Research article

Discordance between lifestyle-related health behaviors and beliefs of urban mainland Chinese: A questionnaire study with implications for targeting health education

  • Received: 12 June 2018 Accepted: 22 January 2019 Published: 20 February 2019
  • Background: Morbidity and mortality in China are increasingly associated with lifestyle behaviors, e.g., smoking, poor nutritional choices, and physical inactivity. Lifestyle-related non-communicable diseases (e.g., hypertension, stroke, heart disease, lung disease) are at critical levels globally, in turn their socioeconomic burdens. Knowledge of lifestyle-related health behaviors and beliefs of mainland Chinese would help inform the design and targeting of cost-effective health education for individuals and campaigns in the interests of promoting and protecting health, and preventing disease. This study’s objective was to describe the lifestyle behaviors and beliefs of a sample of urban mainland Chinese, and their congruence with evidence-based guidelines for maximal health. Methods: A cross-sectional interview questionnaire study was conducted in which 835 mainland Chinese (55% men, 45% women) from four urban areas participated. Results: About half (52%) reported smoking to some degree with 21% being habitual smokers; 33% being above average weight; 62.1% met physical activity guidelines for health benefits; 92% being sedentary for 5.8 ± 3.40 h/d; 66% experiencing moderate/high stress; and sleeping 7.1 ± 1.31 h nightly with 35% reporting sleeping poorly. When standard serving sizes were considered, daily consumption of grains, fruits, and vegetables was reported to be consistent with dietary recommendations for good health, however, added salt (3.7 ± 7.42 tsp) and sugar (3.9 ± 12.99 tsp) exceeded recommendations. Life stress was rated moderate by 59.6% of respondents, with personal and family health stresses ranking highest (43% and 55%, respectively). Regarding beliefs about importance of lifestyle behaviors to health, respondents’ understanding was not consistent with evidence-based recommendations. Only 64% of participants believed smoking abstinence is highly important to health; 56% regular exercise; and 37% consumption of whole grains, 62% fruit and vegetables; and 54% maintaining a healthy body weight. Conclusion: To be congruent with established guidelines for healthy living, health promotion and disease prevention education for individuals and public campaigns warrants targeting health knowledge and beliefs of urban Chinese as well as lifestyle-related health behaviors. The roles of gender, education and living rurally, on lifestyle behaviors and beliefs of the Chinese, warrant elucidation.

    Citation: Peng Wang, Zhenyi Li, Alice Jones, Michael E. Bodner, Elizabeth Dean. Discordance between lifestyle-related health behaviors and beliefs of urban mainland Chinese: A questionnaire study with implications for targeting health education[J]. AIMS Public Health, 2019, 6(1): 49-66. doi: 10.3934/publichealth.2019.1.49

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  • Background: Morbidity and mortality in China are increasingly associated with lifestyle behaviors, e.g., smoking, poor nutritional choices, and physical inactivity. Lifestyle-related non-communicable diseases (e.g., hypertension, stroke, heart disease, lung disease) are at critical levels globally, in turn their socioeconomic burdens. Knowledge of lifestyle-related health behaviors and beliefs of mainland Chinese would help inform the design and targeting of cost-effective health education for individuals and campaigns in the interests of promoting and protecting health, and preventing disease. This study’s objective was to describe the lifestyle behaviors and beliefs of a sample of urban mainland Chinese, and their congruence with evidence-based guidelines for maximal health. Methods: A cross-sectional interview questionnaire study was conducted in which 835 mainland Chinese (55% men, 45% women) from four urban areas participated. Results: About half (52%) reported smoking to some degree with 21% being habitual smokers; 33% being above average weight; 62.1% met physical activity guidelines for health benefits; 92% being sedentary for 5.8 ± 3.40 h/d; 66% experiencing moderate/high stress; and sleeping 7.1 ± 1.31 h nightly with 35% reporting sleeping poorly. When standard serving sizes were considered, daily consumption of grains, fruits, and vegetables was reported to be consistent with dietary recommendations for good health, however, added salt (3.7 ± 7.42 tsp) and sugar (3.9 ± 12.99 tsp) exceeded recommendations. Life stress was rated moderate by 59.6% of respondents, with personal and family health stresses ranking highest (43% and 55%, respectively). Regarding beliefs about importance of lifestyle behaviors to health, respondents’ understanding was not consistent with evidence-based recommendations. Only 64% of participants believed smoking abstinence is highly important to health; 56% regular exercise; and 37% consumption of whole grains, 62% fruit and vegetables; and 54% maintaining a healthy body weight. Conclusion: To be congruent with established guidelines for healthy living, health promotion and disease prevention education for individuals and public campaigns warrants targeting health knowledge and beliefs of urban Chinese as well as lifestyle-related health behaviors. The roles of gender, education and living rurally, on lifestyle behaviors and beliefs of the Chinese, warrant elucidation.


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    Abbreviation BMI: body mass index; NCD: non-communicable diseases;
    Acknowledgments



    Funding: No funding was provided for this study.
    Availability of data and materials: Due to grounds of confidentiality and anonymity, part of the data can be made available by request.
    Authors' contributions: All authors have made substantial contribution to the conceptualization of the work, the design of the study, interpretation of the data, and drafting the article. ED carried out the study design, and administering the acquisition of the data. ZL coordinated the data coding and data analysis. PW carried out the analysis of the data and drafting the manuscript. ED and AJ conceived the study, carried out its design, and drafted and revised the manuscript. MB advised on and reviewed data analysis, edited the manuscript, and contributed to discussion. All authors read and approved of the final manuscript.
    Ethics approval and consent to participate: The study has been approved by the participating institutions adhering to the Helsinki Declaration related to Human Research. Consent to participate in the study was obtained from all participants before proceeding with the interview survey.

    Conflict of interest



    The authors declare that they have no competing interests.

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