Predictors of dietary behaviors and health outcomes in middle-aged men based on social cognitive theory: A cross-sectional study.

Most research about health promoting behaviors has focused on pre-old adults and men, despite clear evidence that the leading cause of death among postmenopausal women is related to health behaviors. This study applied social cognitive theory constructs to exercise, dietary, and stress management health behavior. The purpose of this study was to examine the ability of self-efficacy expectation and outcome expectancy to predict health behavior among older women. Community-dwelling women aged 65 to 92 years were interviewed with previously developed instruments and instruments designed specifically for this study (N = 225). Self-efficacy was the strongest predictor of each of the health behaviors (beta weights: dietary behavior .50; exercise, .39; stress management, .32). Outcome expectancy was not a significant predictor of exercise or dietary behavior. Outcome expectancy was a significant predictor of stress management behavior. The findings of this study, combined with the importance of health promotion behaviors among older women, justify the need for continued research about self-efficacy and health behavior among this vulnerable population.

Non-communicable diseases, arising out of changing lifestyle habits of people, are the foremost causes of mortality and morbidity worldwide. Most of these diseases occur in low and middle-income countries. Chronic diseases can be managed with the help of health behaviors such as proper diet, physical exercise, adherence to medication, and avoidance of health risk behaviors such as smoking, alcohol consumption, sedentary lifestyle, etc. The social cognitive theory addresses the role of personal and environmental factors in an individual's health behavior. The current study aims to understand the role of social cognitive theory on physical activity and dietary behavior amongst individuals diagnosed with type-2 diabetes. A correlational study was conducted among 225 participants with type-2 diabetes, who are under medication. The data was collected using social cognitive questionnaire for physical activity & dietary behavior and Health-Promoting Lifestyle Profile II. Descriptive statistics, Pearson's correlation coefficient and multiple linear regression analysis were used to analyze the data. It was found from the study results that, all the domains of social cognitive theory were significantly correlated with physical activity (p<0.001) and the SCT domains- self-regulation (p<0.001), social support (p<0.001), and outcome expectancy (p<0.05) were significantly correlated with dietary behavior. The results of multiple linear regressions indicated that the domains self- regulation and self- efficacy were the significant predictor for physical activity behavior (R2=.21, p≤0.001) while the domains social support and self-regulation were the significant predictor of dietary behavior (R2=.09, p≤0.001). The study results show that there is an influence of social cognitive domains on physical activity and dietary behaviour. Further, this study suggests that social cognitive theory based intervention can be used to promote healthy behaviour.

ABSTRACTBackground and AimsThe health‐related quality of life (HRQoL) of rural middle‐aged and young people faces many challenges. This study aims to explore the relationship between self‐efficacy and HRQoL in this population, and the mediating role of dietary behavior and the moderating role of social support.MethodsThis study collected information from 718 rural middle‐aged and young people using convenience sampling and online survey questionnaires, used SPSS 26.0 and PROCESS 4.1 to test the hypothesis model.ResultsSelf‐efficacy positively predicted dietary behavior (β = 0.141, t = 3.771, p < 0.001). However, there was no significant relationship with HRQoL (β = 0.102, t = 1.846, p > 0.05). Dietary behavior significantly negatively predicted HRQoL (β = −0.154, t = −4.053, p < 0.001). In addition, the interaction term between dietary behavior and social support significantly positively predicted HRQoL (β = 0.094, t = 2.321, p < 0.05). It indicates that dietary behavior acts as a complete mediator, and social support can regulate the impact of self‐efficacy on HRQoL through dietary behavior.ConclusionMore attention needs to be paid to the HRQoL for rural middle‐aged and young people. Promoting social support and self‐efficacy may play a role in promoting health.

