Indirect Association Research Articles

Who Wants to (Digitally) Live Forever? The Connections That Narcissism Has with Motives for Digital Immortality and the Desire for Digital Avatars.

We examined the role that death anxiety (for self and others) and motivation for digital immortality played in the associations that narcissistic personality traits had with the desire for digital avatars (of self and others) in a sample of Israeli community members (N = 1041). We distinguished between four forms of narcissism: extraverted narcissism (characterized by assertive self-enhancement), antagonistic narcissism (characterized by defensiveness and hostility), neurotic narcissism (characterized by emotional distress), and communal narcissism (characterized by attempts to emphasize superiority over others by exaggerating communal characteristics such as being extraordinarily helpful). Our sequential parallel mediation analyses showed that narcissistic personality traits were associated with fear of death and the desire for symbolic immortality (having a digital avatar for self and others), with mainly indirect associations via fear of death and the motivation for eternal life and to be there for others. Discussion is focused on the role that fear of death and specific "defensive control" motives for having digital avatars (e.g., motivation for eternal life and to be there for others) may play in the desire for digital immortality reported by individuals with narcissistic personality traits.

Linking environmental pressures and trait emotional intelligence to eating symptomatology: the mediating role of unhealthy body self-perceptions

ABSTRACT Objective Research showed that trait emotional intelligence (trait EI), pressures from family, peers and media, and problematic perceptions of one’s body, are plausible antecedents for variation in the severity of eating disorders. This study examined the hypothesis that an association between pressures from one’s environment (peers, family, media), trait EI and eating pathology would be mediated by body uneasiness and appearance concern for one’s body. Method This online cross-sectional study enrolled a sample of 546 participants aged 18–24 years (M = 21.58; SD = 2.05), self-report questionnaires were administered to measure trait EI, environmental pressure, body uneasiness, appearance concern and eating disorder symptomatology. Results The results showed significant associations among trait EI, body uneasiness and appearance concern. Furthermore, significant links were found between environmental pressures, body uneasiness, appearance concern and eating disorders. Moreover, there was a significant association between body uneasiness and eating disorders and between appearance concern and eating disorders. Finally, indirect associations were found from trait EI to eating disorders by body uneasiness and appearance concern, and from environmental pressures to eating disorders by body uneasiness and appearance concern. Conclusions The study’s hypothesis was confirmed and suggested the importance of targeting image disturbances to improve the clinical efficacy of treatments for eating disorders.

Cardiorespiratory fitness and development of childhood cardiovascular risk: The EXAMIN YOUTH follow-up study.

Background: Obesity- and hypertension-related cardiovascular (CV) risk has been shown to originate in childhood. Higher body mass index (BMI) and blood pressure (BP) have been associated with increased large artery stiffness and a lower microvascular arteriolar-to-venular diameter ratio (AVR) in children. This study aimed to investigate the association of cardiorespiratory fitness (CRF) with development of BMI, BP and vascular health during childhood. Methods: In our prospective cohort study, 1,171 children aged 6-8years were screened for CRF, BMI, BP, retinal vessel diameters and pulse wave velocity using standardized protocols. Endurance capacity was assessed by 20m shuttle run test. After 4years, all parameters were assessed in 664 children using the same protocols. Results: Children with a higher CRF at baseline developed a significantly lower BMI (β [95% CI] -0.09 [-0.11 to -0.06] kg/m2, p < 0.001), a lower systolic BP (β [95% CI] -0.09 [-0.15 to -0.03]mmHg, p = 0.004) and a higher AVR (β [95% CI] 0.0004 [0.00004 to 0.0007] units, p = 0.027) after 4years. The indirect association of CRF with development of retinal arteriolar diameters was mediated by changes in BMI. Conclusion: Our results identify CRF as a key modulator for the risk trajectories of BMI, BP and microvascular health in children. Obesity-related CV risk has been shown to track into adulthood, and achieving higher CRF levels in children may help counteract the development of CV risk and disease not only in pediatric populations, but may also help reduce the burden of CVD in adulthood. Registration: http://www.clinicaltrials.gov/ (NCT02853747).

