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Peer-reviewedCC BY 4.0Frontiers in Public Health

Community health information exposure and chronic disease preventive behavior among middle-aged and older adults an exploratory sequential mixed-methods study

  • Jing Jing1,2
  • Nuofan He1
  • Wei Li3
  1. 1College of Geography and Environment, Baoji University of Arts and Sciences
  2. 2Shaanxi Key Laboratory of Disasters Monitoring and Mechanism Simulation, Baoji University of Arts and Sciences
  3. 3Yangzhou University
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Abstract

Introduction: This study examined whether community health information exposure was associated with chronic disease preventive behavior among middle-aged and older adults, with particular attention to the chained mediating roles of risk perception and preventive self-efficacy and the moderating role of health literacy.

Methods: An exploratory sequential mixed-methods design was adopted. In the qualitative phase, semi-structured interviews were conducted with 27 middle-aged and older community residents from six community health service centers in Sichuan and Chongqing, China. In the quantitative phase, 704 valid questionnaires were collected through site-based convenience sampling from eight community health service centers, three senior activity stations, and family-doctor-contracted populations. Confirmatory factor analysis, structural equation modeling, and bootstrap procedures were used to test the proposed model.

Results and discussion: Community health information exposure was positively associated with chronic disease preventive behavior (β = 0.143, p < 0.01) and risk perception (β = 0.417, p < 0.001). Risk perception was further positively associated with preventive self-efficacy (β = 0.358, p < 0.001) and chronic disease preventive behavior (β = 0.119, p < 0.01). Preventive self-efficacy showed the strongest positive association with preventive behavior (β = 0.528, p < 0.001). Risk perception and preventive self-efficacy each showed significant indirect effects, and together formed a significant chained mediation path (indirect effect = 0.079, 95% CI [0.051, 0.115]). Health literacy significantly moderated the path from community health information exposure to risk perception (β = 0.154, p < 0.001) and was associated with a stronger chained indirect effect. Community health information exposure may contribute to chronic disease prevention partly through greater risk awareness and stronger preventive self-efficacy. Improving health literacy may help strengthen the translation of community health information into sustained preventive action, although longitudinal and intervention studies are still needed.

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Cite

BibTeXRIS
BibTeX
@article{jing2026community,
  title = {{Community health information exposure and chronic disease preventive behavior among middle-aged and older adults an exploratory sequential mixed-methods study}},
  author = {Jing Jing and Nuofan He and Wei Li},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1869256},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1869256/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Community health information exposure and chronic disease preventive behavior among middle-aged and older adults an exploratory sequential mixed-methods study
AU  - Jing Jing
AU  - Nuofan He
AU  - Wei Li
PY  - 2026
DA  - 2026/10/27
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1869256
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1869256/full
AB  - Introduction: This study examined whether community health information exposure was associated with chronic disease preventive behavior among middle-aged and older adults, with particular attention to the chained mediating roles of risk perception and preventive self-efficacy and the moderating role of health literacy.  Methods: An exploratory sequential mixed-methods design was adopted. In the qualitative phase, semi-structured interviews were conducted with 27 middle-aged and older community residents from six community health service centers in Sichuan and Chongqing, China. In the quantitative phase, 704 valid questionnaires were collected through site-based convenience sampling from eight community health service centers, three senior activity stations, and family-doctor-contracted populations. Confirmatory factor analysis, structural equation modeling, and bootstrap procedures were used to test the proposed model.  Results and discussion: Community health information exposure was positively associated with chronic disease preventive behavior (β = 0.143, p < 0.01) and risk perception (β = 0.417, p < 0.001). Risk perception was further positively associated with preventive self-efficacy (β = 0.358, p < 0.001) and chronic disease preventive behavior (β = 0.119, p < 0.01). Preventive self-efficacy showed the strongest positive association with preventive behavior (β = 0.528, p < 0.001). Risk perception and preventive self-efficacy each showed significant indirect effects, and together formed a significant chained mediation path (indirect effect = 0.079, 95% CI [0.051, 0.115]). Health literacy significantly moderated the path from community health information exposure to risk perception (β = 0.154, p < 0.001) and was associated with a stronger chained indirect effect. Community health information exposure may contribute to chronic disease prevention partly through greater risk awareness and stronger preventive self-efficacy. Improving health literacy may help strengthen the translation of community health information into sustained preventive action, although longitudinal and intervention studies are still needed.
SN  - 2296-2565
ER  -