A Study On The Influencing Factors Of Health Promotion Behaviour In People At High-risk Of Stroke

ObjectivesThe study aims to explore the influencing factors of health promotion behavior and the moderating role of social capital in the influencing pathway for people at high risk of stroke by constructing a moderated mediated effects model guided by the theory of planned behavior and social capital theory.MethodsA face-to-face questionnaire survey was conducted from November 2020 to April 2021 with 263 people at high risk of stroke in five community health service centers in Qingdao using a convenience sampling method.The general information survey sheet,health-promoting lifestyle profile II Chinese,the social capital scale,and a questionnaire on the constructs related to theory of planned behavior on health promotion behaviors of people at high risk of stroke was used to collect essential information on their sociodemographic characteristics,and statuses of health promotion behaviors,behavioral attitudes,subjective norms,perceived behavioral control,behavioral intentions,and social capital.Descriptive statistical analysis and discrepancy tests were conducted on the data utilizing SPSS 25.0,with frequencies and percentages depicting count data,means ± standard deviations indicating normally distributed measures,and independent t-tests and chi-square tests exploring differences in health promotion behaviors across individual characteristics.Moderated mediated effects analysis was conducted using Mplus 7.0 to validate the theoretical model of planned behavior and the moderating effect exerted by social capital in it.Results1.The health promotion behavioral score of the high-risk group for stroke was(107.23±13.95),with a mean entry score of(2.68±0.35),and the mean entry scores for the dimensions of nutrition,interpersonal relationships,self-actualization,stress coping,health responsibility,and exercise decreased in that order.The mean entry scores for subjective norms,behavioral attitudes,and perceived behavioral control were(4.50±0.80),(4.31±0.80),and(4.10±1.03),respectively,while the mean entry score for intention to engage in health promotion behaviors was relatively low at(3.87±1.09).And the level of social capital was average,with a mean entry score of(3.52±0.62).2.Mediation effect tests showed that attitudes,subjective norms,and perceived behavioral control were influenced primarily by the mediating variable behavioral intention to affect health-promoting behaviors,with indirect effect values and significance levels ofβ=0.054,p=0.047;β=0.062,p=0.040;and β=0.050,p=0.003 respectively.3.The moderated mediating effect test further showed that social capital could only negatively moderate the first half of the mediating effect from behavioral attitudes to health promotion behaviors,which diminished the relationship between behavioral attitudes and behavioral intentions.Social capital could moderate the anterior-posterior half of the mediating pathway from subjective norms to health promotion behaviors,which attenuated the effect of subjective norms on behavioral intentions and enhanced the effect of behavioral intentions on health promotion behaviors.Similarly,the pre-post and semi-path of the mediating effect of perceived behavioral control via behavioral intentions on health promotion behavior were moderated by social capital,specifically,social capital negatively moderated the effect of perceived behavioral control on behavioral intentions and positively moderated the effect of behavioral intentions on health-promoting behavior.Conclusions1.The current status of health promotion behaviors among people at risk of stroke was at a moderate level and needs to be improved.2.Subjective norms are the strongest predictors of intention to engage in health promotion behaviors in people at risk for stroke,followed in descending order by behavioral attitudes and perceived behavioral control.3.Behavioral intentions are the mediating variable for the effects of behavioral attitudes,subjective norms and perceived behavioral control on health promotion behaviors in people at high risk of stroke.4.The facilitation effect of behavioral attitudes,subjective norms and perceived behavioral control on behavioral intentions was reduced when social capital levels were greater in people at high risk of stroke,and the facilitation effect of behavioral intentions on health promoting behaviors was increased.5.Raising awareness of health promotion behaviors is the key to increasing willingness to engage in health promotion behaviors.And a proper understanding of the role of social capital in improving health promotion behaviors among people at high risk of stroke will help to actively promote the transformation of willingness to engage in health promotion behaviors among people at high risk of stroke.