How and when do strengths work? The effect of strengths-based leadership on follower career satisfaction

PurposeDrawing on conversation of resources theory, the present paper aimed to investigate the effect of strengths-based leadership on follower career satisfaction and the mediating role of follower strengths use as well as the moderating role of emotional exhaustion in the relationship.Design/methodology/approachResearch data were gathered at 3 time points with a sample of 210 participants working in various organizations in China. Structural equation model (SEM) was applied to examine the authors' hypotheses.FindingsThe results indicated that strengths-based leadership has a positive impact on follower career satisfaction and follower strengths use fully mediates the effect of strengths-based leadership on follower career satisfaction. More importantly, emotional exhaustion enhanced the direct relationship between strengths use and career satisfaction and the indirect association of strengths-based leadership with follower career satisfaction through follower strengths use.Research limitations/implicationsThe main limitation of the present paper was the single source of research data.Originality/valueThe present paper advances strengths-based leadership theory and research and provides a new insight into cultivating employee career satisfaction.

Asset accumulation, financial inclusion and subjective well‐being: The role of financial formality in South Africa's households

AbstractAsset building and financial inclusion programmes have contributed to the enhancement of consumers' welfare through asset accumulation. Employing the FinScope consumer survey for South Africa, we extended the analysis of the relationship between financial inclusion and asset holding by examining whether this, in turn, improves consumers' subjective well‐being (SWB). Financial inclusion was captured by credit, savings, and insurance whereas multiple correspondence analysis was employed to compute an asset index that captured indicators of individual material possessions. Results from the partial least squares path model suggested that financial inclusion had an indirect positive association with consumers' SWB through increased asset holding, but the association was more pronounced via formal channels of saving, credit, and insurance. As such, social policymakers are encouraged to integrate access to insurance, credit, and savings through formal channels in poverty interventions since this has a greater indirect association with consumers' SWB via increased asset ownership.

How trust in government relates to public attitudes toward shale gas development in China

Public trust in government influences public attitudes toward the development of new technology. However, research conducted to assess the relationship has been done primarily in Western-style democracies. This research examines how public trust in the Chinese government is related, directly and indirectly, to public attitudes toward shale gas development. An online survey of a large convenience sample of Chinese residents (n = 1361) was conducted in 2022 in five provinces where shale gas extraction and/or exploration are occurring. We found that trust in central government has a direct positive association with the perceived benefits and risks of shale gas development. Respondents with higher trust in central and provincial government are more likely to express support shale gas development. There is also a statistically significant indirect positive association with support for shale gas development via greater perceived benefits, yet we did not find a statistically significant indirect effect of trust on support for shale gas development through perceived risks. The results are interesting because in China the government and the shale gas industry are more closely connected than they are in Western-style democracies and the environmental movement in China is at an early stage of development. Future research should examine how attitudes in China evolve as the scale of the shale gas industry grows and the environmental movement grows.

Conquering precarious work through inclusive leadership: Important roles of structural empowerment and leader political skill

Given the prevalence of precarious work in the social fabric of organizations, its negative repercussions for employees and organizations, and the scarcity of research on how organizational leadership can improve working conditions, we suggest inclusive leaders as a remedy to precarious work. Drawing on stakeholder theory, we propose that inclusive leadership is negatively associated with precarious work, both directly and indirectly, via structural empowerment. We also hypothesize that leader political skill moderates the positive relationship between inclusive leadership and structural empowerment and the negative indirect (via structural empowerment) association between inclusive leadership and precarious work. Two-source and time-lagged survey data collected from 311 employees and their supervisors supported our hypotheses. Other than contributions to the literature on inclusive leadership, structural empowerment, and precarious work, this study offers several imperative practical implications that can help organizations counter precarious work and its negative repercussions.

A longitudinal study of the mediating role of resilience in the impact of trait mindfulness on anxiety and aggression in Chinese college students with left‐behind experiences

AbstractThe present study investigated how trait mindfulness is related to anxiety and aggression by considering the mediating role of resilience with the longitudinal data among Chinese college students with left‐behind experience. A total of 391 Chinese college students with left‐behind experiences completed the Mindful Attention Awareness Scale, the Connor‐Davidson Resilience Scale, the Chinese college students’ version of the Buss‐Perry Aggression Questionnaire, and the Depression Anxiety Stress Scales at two‐time points. Structural equation modeling was used to analyze the data, and the results indicated that resilience (T1) mediated the relationship between trait mindfulness (T1) and anxiety (T2) (indirect effect = −0.053, 95% confidence interval [CI] = [−0.119, −0.005]) as well as aggression (T2) (indirect effect = −0.070, 95% CI = [−0.127, −0.029]). Therefore, trait mindfulness had direct and indirect negative associations with anxiety and aggression, and resilience mediated the relationship between trait mindfulness and both anxiety and aggression. The findings of the study provide valuable insights into the potential benefits of trait mindfulness and resilience in improving mental health outcomes and suggest clinical potential in the improvement of mental health among college students with left‐behind experiences.

