Does health literacy moderate the psychological pathways of physical activity from guideline awareness to behavior? A multi-group structural equation modeling

BMC Public Health

Research

Susumu S. Sawada¹  Kazuhiro Harada²  Takayuki Tajima³  Yuko Oguma⁴ 

[1] Faculty of Sport Sciences, Waseda University, 2-579-15, 359-1192, Mikajima, Tokorozawa, Saitama, Japan;Graduate School of Human Development and Environment, Kobe University, 3-11, Tsurukabuto, 657-8501, Kobe, Nada, Japan;Graduate School of Human Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-Ku, 116-8551, Tokyo, Japan;Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku, 223-8521, Yokohama, Kanagawa, Japan;Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku, 223-8521, Yokohama, Kanagawa, Japan;Graduate School of Health Management, Keio University, 4411 Endo, 252-0883, Fujisawa, Kanagawa, Japan;

关键词: Guideline;    Awareness;    Knowledge;    Attitude;    Intention;    Exercise;    Health literacy;    Surveys and Questionnaires;    Latent Class Analysis;   

DOI  :  10.1186/s12889-023-15012-3

 received in 2022-06-23, accepted in 2023-01-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAwareness, knowledge, beliefs, and behavioral intentions of physical activity (PA) guidelines may be important mediating factors for promoting PA. However, these pathways of the psychological process to PA behavior have not been examined. These pathways may differ depending on health literacy levels. This study investigated the pathways to PA, from guideline awareness to behavior, and further examined whether they differed by health literacy.MethodsA cross-sectional study was conducted with 7,000 Japanese participants aged 20–69 years. The participants were registered with an Internet survey company. Participants’ awareness, knowledge, beliefs, and behavioral intentions regarding the PA guidelines of Japan, the volume of moderate-to-vigorous intensity PA, activity level, and health literacy were examined through a questionnaire. The PA pathways, from guideline awareness to behavior, were examined by structural equation modeling (SEM), with PA behavior as the dependent variable. Multi-group SEM was conducted to examine the moderating effect of health literacy on PA pathways. Health literacy scores were dichotomized into high and low groups in multi-group modeling by the median split.ResultsSEM revealed that PA guideline awareness directly affects PA behavior and has certain indirect effects through the mediation of knowledge, beliefs, and behavioral intentions. Furthermore, the multi-group SEM showed that the proportion of indirect effects (path coefficient [PC]: 0.11, 95% confidence interval [CI]: 0.10–0.13) was higher than direct effects (PC: 0.07, 95%CI: 0.03–0.11) in the high-health literacy group. In contrast, the proportion of direct effects (PC: 0.22, 95%CI: 0.15–0.30) was higher than indirect effects (PC: 0.06, 95%CI: 0.05–0.07) in the low-health literacy group.ConclusionsPA guideline awareness is both directly and indirectly associated with PA behavior, mediated by psychological pathways of knowledge, beliefs, and behavioral intentions, and influenced by health literacy. These results suggest that health literacy should be considered when implementing PA guideline-based interventions.

【 授权许可】

CC BY   
© The Author(s) 2023

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