Wu Yibo, Yu Zhenjie, Yin Xiaoqiu, Li Yimiao, Jiang Yang, Liu Gongli, Sun Xinying
Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China.
Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Front Psychiatry. 2024 Dec 9;15:1497872. doi: 10.3389/fpsyt.2024.1497872. eCollection 2024.
The aim of the study was to to uncover the factors influencing the initiation and maintenance of health behaviors indiabetes mellitus (DM) patients, utilizing baseline data from a randomized controlled trial to construct a structural equation model based on the Multi-Theory Model (MTM) and Health Action Process Approach (HAPA) scales.
The study recruited participants with type 2 diabetes, aged between 18 and 75 years, from 45 distinct locations in Beijing, China.Patients [N = 406, n = 232 (57.1%) females, n = 232 (42.9%) males; Mean (SD) age = 56.7(10.9)] completed self-reported questionnaire about constructs from integrated theories concerning health behavior. To test the associations between the variables, structural equation modeling with latent variables was employed. Based on the path coefficients of Structural Equation Modeling(SEM), we verified all the hypotheses.
Disadvantages, Advantages, Self-efficacy for Initiating Behavior, and Changes in Physical Environment are all prove to have an effect on intention, with the effect of Disadvantages being negative. Intention positively influenced Action Planning and Coping Planning, both of which in turn significantly predicted Initiation of Behavior Change. Practice for change, Emotional Transformation, Changes in Social Environment, and Self-efficacy for Sustaining Behavior were all affected by Outcome Expectancies and Risk Perception positively. Meanwhile, Practice for change, Emotional Transformation, Changes in Social Environment and Self-efficacy for Sustaining Behavior- would have a significant predictive effect on Maintenance of Behavioral Change.
The empirical evidence from this study robustly validates the majority of its theoretical constructs, affirming that MTM-HAPA possess significant explanatory capability in delineating the factors that underpin both the Maintenance of health-related behaviors and the Initiation of Behavior Changes in individuals suffering from DM.
本研究旨在利用一项随机对照试验的基线数据,构建基于多理论模型(MTM)和健康行动过程方法(HAPA)量表的结构方程模型,以揭示影响糖尿病(DM)患者健康行为启动和维持的因素。
本研究从中国北京45个不同地点招募了年龄在18至75岁之间的2型糖尿病患者。患者 [N = 406,n = 232(57.1%)为女性,n = 232(42.9%)为男性;平均(标准差)年龄 = 56.7(10.9)] 完成了关于健康行为综合理论构建的自我报告问卷。为了检验变量之间的关联,采用了带有潜在变量的结构方程建模。基于结构方程模型(SEM)的路径系数,我们验证了所有假设。
劣势、优势、行为启动自我效能和物理环境变化均被证明对意图有影响,其中劣势的影响为负。意图对行动规划和应对规划有积极影响,而这两者又反过来显著预测行为改变的启动。改变实践、情绪转变、社会环境变化和维持行为自我效能均受到结果期望和风险感知的积极影响。同时,改变实践、情绪转变、社会环境变化和维持行为自我效能对行为改变的维持有显著预测作用。
本研究的实证证据有力地验证了其大部分理论构建,肯定了MTM - HAPA在描述影响DM患者健康相关行为维持和行为改变启动的因素方面具有显著的解释能力。