Association of Childhood Area-Level Ethnic Density and Psychosis Risk Among Ethnoracial Minoritized Individuals in the US

The protective ethnic density effect hypothesis, which suggests that minoritized individuals who grow up in neighborhoods with a high proportion of ethnoracial minoritized groups are protected from the effects of perceived discrimination, has not been examined among individuals at clinical high risk of psychosis (CHR-P). This level of examination may help identify intervention targets for preventing psychosis among high-risk individuals. To examine the association between area-level ethnic density during childhood, perceived discrimination, and psychosis risk outcomes among ethnoracial minoritized individuals with CHR-P. Data were collected as part of the North American Prodrome Longitudinal Study-2 (NAPLS 2) between November 2008 and March 2013. Participants included ethnoracial minoritized youth with CHR-P. Area-level ethnoracial minoritized density pertained to the percent of ethnoracial minoritized individuals within the participant's county during childhood. Generalized mixed-effects models with random intercepts for participants, NAPLS 2 site, and county estimated the associations between area-level ethnic density and the risk of psychosis risk outcomes. Self-reported experience of discrimination was assessed. Mediation analyses computed the indirect association of perceived discrimination in the prospective correlation between ethnic density and psychosis risk outcomes. Analyses took place between December 2021 and June 2023. Psychosis risk outcomes included remission, symptomatic, progression, and conversion to psychosis and were assessed throughout 24-month follow-up. Of 193 individuals, the mean (SD) age was 17.5 (3.4) years and 113 males (58.5%) were included. Participants self-identified as Asian (29 [15.0%]), Black (57 [29.0%]), Hispanic (any race; 87 [45.0%]), or other (First Nations, Middle Eastern, and interracial individuals; 20 [10.4%]). Greater area-level minoritized density was associated with a lower likelihood of remaining symptomatic (relative risk [RR], 0.54 [95% CI, 0.33-0.89]) and having progressively worsening symptoms (RR, 0.52 [95% CI, 0.32-0.86]) compared with being in remission. More perceived discrimination was associated with a higher risk of staying symptomatic (RR, 1.43 [95% CI, 1.09-1.88]) and progressively worsening (RR, 1.34 [95% CI, 1.02-1.78]) compared with being in remission. Perceived discrimination significantly mediated 21.7% (95% CI, 4.1%-67.0%; P = .02) of the association between area-level minoritized density and the likelihood of being in remission. This study found that among ethnoracial minority youth with CHR-P, growing up in communities with a greater proportion of ethnically minoritized individuals was associated with remission of psychosis risk symptoms partly through lower levels of perceived discrimination. Understanding how the social environment impacts early psychosis risk may help develop effective interventions to prevent psychosis, especially for vulnerable minoritized youth.

Linking quality supervisory support to turnover intentions among rural healthcare professionals: The mediating role of performance appraisal satisfaction and moderating role of perceived organizational support

This study examines the relationships among quality supervision, performance appraisal satisfaction, and employee turnover. It explores the moderating role of perceived organizational support in these relationships within the context of rural healthcare. Data for this study were obtained from an online survey of employees from a large rural health facility in the Southeastern United States. Hypothesized relationships were examined using regression-based moderated mediation analysis. The empirical results suggest a negative relationship between the quality of supervisory support and turnover intentions, mediated partially by employees’ performance appraisal satisfaction. The indirect effect of quality supervisory support on turnover intention and the direct effect of performance appraisal satisfaction on turnover were also found to be moderated by perceived organizational support. Understanding factors that drive employee retention can help inform effective managerial practices and interventions for reducing turnover. Our study contributes to practice and the existing literature by examining the boundary conditions of perceived organizational support on the direct and indirect association between quality supervisory support and turnover intentions via performance appraisal satisfaction.

The Importance of Employee Trust as a Mediating Job Satisfaction, Employee Relations and Employee Performance

Purpose – The aim of the study sought to ascertain the impact of employee relations and job satisfaction. Relations with mediation of Employee Trust on employee performance at the delivery service provider company PT TAB in Indonesia. Methodology/approach – These studies employ quantitative descriptive methods. Using a quota sampling type with a non-probability sampling technique, there are 203 couriers at DKI Jakarta who have been employed for over a year. SEM-PLS data analysis with the SmartPLS 3.2.9 program. Findings – According to research, job happiness and employee relations have a favorable and strong direct relationship to employee performance, whereas employee trust has no bearing. Another conclusion was that there was no evidence for an indirect association between work satisfaction and employee relations on employee performance. Novelty/value – It is recommended that the company maintain and maintain the current svstem and promotions and consider reviewing matters related to the distribution of information and policies within the company and continue to consider the recruitment and training system to improve the capabilities of couriers at PT TAB.

