Danquah Emelia, Asiamah Nestor, Jnr Reginald Arthur-Mensah, Chan Alex Sui Wing, Khan Hafiz T A
Research Directorate, Koforidua Technical University, Koforidua, E/R, Ghana.
Division of Interdisciplinary Research and Practice, University of Essex, School of Health and Social Care, Colchester, Essex, CO4 3SQ, UK.
BMC Public Health. 2025 Jan 31;25(1):400. doi: 10.1186/s12889-025-21596-9.
Many studies have highlighted the association between frailty, physical activity behaviour (PAB), and well-being, but no study has investigated a potential moderated mediating role of functional difficulty in this relationship. This association may not be the same between different income levels. This study, therefore, assessed the above moderated mediation between low- and higher-income samples.
This research employed a cross-sectional design in accordance with established research-reporting guidelines. The study population comprised two distinct Ghanaian samples, with N = 942 individuals in the low-income group and N = 600 individuals in the higher income group. Data analysis was carried out using Hayes's Process model through structural equation modelling, with additional sensitivity analyses performed through hierarchical linear regression.
Frailty had a direct negative effect and an indirect negative effect (through functional difficulty) on well-being in both samples. A partial mediation of functional difficulty was found in the relationship between frailty and well-being in both samples. We also found evidence of a moderated mediation by functional difficulty in both samples; however, this effect was stronger in the higher-income sample.
Older employees with frailty are less likely to report lower functional difficulty and well-being at higher PAB. Our results suggest a need for workplace programmes aimed at encouraging PAB. It also reinforces the importance of individuals performing and maintaining PAB.
许多研究都强调了虚弱、身体活动行为（PAB）与幸福感之间的关联，但尚无研究探讨功能困难在这种关系中可能的调节中介作用。不同收入水平之间的这种关联可能并不相同。因此，本研究评估了低收入和高收入样本之间上述的调节中介作用。
本研究采用横断面设计，符合既定的研究报告指南。研究人群包括两个不同的加纳样本，低收入组有N = 942人，高收入组有N = 600人。数据分析通过结构方程模型使用海斯过程模型进行，另外还通过分层线性回归进行了敏感性分析。
在两个样本中，虚弱对幸福感都有直接的负面影响和间接的负面影响（通过功能困难）。在两个样本中，功能困难在虚弱与幸福感之间的关系中起到了部分中介作用。我们还发现两个样本中都存在功能困难的调节中介效应的证据；然而，这种效应在高收入样本中更强。
身体虚弱的老年员工在较高的身体活动水平下，报告较低功能困难和幸福感的可能性较小。我们的结果表明需要制定旨在鼓励身体活动的工作场所计划。这也强化了个人进行并维持身体活动的重要性。