ABSTRACTPregnant women living with HIV represent one of the most high-priority groups for HIV treatment and health assessment. Although social support has been shown to be a protective factor for improved health-related quality of life (HRQoL), and depression and anxiety have been identified as two major causes of psychological distress among people living with HIV, it is still unclear how social support, anxiety, and depression interact to influence HRQoL. The objective of our study was to demonstrate the nature of predictors, direct effects and mediator effects among social support, anxiety, depression symptoms and HRQoL in pregnant women living with HIV. We investigated a total of 101 pregnant women living with HIV in Yunnan province in China from April 2016 to June 2016. All participants completed the Social Support Rating Scale (SSRS), the Chinese version of the Hospital Anxiety and Depression Scales (HADS) and Quality of Life instruments (EuroQoL Five Dimensions Questionnaire, EQ-5D). The relationships between the variables were examined by Pearson's or Spearman's correlation analysis. Predictor effects were tested using separate multiple regressions, controlling for demographic variables and HIV diagnosis variables. Direct and mediation effects of social support on HRQoL were tested using a structural equation model (SEM). Anxiety and depression symptoms were negatively correlated with subjective social support, support utilization, social support and HRQoL. Social support significantly predicted better HRQoL, and anxiety and depression symptoms significantly predicted poorer HRQoL. Anxiety and depression symptoms partially mediated the associations between social support and HRQoL. Anxiety and depression symptoms completely mediated the associations of objective support and support utilization with HRQoL. Interventions to improve HRQoL in pregnant women living with HIV must consider the mediation effect of anxiety and depression symptoms on the association between social support and HRQoL. Social support interventions are valid only when anxiety and depression symptoms are managed effectively.

The association between diet quality, dietary behavior and health-related quality of life has been mostly examined in children and adolescents with specific chronic diseases. No systematic review has synthesized the influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents. The purpose of this study was to systematically review the primary studies that evaluated the association between diet quality, dietary behavior and health-related quality of life in the general population of children and adolescents and to synthesize the findings for the association. A computer search in the databases of MEDLINE, EMBASE and PSYCINFO was performed to retrieve English language studies that were published from 1946 up to April 8, 2018. We also screened the PubMed-related articles and the reference lists of the existing relevant literature to identify other eligible studies. We synthesized the association between diet quality, dietary behavior and health-related quality of life using both a qualitative method and meta-analysis. We reported the review following up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. Seventeen studies were included in the synthesis including twelve cross-sectional studies and five longitudinal studies. We found that diet quality and dietary behavior were associated with health-related quality of life in children and adolescents. The positive effect of healthy diets on health-related quality of life was observed for multiple domains of health-related quality of life, including physical, school and emotional functioning, and psychosocial quality of life. We observed a dose-response relationship between the diet exposure and health-related quality of life, where an unhealthy dietary behavior or lower diet quality was associated with decreased health-related quality of life among children and adolescents. The findings of the systematic review suggest the importance of promoting healthy diets and nutrition for good health-related quality of life among children and adolescents. Future research is needed to strengthen the evidence for prospective relationships and for the dose-response effect between diet quality, dietary behavior and health-related quality of life among children and adolescents.

Global aging is one of the most significant social trends of the 21st century. Health-Related Quality of Life (HRQoL) is an important indicator not only for evaluating the effectiveness of medical interventions, public health policies, and disease management, but also for enhancing the health of the older adult. This study aimed to explore the mechanisms through which life events and social support affect the HRQoL of rural older adults, with the aim of promoting healthier aging in this population. A stratified random sampling method was used to select rural older adult individuals from southeastern Henan Province, China. Data were collected using the Life Events Scale, the Social Support Scale (SSS), and the SF-8 Health Survey. T test and the analysis of variance were employed to compare characteristics differences in HRQoL. Pearson's correlation analysis was used to assess the relationships between life events, social support, and HRQoL. And a regression test was used for Moderating Effect analysis. The participants in this questionnaire survey showed that Univariate analysis revealed statistically significant associations between age, education, chronic disease in HRQoL among the rural older adult. Pearson correlation analysis revealed significant negative correlations not only between life events and social support, but also between life events and HRQoL, while a significant positive correlation was found between social support and HRQoL. Regression analysis for moderating effects showed that life events negatively predicted HRQoL, while social support positively predicted HRQoL. The interaction term of the product life events and social support was also significant. Our results confirm that life events and social support were significant predictors of the HRQOL among rural older adults, with social support acting as a moderating variable, and provide empirical evidence that enhancing social support systems and reducing negative life events are crucial for improving the health-related quality of life in rural older adult populations and achieving healthy aging.