Socioeconomic status and health literacy as the important predictors of general health in Iran: a structural equation modeling approach

&#x0D; Background: We aimed to determine the level of health literacy (HL), and its association with general health. In addition, we investigated the direct and indirect association of socioeconomic status (SES) and general health among the adult population in Iran.&#x0D; Methods: This cross-sectional study involved 750 literate adults' people. The SES was assessed based on the owning of assets. HL was evaluated using a validated questionnaire in Iran. General health was assessed using the WHO general health questionnaire. The simple and adjusted linear regression models, and structural equation modeling (SEM) were used for data analysis.&#x0D; Results: In adjusted model, female gender, higher level of education, use of books, pamphlets, or brochures as a source of health information, the higher level of SES were positively associated with higher HL. In addition, the HL was significantly associated with higher scores of general health. Results of SEM showed that the direct effect of SES on general health was not significant, but the indirect effect via HL was significant (path coefficient: 0.24; p&lt;0.001).&#x0D; Conclusion: Results of our study indicated HL is strongly associated with general health among the adult population. SES had a significant indirect association with general health via the effect on health literacy.&#x0D;

A socio-ecological perspective on psychological well-being in a culturally diverse context: The role of perceived national multicultural norms

The research examined perceived national norms for multiculturalism, Multicultural Contact (MC), Multicultural Ideology (MI) and Multicultural Policies and Practices (MPP), as associated with well-being in a community sample. One hundred and twenty-five British Indians and 250 British Whites completed an online survey with measures of Normative Multiculturalism, belonging, and psychological well-being (positive affect, flourishing, and life satisfaction). A multi-group mediational model was tested with direct and indirect (via belonging) paths to well-being. Results demonstrated significant direct and indirect associations of MC on well-being for Indians and indirect associations for Whites. MPP produced the same indirect pathways, but only for Indians. MI was not significantly related either to belonging or well-being. The findings are discussed in relation to broader theorizing on multiculturalism and their practical implications in the British socio-political context.

A conditional process analysis of suicidal thoughts and behaviors in outpatient parents: Examining the Narrative Crisis Model by parenthood status.

No study to date has examined the moderating effect of parenthood on suicidal states and outcomes using a conditional process model. The Narrative Crisis Model, a multi-stage model from interpersonal distress to suicidal outcomes mediated by Suicide Crisis Syndrome severity, was assessed (H1). The present study tested whether (H2) parenthood moderates the indirect association between interpersonal distress and suicidality to reduce suicide risk. Psychiatric outpatients (N = 466) completed measures assessing the severity of interpersonal distress and Suicide Crisis Syndrome, as well as a clinical interview of suicidal thoughts and behaviors. The sample was predominantly female (65.7%), with ages ranging from 18 to 84 years. Mediation was conducted on the total sample (H1) and a conditional process analysis compared parents (n = 170) and non-parents (H2). Suicide Crisis Syndrome severity mediated the relationship between interpersonal distress and suicidal outcomes. Parenthood moderated the indirect relationship between interpersonal distress and suicidal outcomes through Suicide Crisis Syndrome such that parents had a significantly higher suicide risk than non-parents (index = 0.058; 95% CI [0.005, 0.139]). In the context of an outpatient population, parents appear to be more at risk for developing a suicidal crisis and engaging in suicidal thoughts and behaviors than non-parents. Parenthood may act as a pile-up stressor for this population, outweighing the protective effects of having children. In this way, the Narrative Crisis Model is a theoretical model suitable for the examination of complex factors impacting risk for near-term suicidal thoughts and behaviors.

A Psychosocial Model of COVID-19 Vaccination: Antecedent and Concurrent Effects of Demographics, Traits, Political Beliefs, Vaccine Intention, Information Sources, Mandates, and Flu Vaccine History.

