Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, 523808, Guangdong, China.
Institute of Public Health and Wellness, Guangdong Medical University, Dongguan, China.
BMC Public Health. 2024 Oct 11;24(1):2780. doi: 10.1186/s12889-024-20272-8.
The literature shows that social support is an important factor influencing health behaviors. This study aimed to explore the relationships and intrinsic pathways of social support, loneliness, economic income, and health behaviors among older adults during the Corona Virus Disease 2019 (COVID-19) pandemic, and to provide a theoretical basis for the implementation of health behaviors interventions for older adults.
A cluster-random-sampling survey was adopted within two towns in Dongguan, China. Demographic characteristics, social support, loneliness, economic income and health behaviors were measured. The Social Support Appraisals scale (SS-A), the ULS-8 Loneliness Scale, and the Self-rated abilities for health practice scale (SRAHPS) were used to measure social support, loneliness, and health behaviors in older adults, respectively. A moderated mediation model was built to examine the relationships among social support, loneliness, economic income, and health behaviors using the SPSS PROCESS 4.0 macro. We conducted bootstrapping of regression estimates with 5000 samples and a 95% confidence interval.
621 older adults completed the questionnaire. Most of the participants were female, accounting for 75.0%, and the average age was 81.11 years (SD = 8.11). The median (interquartile range) of the participants' average monthly economic income was 800 (500-1000)RMB. The results of the mediation analysis showed that loneliness partly mediated the relationship between social support and health behaviors (B = 0.024, 95%CI: 0.007, 0.042), with the mediating effect accounting for 4.56% of the total effect. The moderation mediation analysis revealed a positive moderating role of economic income in the relationship between social support and loneliness (B = 0.114, 95%CI: 0.054, 0.174). Specifically, the relationship between social support and loneliness was found to be weaker for older adults with a high economic income compared to those with a lower economic income.
The provision of enhanced social support and the alleviation of loneliness among older adults during an epidemic can facilitate the development of healthy behaviours, particularly among those who are economically disadvantaged.
文献表明，社会支持是影响健康行为的重要因素。本研究旨在探讨社会支持、孤独感、经济收入与老年人在新型冠状病毒肺炎（COVID-19）大流行期间健康行为的关系及其内在途径，为实施老年人健康行为干预提供理论依据。
采用整群随机抽样的方法，在东莞的两个镇进行调查。测量了人口统计学特征、社会支持、孤独感、经济收入和健康行为。采用社会支持评价量表（SS-A）、孤独感量表（ULS-8）和自我评估健康实践能力量表（SRAHPS）分别测量老年人的社会支持、孤独感和健康行为。采用 SPSS PROCESS 4.0 宏程序构建调节中介模型，检验社会支持、孤独感、经济收入与健康行为之间的关系。采用 5000 个样本和 95%置信区间的回归估计进行自举。
621 名老年人完成了问卷。大多数参与者为女性，占 75.0%，平均年龄为 81.11 岁（SD=8.11）。参与者平均月经济收入中位数（四分位距）为 800（500-1000）元。中介分析结果表明，孤独感部分中介了社会支持与健康行为之间的关系（B=0.024，95%CI：0.007，0.042），中介效应占总效应的 4.56%。调节中介分析显示，经济收入对社会支持与孤独感之间的关系具有正向调节作用（B=0.114，95%CI：0.054，0.174）。具体而言，与经济收入较低的老年人相比，经济收入较高的老年人的社会支持与孤独感之间的关系较弱。
在疫情期间，为老年人提供更多的社会支持和减轻孤独感，可以促进健康行为的发展，特别是在经济弱势群体中。
