Evidence map›Paper›PMID 41372839›Full record

ArticleBMC public health2025

A socioecological model of multilevel determinants for proactive health behaviors among Chinese adults with chronic diseases.

Chaoyi Chen, Yanhua Hao, Weilan Xu, Ze Liu, Yuwei Zhang, Zhanchun Feng

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Chaoyi ChenSchool of Health Management, Harbin Medical University, Harbin, China.
Yanhua HaoSchool of Health Management, Harbin Medical University, Harbin, China. hyhyjw@126.com.
Weilan XuQiqihar Medical University, Qiqihar, China.
Ze LiuHarbin Medical University Cancer Hospital, Harbin, China. liuzejhwsx@163.com.
Yuwei ZhangSchool of Health Management, Harbin Medical University, Harbin, China.
Zhanchun FengSchool of Medicine and Health Management, Tongji Medical College of Huazhong, University of Science and Technology, Wuhan, China.

Funding

China Postdoctoral Science Foundation 2025M770709National Natural Science Foundation of China 72274046
6 · The paper itself

Abstract

backgroundChronic diseases have become a major public health challenge facing the world. Identifying key factors and developing effective management strategies to promote proactive health behaviors in patients is crucial for improving health outcomes.

objectiveThis study aims to construct a comprehensive model of proactive health behaviors in chronic disease patients, elucidate multilevel determinants, and guide targeted policy interventions in China.

methodsA cross-sectional survey was conducted among 805 patients with chronic diseases in China. Latent profile analysis (LPA) was conducted to identify distinct profiles of proactive health behaviors among patients. Binary logistic regression analysis was used to verify and analyze the determinants affecting the proactive health behaviors of patients.

resultsAmong the 805 participants, 471 were classified as highly proactive, and 334 were classified as less proactive. The average score for proactive health behaviors was 70.37 ± 10.93. Several factors positively predicted proactive health behaviors: patients aged > 74 years (AOR = 8.85, 95% CI 2.06-39.45), married patients (AOR = 1.78, 95% CI 1.02-3.11), urban residents (AOR= 1.33, 95% CI 1.04-1.70), those with stronger health intentions (AOR = 1.42, 95% CI 1.28-1.60), higher self-efficacy (AOR = 1.12, 95% CI 1.04-1.20), positive health beliefs (AOR = 1.21, 95% CI 1.09-1.34)), and greater community support (AOR = 1.18, 95% CI 1.07-1.32). Regarding policy support, perceiving an adequate upper payment limit for drugs was associated with twice the odds of proactive health behaviors (AOR = 2.61, 95% CI 1.44-4.78). Additionally, age and the medication reimbursement policy for drug expenses exerted negative effects on proactive health behaviors (β = -0.507, P < 0.01).

conclusionGovernments should transform medical insurance from a passive payer into an active health investor. By incorporating behavioral economics principles, such a reform reallocates policy design, resources, and decision-making power toward disadvantaged populations. This shift breaks the "well-intentioned policy trap", achieving lower medical costs alongside improved population health.

Indexed as

Health BehaviorAdultAgedChinaChronic DiseaseCross-Sectional StudiesEast Asian PeopleFemaleHumansMaleMiddle AgedSurveys and QuestionnairesChronic diseasesHealth servicePatientsPolicyProactive health behaviors

Identifiers

PMID41372839
PMCPMC12781774

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.