JMIR Publications

ABSTRACT

Background:

Modifiable unhealthy behaviors account for over two-thirds of new Non-Communicable Diseases(NCDs) cases. Behavioral risk factor reduction is a potential cost-effective means to improve long-term health outcomes. Although family serves as a pivotal cornerstone for fostering and maintaining individuals’ health, the associations between family health and proactive health behavior remain unclear.

Objective:

This study aimed to construct a comprehensive index to measure proactive health behavior and then estimate the associations of combined family health with health literacy and proactive health behavior among Chinese adults.

Methods:

We conducted a cross-sectional survey involving 30,044 participants from the 2023 Psychology and Behavior Investigation of Chinese Residents (PBICR). Hierarchical multiple regressions were employed to analyze the correlations between family health, health literacy, and proactive health behavior, controlling for potential covariates. The moderated mediation effect of family communication on the association between family health and health literacy was assessed using the PROCESS macro for SPSS.

Results:

Family health was positively correlated with proactive health behavior (β=.155,P＜.001) with covariates and mediator controlled. Health literacy was associated with a increase in proactive health behavior(β=.062,P＜.001) and mediated the positive effect on proactive health behavior(β=.042,P＜.001) across all age groups. Additionally, family communication significantly moderated the mediating effect of health literacy (index=.015,95%CI 0.011-0.020).

Conclusions:

Enhancing family health is instrumental in encouraging proactive health behavior, particularly among older adults. Our findings underscore the significance of targeting family health in health interventions, with a focus on strengthening family communication and implementing integrated strategies to enhance health promotion efforts.