Introduction: Morbidity and mortality among adults with non-communicable diseases (NCDs) are associated with poor dietary behaviours, often influenced by food security constraints. An important approach is to promote nutrition literacy to change dietary behaviours and health outcomes. The impact of nutrition literacy (NL) programmes on adults is recognised in the literature. However, there is a lack of studies that have comprehensively analysed their effects. This study aimed to conduct a literature review about NL programmes for adults to enhance nutrition literacy, dietary behaviour, food security, or health outcomes. Methods: A systematic review was conducted on original articles from ScienceDirect, PubMed, Scopus, and CINAHL, published between 2014 and 2024, targeting adults aged 18 years and over. Results: Ten studies were eligible for inclusion; the most commonly used model was the Social Cognitive Learning Theory. Interventions focused on nutrition education, workshops, skills training/hands-on activities, consultations, family involvement, online interventions, and home visits, typically lasting 4 to 16 weeks. Assessments were conducted at baseline, post-intervention, and follow-up (3 to 12 months), showing significant enhancements in one or more outcomes, including nutrition literacy, dietary behaviour, food security, or health outcomes. Conclusions: NL programmes showed an improvement in nutrition literacy, dietary behaviour, food security, and health outcomes. However, some studies were limited by small sample sizes, the absence of a control group, and a lack of follow-up. For future directions, high-quality randomised controlled trials and longitudinal studies could be conducted to ascertain outcomes.

Background: This study was conducted to identify the factors that affect the health-related quality of life (HRQoL) of middle-aged men with metabolic syndrome (MetS) based on their stress level using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: The participants of this study were men aged between 40–64 with MetS who were included in the KNHANES. The main variables of this study were HRQoL, which was measured using the EuroQol-5 Dimension (EQ-5D); general characteristics, health-related characteristics, and dietary behaviors. Results: The subjective health of the group with less stress was significantly better. Compared to the unhealthy group, the groups perceived as healthy and normal had a higher HRQoL. The economic level, suicidal ideation, and dinner arrangement (presence of family) of the stressed group were significantly associated with their HRQoL. Compared to a low economic level, the high and middle economic levels were more associated with the subjects’ HRQoL. Compared to the group without suicidal ideation, the group that experienced suicidal association had a lower HRQoL. Compared to the group that did not dine with their family, the group that dined with family had a higher HRQoL. Conclusions: The results of this study expand the scientific understanding of HRQoL based on stress among middle-aged men with metabolic syndrome. Since differences in the influence of the factors that affect HRQoL were identified based on the level of stress experienced, the stress level of middle-aged men should be considered when devising an intervention strategy to improve their HRQoL.

The idea of health-related quality of life (HRQOL) is not new. In 1946, the constitution of the World Health Organization defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” ([1][1]). Today, the HRQOL concept addresses

PurposeThis study aimed to determine the level of health-related quality of life (HRQoL) of children and adolescents who received hematopoietic stem cell transplantation (HSCT) and to examine factors influencing HRQoL.MethodsThis cross-sectional descriptive study involved 85 participants aged 10 to 19 years who received treatment from 3 months to 5 years after HSCT. Symptom experiences, stress and coping, self-esteem, social support, and HRQoL were measured. Descriptive analysis, the independent t-test, one-way analysis of variance, Pearson correlation analysis, and stepwise multiple regression were used for data analysis.ResultsThe mean HRQoL score was 72.26 points out of 100. HRQoL showed statistically significant correlations with symptom experiences, stress, self-esteem, social support, satisfaction with peer relationships, and perceived attentiveness of the medical team. The most influential predictors of HRQoL were symptom experiences (β=−.51, p<.001) and satisfaction with peer relationships (β=.32, p<.001).ConclusionThe experiences of different symptoms by children and adolescents who receive HSCT must be considered. In addition, nursing interventions, such as self-help meetings with peer groups, should be provided to improve their HRQoL.

