A Study Of Health Beliefs Among Chinese Adults

Health is the basis of human survival and development, and a basic precondition for happiness. A nation?s level of health is an important component of its strength and competitiveness, making health a key strategic factor in the nation?s economic and social development. Health beliefs have great significance in promoting individuals? health and cultivating healthy lifestyles. We consider people?s health beliefs to be a set of firmly held opinions about healthy living-individual systems of ideas relating to illness prevention, maintaining health, and striving to attain the best possible health status. This includes an individual?s ideas about issues, such as the definition of health, the importance of health, factors influencing health, methods for improving health, etc. Individuals holding different health beliefs will thus, exhibit different health behaviors, lifestyles, and health conditions. This study examinedspecificcharacteristics, composition, and mechanisms of health beliefs among Chinese adults using a mixed-methods qualitative and quantitative approach. Our research includes four sections.The first section summarizes our literature review and presents our research questions. Health is not a static state, but rather a dynamic process with a tendency to achievinga better condition; an individual has a great deal of autonomy concerning his or her health and health beliefs play a guiding role in shaping health behaviors, lifestyle, and health status. While reviewing the three main research approaches to health beliefs(empirical, hermeneutic, and socio-cultural), we discovered that previous research on health beliefs has been primarily concerned with disease-related beliefs and that comparatively, few studies have investigated beliefs about the active promotion of health. The composition of health beliefs in foreign countries might not be suitable for representing those of China and only a few domestic studies have thoroughly explored the health beliefs of Chinese adults. Therefore, based on these findings, we formulated our research questions and study design.The second section consists of two qualitative research studies. The first study investigated the health beliefs among modern Chinese adults using health-related proverbs. Our researchers evaluated 1,323 health adages contained in recently published collections of health-related proverbs, eliminating redundant and obscure proverbs to obtain 369 proverbs with clear meanings. The results of a survey of 518 participants measuring their degree of familiarity with and beliefs about the proverbs indicated that the most familiar and widely believed proverbs included six main types: 1) maintaining health through morality and refining mind and nature; 2) eating and drinking in moderation and practicing healthy lifestyle habits on a routine basis; 3) taking preventative health measures and the importance of a healthy body in fending off disease; 4) conforming to nature and maintaining positive habits; 5) using diet as medicine; and 6) other categories. We provided these categories as a reference for future research of the composition of lay health beliefs. The second study involved conducting in-depth interviews with 21 respondents; the results of the analysis indicated that lay health beliefs not only included absence of illness, but also the pursuit of happiness, and the belief that one?s lifestyle can promote health. These findings can also serve as a reference for the future development of preliminary scales to measure lay health beliefs among Chinese adults.The third section consists of five quantitative research studies(Studies 3 to 7). The third study examined the basic content of lay health beliefs through the analysis of in-depth interviews of the respondents? degree of familiarity with and beliefs about the health-related proverbs using an open-ended questionnaire survey of 189 adult respondents. Furthermore, we selected health beliefs with a high degree of familiarity based on the ratings of 293 respondents, and used them as the basis for developing a preliminary multidimensional measure of Chinese adults? health beliefs. This preliminary measure was used to survey 362 Chinese adults. We performed item analysis and exploratory factor analysis of the survey results to obtain the final 28-item multidimensional measure of health beliefs. Thereafter, confirmatory factor analysis and correlation analysis of the 367 respondents? answers on the final measure confirmed that the survey instrument met standard psychometric requirements, was practical, and had a high degree of reliability. The fourth study examined the basic state of health beliefs among Chinese adults by investigating differences in health beliefs based on demographic variables, such as sex, age, marital status, educational level, and household income. We found that the levels of the absence of illness belief were significantly higher in the married cohort than in the unmarried adult cohort. Furthermore, the levels of health habits and behaviors belief and the absence of illness belief among the cohorts with household incomes under 100,000 RMB, were significantly lower than those of all cohorts with household incomes over 100,000 RMB. This finding indicates that using a multidimensional measure of health beliefs among Chinese adults can differentiate demographic groups with dissimilar health beliefs. The fifth study investigated the relationship between health beliefs and health-promoting lifestyles and subjective well-being. We found that health beliefs positively predicted subjective well-being and that a health-promoting lifestyle played an intermediary role between health beliefs and subjective well-being. These findings revealed the close relationship between health beliefs and health behaviors, illustrating that the core value of health beliefs is a behavioral tendency. Our findings also indicated that the multidimensional measure of health beliefs among Chinese adults had a high degree of content validity. The sixth study investigated health beliefs as predictors of a health-promoting lifestyle and examined the influence of personal experience on the relationship between health beliefs and health-promoting lifestyle. The findings revealed that self-esteem, positive emotion, and loneliness were factors influencing the predictive ability of health beliefs on health-promoting lifestyles. This indicates that health beliefs have a high degree of predictive ability for health behaviors after controlling for personality factors, and that it further demonstrates the effectiveness of a multidimensional measure of health beliefs among Chinese adults. The seventh study was an experimental investigation of the relationship between health beliefs and the resting state f MRI data(regional homogeneity, Re Ho). Our findings revealed that each of the health belief dimensions corresponded to different modes of brain activity, indicating that the four dimensions of this measure seem to have a physiological basis.The fourth section includes a comprehensive discussion and conclusion. We further analyze the reliability of the multidimensional measure of health beliefs among Chinese adults, as well as the rationality of the four-dimensional structure of health beliefs. First, we discuss the temporal traits of the four dimensions of health beliefs. Second, we interpret the traditionality of the four dimensions of health beliefs. Third, we analyze the discriminability of the multidimensional health beliefs scale for Chinese adults. Finally, we propose methods for promoting China?s national health, a combination of further enhancing positive lay health beliefs and promoting healthy behaviors. Thus, beliefs and actions should mutually advance one another, creating a positive interaction between health beliefs, health actions, and health status that will ultimately benefit the people of China.Our research yielded the following conclusions:(1) Chinese adults? health beliefs include health philosophies from traditional Chinese culture, as well as modern notions. This was reflected in both the proverb analysis and in-depth interviews.(2) The multidimensional measure of health beliefs among Chinese adults includes four dimensions: virtue cultivation; health behaviors and habits; absence of illness, and adaptability and enjoyment. This measure is practical and has a high-degree of reliability.(3) Statistically significant discrepancies in health beliefs were found among the Chinese adults; this was seen in the level of absence of illness belief, which was significantly higher among the married adult cohort than the unmarried adult cohort was. Additionally, the level of beliefs about health behaviors and habits, and the level of absence of illness belief was significantly lower among the cohorts with a household income of less than 100,000 RMB than among all cohorts with a household income of over 100,000 RMB.(4) Health beliefs are a positive indicator of subjective well-being, mediated through a healthy lifestyle.(5) In terms of national health education, we propose a combination of further enhancing lay health beliefs and promoting healthy behaviors. Thus, beliefs and actions should mutually advance one another, creating a positive interaction between health beliefs, health actions, and health status that will continue to improve the health of the Chinese people.