.83 billion in 2021, an 18.3% increase over 2020. However, organic food still constitutes less than 1% of China's total food market. Previous research focused on initial purchase intentions during the pandemic, but little was known about factors driving continued purchase intentions in the post-pandemic period, particularly in the Chinese context.
**Methods:** Data were collected via an online questionnaire (www.wenjuan.com) distributed through WeChat from November 1–15, 2022. The target population was Chinese consumers aged 20 years and older. Of 514 questionnaires received, 54 were excluded due to linear response patterns or incomplete data, yielding 460 usable responses (89.5% usable rate). The sample was 51.7% female and 48.3% male, with most respondents aged 20–30 years. The questionnaire used a 7-point Likert scale and measured nine constructs: attitude, subjective norms, perceived behavioral control (PBC), face consciousness, group conformity, health consciousness, perceived value of organic food (PVOF), impact of COVID-19 (IOC), and continuous purchase intention (CPI). Data were analyzed using SPSS v29 and AMOS v29, with confirmatory factor analysis (CFA) for reliability and validity, followed by structural equation modeling (SEM) for hypothesis testing.
**Key Results:** The M-TPB model demonstrated superior explanatory power (R² = 0.65) compared to the standard TPB model (R² = 0.40). Both models showed good fit: for M-TPB, RMSEA = 0.045, CFI = 0.973, TLI = 0.973, IFI = 0.968, GFI = 0.926, χ²/df = 1.916. All Cronbach's α values exceeded 0.7, composite reliability (CR) ranged from 0.819 to 0.938, and AVE scores ranged from 0.601 to 0.835, confirming adequate reliability and validity. Path analysis revealed that attitude (β = 0.223, t = 7.647, p < 0.001) and PBC (β = 0.051, t = 2.582, p < 0.05) significantly predicted CPI in the M-TPB model. Subjective norms were not significantly related to CPI (β = 0.057, t = 1.515, p > 0.05). Face consciousness (β = 0.082, t = 3.315, p < 0.001) and group conformity (β = 0.102, t = 4.768, p < 0.001) both significantly influenced CPI. Health consciousness showed a strong positive effect (β = 0.338, t = 7.861, p < 0.001). PVOF had the largest influence among M-TPB constructs (β = 0.2100, t = 5.816, p < 0.01). IOC significantly and positively affected health consciousness (β = 0.190, t = 5.122, p < 0.001), PVOF (β = 0.272, t = 6.900, p < 0.001), and CPI (β = 0.091, t = 3.714, p < 0.001).
**Clinical Implications:** While this study is not directly clinical, it has public health implications. The findings suggest that the COVID-19 pandemic has created a window of opportunity for promoting healthier and safer food choices, including organic food consumption. Health consciousness emerged as a critical driver of continued organic food purchase intentions, indicating that public health messaging emphasizing the health benefits of organic food could be effective. The significant role of IOC suggests that pandemic-related health concerns can be leveraged to encourage sustained healthy eating behaviors. For stakeholders in the organic food industry, strategies should focus on communicating the nutritional and safety value of organic products, leveraging social influences (face consciousness and group conformity), and reinforcing positive attitudes toward organic food to maintain consumer engagement in the post-pandemic era.