본 연구는 허약의 고위험군인 후기노인의 건강관련 삶의 질 향상을 위한 기초자료를 제공하고자 허약, 사회적 지지 및 건강관련 삶의 질 간의 관계를 조사하였다. 서술적 조사연구인 본 연구를 위하여 2016년 03월 01일 부터 03월 31일까지 K군에 소재하는 노인복지시설에서 75세 이상 노인을 대상으로 구조화된 설문지를 이용하는 일대일 면담을 통해 총 211명의 자료를 수집하였다. 수집된 자료는 SPSS/WIN과 Amos 18.0 프로그램으로 t-test, Pearson’s correlation coefficient 및 경로분석을 사용하여 분석하였다. 80세를 기준으로 한 연령집단 간 차이검정결과, 80세 이상인 경우 유의하게 허약수준이 더 높고(t=-2.51, p=.013), 건강관련 삶의 질이 낮았으나 (t=3.29, p=.001), 사회적 지지는 유의한 차이를 보이지 않았다(t=1.28, p=.201). 허약, 사회적지지, 건강관련 삶의 질 간의 상관관계 분석결과, 허약수준이 높을수록 사회적 지지(r=-.21, p=.003)와 건강관련 삶의 질이 유의하게 낮았고(r=-.65, p<.001), 건강관련 삶의 질은 사회적 지지가 높을수록 유의하게 높았다(r=.18, p=.010). 사회적 지지와 건강관련 삶의 질 사이에서 허약의 매개효과를 조사한 결과, 사회적 지지는 허약에(β=-.21, p=.016) 허약은 건강관련 삶의 질에 유의한 직접효과를 미치나(β=-.06, p=.004), 사회적 지지는 건강관련 삶의 질에 유의한 직접효과를 미치지 않고(β=.00, p=.562) 허약을 매개하여 유의한 간접효과를 미쳐(β=.01, p=.012) 사회적 지지와 건강관련 삶의 질 사이에서 허약의 완전매개효과가 있었다. 사회적 지지는 허약을 예방하고 허약수준의 개선은 건강관련 삶의 질을 증진시킨다. 그러므로 후기노인의 건강관련 삶의 질 제고를 위해 연령별 사회적 지지 방안을 포함하는 다면적인 허약 예방 프로그램의 개발이 필요하다.This study investigated the relation between frailty, social support, and health-related quality of life to provide basic data to improve the health-related quality of life of old-old elderly who are a high risk group for frailty. For this descriptive study, one-on-one interviews with structured questionnaires were conducted for elderly aged 75 years or older at elderly welfare facilities in K county from March 01 to 31 in 2016, and a total of 211 elderly were interviewed. The collected data were analyzed by t-test, Pearson’s correlation coefficient, and path analysis using SPSS/WIN and AMOS 18.0 program. For the differences between the age groups, those aged over 80 years had a significantly higher frailty (t=-2.51, p=.013) and a lower health-related quality of life than those aged below 80 years (t=3.29, p=.001); however, there was no significant difference in social support (t=1.28, p=.201). The correlation between frailty, social support and health-related quality of life showed that as frailty became higher, social support (r=-.21, p=.003) and health-related quality of life (r=-.65, p<.001) were significantly lower, and health-related quality of life was significantly higher with a higher social support (r=.18, p=.010). As a result of investigating the mediating effects of frailty between social support and health-related quality of life, social support had a significant direct effect on frailty (β=-.21, p=.016) and frailty had a significant direct effect on health-related quality of life (β=-.06, p=.004); however, social support had no significant direct effect on health-related quality of life (β=.00, p=.562). Social support had a significant indirect effect on health-related quality of life and a mediating effect on frailty (β=.01, p=.012); therefore, the full mediation effect of frailty between social support and health-related quality of life was verified. Social support prevents frailty, and improving frailty enhances health-related quality of life. Therefore, it is necessary to develop a multifactorial frailty prevention program that includes age-specific social support strategies to improve the health-related quality of life in old-old elderly.

BackgroundSevere mental illnesses (SMIs) have become one of the public health problems of great concern in society, which not only bring physical and mental pain to patients but also heavy burden to families. It is known that the health-related quality of life (HRQoL) of patients and caregivers’ social support are correlated with caregivers’ family burden of disease, but the interaction mechanism among them is not clear. The purpose of this study was to investigate the association between HRQoL in patients with SMIs and the family burden of disease and to examine the mediating role of caregivers’ social support.MethodsFrom January to July 2022, this cross-sectional study was conducted in 23 community health service centers in Nanjing, China. We recruited 924 patients with SMIs and their caregivers, using a random sampling method. Hayes’ PROCESS macro was used to test the mediation effect of caregivers’ social support in the relationship between patients’ HRQoL and family burden of disease. Indirect effects were tested using bootstrapped confidence intervals (CI).ResultsThe SF-36 score of patients with SMIs was 57.85 (49.59, 63.64), while the caregivers’ social support was measured at 32.00 (27.00, 35.00), and the family burden of disease scored 16.00 (8.00, 24.00). Spearman correlation analysis revealed a negative correlation between the patients’ HRQoL and the family burden of disease (r = -0.54, p < 0.01). Furthermore, caregivers’ social support was negatively correlated with the family burden of disease (r = -0.19, p < 0.01). The mediating role of caregivers’ social support between the patients’ HRQoL and the family burden of disease was confirmed by the Bootstrap test (p < 0.01), with a mediating effect of 2.75% (β = -0.016, 95% CI = -0.031, -0.002).ConclusionsThis study highlights that caregivers experience a heavy family burden of disease. The patients’ HRQoL not only directly affects the family burden of disease but also indirectly influences it through the caregivers’ social support. Therefore, relevant departments need to prioritize improving patients’ HRQoL and expanding caregivers’ social support networks when developing targeted intervention programs to reduce the family burden of SMIs.

