Journal of Peking University(Health Sciences) ›› 2018, Vol. 50 ›› Issue (4): 711-716. doi: 10.3969/j.issn.1671-167X.2018.04.024

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Application of multi-group structural equation model in comparative study of HBM related to recreational physical activity among population with high risk of chronic diseases and healthy people

WU Shi-yan1, ZHANG Xu-xi1, SUN Kai-ge1, HU Kang, LIU Si-jia2△, SUN Xin-ying1△   

  1. (1. Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China; 2.Tongzhou Center for Disease Prevention and Control, Beijing 101100, China)
  • Online:2018-08-18 Published:2018-08-18
  • Contact: LIU Si-jia, SUN Xin-ying E-mail:xysun@bjmu.edu.cn

Abstract: Objective: To explore mechanism of health beliefs by application of health belief model (HBM) and structural equation modeling (SEM) with regard to recreational physical activity (PA), to identify the differences of among population with high risk of chronic diseases and healthy people, and to provide the specific  interventions of recreational physical activity and reference for health relevant policy-making in the future. Methods: A total of 2 736 residents with high risk of chronic diseases and 1 514 healthy people were involved. A questionnaire survey, physical examination and biochemical examination were conducted. The questionnaire based on HBM had acceptable validity and reliability. The proposed model based on the total sample size of the two groups was developed using the structural equation model-ing and multicomparison in the ways of appearance and parameters were also validated. Results: The median amount of recreational (PA) among population with high risk of chronic diseases and healthy people were 0.0 thousand-step equivalent with quartile of (0.0, 4.6) and 0.0 thousand-step equivalent with quartile of (0.0, 4.0) respectively. The results of SEM suggested that the direct effects of perceived objective barriers(β=-0.245), perceived subjective barriers(β=-0.057), cues to action(β=-0.043) and self-efficacy(β=0.117) on recreational (PA) were significant. Self-efficacy was the most important mediator. The multigroup comparisons indicated that the models of the two groups had the same appearance but the parameters between them were significant (Δ χ2= 27.4, P<0.05). The multi-group structural equation model (MSEM) indicated that two paths from cues to action and from perceived subjective barriers to recreational (PA) were not statistically significant among the population with high-risk of chronic diseases. In the two groups, one path coefficient from perceived objective barriers to subjective barriers (P=0.007) was statistically significant (P<0.05). Conclusion: The recreational (PA) levels of both groups were lower. Health beliefs on recreational (PA) of the two groups played different roles and some paths were also different. Therefore, specific interventions and strategies should be developed for different people. For residents with high risk of chronic diseases, much more attention should be paid to reduce the objective and subjective barriers of recreational physical activity and to improve self-efficacy so as to delay or prevent the occurrence of chronic diseases and then to improve the quality of life of this kind of population.

Key words: Recreational physical activity, Health belief model, Multi-group structural equation mo-deling, High risk population, Healthy people

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[1] WU Shi-yan, ZHANG Xu-xi, YANG Shuai-shuai, SUN Kai-ge, JIA Wei-lan, SHAO Chun-xin, WU Qin, XUAN Xiao-wei, LIU Yong-chang, LIU Si-jia, SUN Xin-ying. Physical activity level and its influence factors among residents in one suburb district of Beijing [J]. Journal of Peking University(Health Sciences), 2016, 48(3): 483-490.
[2] CHEN Juan, LIAO Yi-Xing, LI Zhuo-Ting, TIAN Ye, YANG Shuai-Shuai, TU Da-Hong, HE Chao, SUN Xin-Yang. Analysis of the determinants of salt-restriction behavior among urban and rural residents in Beijing with health belief model [J]. Journal of Peking University(Health Sciences), 2014, 46(2): 242-246.
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