To date, research investigating psychosocial correlates of COVID-19 vaccination has been cross-sectional, parochial, and/or reliant upon non-stratified international samples, resulting in difficulty in clarifying the contributions of various vaccination-related influences. The present study tested a novel integration of prospective and concurrent associations of demographic and dispositional tendencies, intervening illness and preventive beliefs, vaccine intention, illness experiences, and concurrent contextual vaccine-related influences with subsequent COVID-19 vaccination. The preregistered study used a stratified online U.S. sample (N = 500), with assessments aligned to (a) "15 days to slow the spread" in March 2020, (b) vaccine authorization and major case/mortality surge during December 2020 and January 2021, and (c) the period following full vaccine approval in August 2021 during the third major/case mortality surge during September and October 2021. Path modeling showed the absence of children in the household and greater education were prospective predictors of vaccination. Trait openness and less conservative political beliefs showed indirect prospective associations with vaccination via stronger intermediating vaccine intention. Contextual vaccine-related influences of vaccine-related information sources, employer mandates, and flu vaccine history also showed direct associations with vaccination. In contrast to expectations, lower conscientiousness showed a direct prospective association with vaccination. Controlling for interrelations among study variables, the results of the integrative psychosocial model clarified the unique contributions and pathways from antecedent characteristics to vaccination while accounting for vaccine-related contextual influences, providing further direction for refining the timing and content of public health messaging for vaccination.

The Perils of Not Being Attractive or Athletic: Pathways to Adolescent Adjustment Difficulties Through Escalating Unpopularity.

Adolescents who lack traits valued by peers are at risk for adjustment difficulties but the mechanisms responsible for deteriorating well-being have yet to be identified. The present study examines processes whereby low athleticism and low attractiveness give rise to adolescent adjustment difficulties. Participants were public middle school students (ages 10 to 13 years, Mage = 11.54, SDage = 1.00) in the USA and Lithuania (300 girls, 280 boys; 52.7% girls). Self-reports of alcohol misuse and loneliness were collected three times during an academic year (M = 12.3 week intervals). Athleticism, attractiveness, unpopularity, and peer rejection were assessed through peer nominations. Full longitudinal mediation analyses examined direct and indirect pathways from stigmatized traits (i.e., low athleticism, low attractiveness) to adjustment difficulties (i.e., alcohol misuse, loneliness) through two indices of low peer status: unpopularity and rejection. The results indicated that the possession of stigmatized traits predicted escalating unpopularity, which, in turn, predicted increasing adjustment difficulties. Similar indirect associations did not emerge with rejection as a mediator, underscoring the unique role of power and prominence (and the lack thereof) in socioemotional development. The findings underscore the adjustment risks and interpersonal challenges that confront children and adolescents who lack traits valued by peers.

Predictors of negative moral appraisals and their association with symptoms of post-traumatic stress and depression in the context of COVID-19 related stressors.

Research on moral injury (MI) suggests that negative moral appraisals of stressful events can impact mental health in high-stakes occupational contexts (e.g., military). Few studies have examined these associations in the general population, limiting the generalisability of findings. Furthermore, factors that may predispose an individual to adverse outcomes in the context of moral stressors remain largely unknown. The objectives of this study were to (1) explore the applicability of the MI construct to stressors experienced by the general public during the COVID-19 pandemic; (2) explore how trait differences in sense of duty, religiosity/spirituality, anxiety sensitivity, and guilt, shame, and anger, predict negative moral appraisals of COVID-19 stressors. Participants (n=355) completed an online survey assessing exposure to and appraisals of COVID-19 stressors, mental health symptoms, and dispositional characteristics (i.e., trait emotions, anxiety sensitivity, sense of duty, religiosity/spirituality). Path analysis revealed specific indirect associations between self-based moral appraisals and posttraumatic stress disorder (PTSD) and depression through guilt, and between both self- and other-based moral appraisals and PTSD and depression through anger. Number of COVID-19 stressors had no influence on associations. Sense of duty, reparative guilt, and anxiety sensitivity best predicted negative moral appraisals. Findings partially support the applicability of the MI construct outside the occupational context.

