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.

Behavioral Intervention Components Associated With Cost-effectiveness: A Comparison of Six Domains

Background To help implement behavior change interventions (BCIs) it is important to be able to characterize their key components and determine their effectiveness. Purpose This study assessed and compared the components of BCIs in terms of intervention functions identified using the Behaviour Change Wheel Framework (BCW) and in terms of their specific behavior change techniques (BCTs) identified using the BCT TaxonomyV1, across six behavioral domains and the association of these with cost-effectiveness. Methods BCIs in 251 studies targeting smoking, diet, exercise, sexual health, alcohol and multiple health behaviors, were specified in terms of their intervention functions and their BCTs, grouped into 16 categories. Associations with cost-effectiveness measured in terms of incremental cost-effectiveness ratio (ICER) upper and lower estimates were determined using regression analysis. Results The most prevalent functions were increasing knowledge through education (72.1%) and imparting skills through training (74.9%). The most prevalent BCT groupings were shaping knowledge (86.5%), changing behavioral antecedents (53.0%), supporting self-regulation (47.7%), and providing social support (44.6%). Intervention functions associated with better cost-effectiveness were those based on training (βlow = −15044.3; p = .002), persuasion (βlow = −19384.9; p = .001; βupp = −25947.6; p < .001) and restriction (βupp = −32286.1; p = .019), and with lower cost-effectiveness were those based on environmental restructuring (β = 15023.9low; p = .033). BCT groupings associated with better cost-effectiveness were goals and planning (βlow = −8537.3; p = .019 and βupp = −12416.9; p = .037) and comparison of behavior (βlow = −13561.9, p = .047 and βupp = −30650.2; p = .006). Those associated with lower cost-effectiveness were natural consequences (βlow = 7729.4; p = .033) and reward and threat (βlow = 20106.7; p = .004). Conclusions BCIs that focused on training, persuasion and restriction may be more cost-effective, as may those that encourage goal setting and comparison of behaviors with others.

Future directions of the National Institutes of Health Science of Behavior Change Program

Background The National Institutes of Health Science of Behavior Change Common Fund Program has accelerated the investigation of mechanisms of behavior change applicable to multiple health behaviors and outcomes and facilitated the use of the experimental medicine approach to behavior change research. Purpose This commentary provides a brief background of the program, plans for its next phase, and thoughts about how the experimental medicine approach to behavior change research can inform future directions in two areas of science—reproductive health and COVID-19 vaccine uptake. Conclusions The incorporation of a mechanisms-based approach into behavior intervention research offers new opportunities for improving health.

Factors Related to Longitudinal Patterns of Multiple Health Behaviors in Chinese Freshmen

Students with multiple health risk behaviors (HRB) have increased amount of research attention. The study aimed to examine the multiple health behaviors and whether these behaviors differ by demographic characteristics and social factors in a 1-year follow-up study among 1,989 students. All the measures were from the Youth Risk Behavior Surveillance System. Associations between demographic characteristics/social factors and multiple HRB were examined by logistic regression models. Binary logistic models indicated that females had generally higher odds of physical inactivity but lower odds of cigarette smoking, alcohol drinking, suicide attempt, and breakfast skipping. Students more than 18 years had higher odds of cigarette smoking. Physical inactivity was negatively correlated with playing school sports teams and taking extracurricular activities. Students with screen time >2 hr/d were more likely to be with physical inactivity or alcohol drinking. Logistic regression models showed that males showed higher odds of two, three, and four to six HRB at 3T. Not taking part in school sports teams/extracurricular activities and screen time >2 hr/d at baseline were risk factors of multiple HRB. Our results reveal a close association between youth risk behaviors and demographic characteristics/social factors. Health promotion interventions of co-occurred behavior should be conducted at schools.