A Network Analysis of Multiple Preconception Health Behaviors in Chinese Women

A healthy preconception lifestyle, consisting of multiple health behaviors, is crucial for preventing adverse health outcomes in mothers and offspring. Although inter-behavior relations may be leveraged to boost the effectiveness of lifestyle education and multiple health behavior changes, this has not been adequately explored in the existing literature. Adopting a network perspective, the present study conceptualized multiple health behaviors as a behavior network (i.e., behaviors as nodes, inter-behavior relations as edges) and utilized network analysis to investigate the patterns of interdependence of preconception health behaviors in a large sample of Chinese women. We used the data of a population-based cohort study in China to estimate the behavior network. An analytic sample included 41,127 Chinese women who were surveyed about their adoptions of multiple health behaviors during the preconception period. Network analysis revealed a relatively dense behavior network and visualized the network structure of multiple preconception health behaviors, suggesting that the behaviors were strongly interconnected. Subsequent centrality analysis identified three central behaviors (i.e., avoiding passive smoke, reducing psychosocial stress, and reducing alcohol) that had distinctively stronger connections to other behaviors within the network. This study demonstrated the applicability of the network model in multiple health behavior research. Our findings highlight the interdependence of preconception health behaviors and implicate the potential usefulness of targeting central behaviors in preconception lifestyle education.