BackgroundApproaches to improve physical activity (PA), diet, and health-related quality of life (HRQOL) during postpartum in diverse women with elevated weight are needed.MethodsHealth In Pregnancy and Postpartum (HIPP) was a randomized controlled trial that followed African American and white women with overweight or obesity from pregnancy through 12 months postpartum. Participants were randomized to a behavioral intervention grounded in social cognitive theory (n = 112) or standard care (n = 107). From enrollment (≤ 18 weeks gestation) through 6 months postpartum, the intervention group received two in-depth counseling sessions (one each during pregnancy and postpartum), counseling calls, behavioral podcasts, and access to a private Facebook group, while the standard care group received monthly mailings and podcasts focused on healthy pregnancy and infant development. PA (SenseWear armband), diet (ASA24), and HRQOL (SF-12) measurements were obtained from blinded assessors at baseline and 6- and 12-months postpartum. Linear or quantile regression models, depending on conformity to normality assumptions, were used to test differences between behavioral intervention and standard groups in PA outcomes (minutes/day of total PA, light PA, and moderate-to-vigorous intensity PA (MVPA), and total steps/day), dietary outcomes (diet quality and six measures of dietary intake), and HRQOL at 6- and 12-months postpartum, controlling for baseline values, race, parity, weight status, education, maternal age, gestational age, and caloric intake (for most diet models).ResultsThere were no statistically significant differences by group for any PA, diet, or HRQOL outcomes at 6 or 12 months postpartum. Irrespective of group assignment, all PA outcomes improved from pregnancy to postpartum, as did kcals and the mental component of HRQOL. Furthermore, while not statistically significant, virtually all PA outcomes, except MVPA at 12 months, and several dietary outcomes, including diet quality, had patterns favoring the intervention group but with small effect sizes.ConclusionsPostpartum PA, diet, and HRQOL did not differ significantly between women in the behavioral intervention group and those in the standard care group. Given the increased responsibilities and stress that women face during the postpartum period, this appears to be a challenging time to make lifestyle changes.Trial registrationThis trial was registered at ClinicalTrials.gov on 10/09/2014. Identifier: NCT02260518.

Introduction: Social support is known to influence health-related quality of life and is associated with health outcomes, such as self-care, hospitalization rate, mortality. Sex and race differences in social support and clinical outcomes have been reported, but less is known about how social support varies among cardiac ICU survivors. Research Question and Hypothesis: This study aimed to examine whether the association between social support and the quality of life differed by sex and race, and whether higher levels of social support were associated with better quality of life among survivors of cardiac intensive care. Methods: This cross-sectional study was part of the Wellness and Needs of Men and Women after a Cardiac Intensive Care Unit Stay (WellNOW) study, an ongoing longitudinal cohort of CICU survivors. Data were collected from 130 participants diagnosed who were transferred to a step-down unit following discharge from the Cardiac Intensive Care Unit. The primary independent variable was social support, assessed using the ENRICHD Social Support Instrument. The outcome variable was health-related quality of life, measured using the 12-item Short Form Survey, comprising physical and mental component scores. Sex and race were self-reported and examined as potential effect modifiers. Multiple linear regression analyses were conducted, with interaction terms for sex and race tested in separate models, controlling for age, educational level, length of intensive care unit stay, and comorbidity. Results: Participants were an average age of 61.8 ± 13.4 years. The sample was mostly female (55.4%, n=72). Nearly one third of participants were Black (30.8%, n=40); most participants were White (62.3%, n=81). Higher social support was positively associated with better mental health-related quality of life (β = 0.62, p=0.001), while no association was found for the physical component of health-related quality of life (β=0.03, p=0.859), in adjusted regression models. The relationship between social support and mental health-related quality of life was not moderated by sex nor race. Conclusion: Better health-related quality of life, notably in the mental health domain, was associated with higher levels of social support among cardiac intensive care unit survivors. However, sex and racial differences did not affect this correlation. Future interventions may aim to enhance psychological wellness by increasing perceived social support in this population.

What's missing in sex chromosome aneuploidies? Representation and inclusion