Associations of Military-Related Traumatic Brain Injury With New-Onset Mental Health Conditions and Suicide Risk

Research to identify the direct and indirect associations of military-related traumatic brain injury (TBI) with suicide has been complicated by a range of data-related challenges. To identify differences in rates of new-onset mental health conditions (ie, anxiety, mood, posttraumatic stress, adjustment, alcohol use, and substance use disorders) among soldiers with and without a history of military-related TBI and to explore the direct and indirect (through new-onset mental health disorders) associations of TBI with suicide. This retrospective cohort study used data from the Substance Use and Psychological Injury Combat Study (SUPIC) database. Demographic, military, and health data from the Department of Defense within SUPIC were compiled and linked with National Death Index records to identify deaths by suicide. Participants included US Army soldiers who returned from an Afghanistan or Iraq deployment. Data were analyzed from September to December 2022. Military-related TBI. The outcome of interest was suicide. Secondary outcomes were incidence of new-onset mental health conditions. Mediation analyses consisted of accelerated failure time (AFT) models in conjunction with the product of coefficients method. The 6 new-onset mental health diagnosis categories and the 2 or more categories variable were each considered separately as potential mediators; therefore, a total of 14 models plus the overall AFT model estimating the total effect associated with TBI in suicide risk were fit. The study included 860 892 soldiers (320 539 soldiers [37.2%] aged 18-24 at end of index deployment; 766 454 [89.0%] male), with 108 785 soldiers (12.6%) with at least 1 documented TBI on their military health record. Larger increases in mental health diagnoses were observed for all conditions from before to after documented TBI, compared with the matched dates for those without a history of TBI, with increases observed for mood (67.7% vs 37.5%) and substance use (100% vs 14.5%). Time-to-suicide direct effect estimates for soldiers with a history of TBI were similar across mediators. For example, considering new-onset adjustment disorders, time-to-suicide was 16.7% faster (deceleration factor, 0.833; 95% CI, 0.756-0.912) than for soldiers without a history of TBI. Indirect effect estimates of associations with TBI were substantial and varied across mediators. The largest indirect effect estimate was observed through the association with new-onset substance use disorder, with a time to suicide 63.8% faster (deceleration factor, 0.372; 95% CI, 0.322-0.433) for soldiers with a history of TBI. In this longitudinal cohort study of soldiers, rates of new-onset mental health conditions were higher among individuals with a history of TBI compared with those without. Moreover, risk for suicide was both directly and indirectly associated with history of TBI. These findings suggest that increased efforts are needed to conceptualize the accumulation of risk associated with multiple military-related exposures and identify evidence-based interventions that address mechanisms associated with frequently co-occurring conditions.

The Dark Tetrad, online moral disengagement, and online aggression perpetration among adults

Online aggression is a form of antisocial online behavior that has been widely studied among adolescents, but adults of all ages are involved as well. The goal of the present study is to broaden the understanding of potential risk factors of online aggression perpetration. Associations between socially aversive personality traits and online aggression are examined. In contrast to previous research and to account for ICT affordances, the present study argues for and tests the mediating role of online moral disengagement, and not traditional moral disengagement, in the relationships between traits and perpetration. To this aim, a cross-sectional dataset, balanced in terms of age, was collected among 2,000 adults aged 19–79. A path model revealed indirect associations for two traits, psychopathy and sadism, with online aggression perpetration via online moral disengagement, while controlling for online aggression victimization. Theoretical and practical implications are discussed.

Urban-rural disparity in body mass index: is dietary knowledge a mechanism? Evidence from the China Health and Nutrition Survey 2004-2015.

The co-existence of undernutrition and overweight/obesity has been recognised as a severe challenge in China, with substantial urban-rural disparity. We evaluated short- and long-term associations of urban-rural locality on body mass index (BMI) in Chinese adults overall and stratified by sex, focusing on whether dietary knowledge plays a mediating role. We used cross-sectional and longitudinal study designs with structural equation modelling based on the 2004 (T1) and 2015 (T2) waves of the China Health and Nutrition Survey. We adjusted the models for covariates and performed sensitivity analyses. We cross-sectionally analysed 8932 (53.1% women) and 11 216 adults (54.3% women) at T1 and T2, respectively, and longitudinally investigated 4073 adults (55.6% women) in both T1 and T2. The estimated average dietary knowledge and mean BMI increased from T1 to T2. At each time point, we found significant indications of direct (e.g. urban-rural locality to BMI, urban-rural locality to dietary knowledge, and dietary knowledge to BMI) and indirect associations (e.g. urban-rural locality to dietary knowledge to BMI) overall and for men and women (except that urban-rural locality to BMI) separately. The long-term association between urban-rural locality and BMI attenuated over time and was not mediated by dietary knowledge change alone. Nevertheless, dietary knowledge interacted with BMI, which acted as a pathway from urban-rural locality to BMI in the long term. Urban-rural disparity in BMI persists in Chinese adults and is mediated by dietary knowledge. Policy and educational efforts to improve dietary knowledge among rural people may reduce China's urban-rural disparity in BMI.