Abstract：
Awareness, knowledge, beliefs, and behavioral intentions of physical activity (PA) guidelines may be important mediating factors for promoting PA. However, these pathways of the psychological process to PA behavior have not been examined. These pathways may differ depending on health literacy levels. This study investigated the pathways to PA, from guideline awareness to behavior, and further examined whether they differed by health literacy.
A cross-sectional study was conducted with 7,000 Japanese participants aged 20-69 years. The participants were registered with an Internet survey company. Participants\' awareness, knowledge, beliefs, and behavioral intentions regarding the PA guidelines of Japan, the volume of moderate-to-vigorous intensity PA, activity level, and health literacy were examined through a questionnaire. The PA pathways, from guideline awareness to behavior, were examined by structural equation modeling (SEM), with PA behavior as the dependent variable. Multi-group SEM was conducted to examine the moderating effect of health literacy on PA pathways. Health literacy scores were dichotomized into high and low groups in multi-group modeling by the median split.
SEM revealed that PA guideline awareness directly affects PA behavior and has certain indirect effects through the mediation of knowledge, beliefs, and behavioral intentions. Furthermore, the multi-group SEM showed that the proportion of indirect effects (path coefficient [PC]: 0.11, 95% confidence interval [CI]: 0.10-0.13) was higher than direct effects (PC: 0.07, 95%CI: 0.03-0.11) in the high-health literacy group. In contrast, the proportion of direct effects (PC: 0.22, 95%CI: 0.15-0.30) was higher than indirect effects (PC: 0.06, 95%CI: 0.05-0.07) in the low-health literacy group.
PA guideline awareness is both directly and indirectly associated with PA behavior, mediated by psychological pathways of knowledge, beliefs, and behavioral intentions, and influenced by health literacy. These results suggest that health literacy should be considered when implementing PA guideline-based interventions.
A cross-sectional study was conducted with 7,000 Japanese participants aged 20-69 years. The participants were registered with an Internet survey company. Participants\' awareness, knowledge, beliefs, and behavioral intentions regarding the PA guidelines of Japan, the volume of moderate-to-vigorous intensity PA, activity level, and health literacy were examined through a questionnaire. The PA pathways, from guideline awareness to behavior, were examined by structural equation modeling (SEM), with PA behavior as the dependent variable. Multi-group SEM was conducted to examine the moderating effect of health literacy on PA pathways. Health literacy scores were dichotomized into high and low groups in multi-group modeling by the median split.
SEM revealed that PA guideline awareness directly affects PA behavior and has certain indirect effects through the mediation of knowledge, beliefs, and behavioral intentions. Furthermore, the multi-group SEM showed that the proportion of indirect effects (path coefficient [PC]: 0.11, 95% confidence interval [CI]: 0.10-0.13) was higher than direct effects (PC: 0.07, 95%CI: 0.03-0.11) in the high-health literacy group. In contrast, the proportion of direct effects (PC: 0.22, 95%CI: 0.15-0.30) was higher than indirect effects (PC: 0.06, 95%CI: 0.05-0.07) in the low-health literacy group.
PA guideline awareness is both directly and indirectly associated with PA behavior, mediated by psychological pathways of knowledge, beliefs, and behavioral intentions, and influenced by health literacy. These results suggest that health literacy should be considered when implementing PA guideline-based interventions.
摘要：
背景：意识，知识,信仰,和身体活动行为意向（PA）指南可能是促进PA的重要中介因素。然而,这些心理过程到PA行为的途径尚未研究。这些途径可能因健康素养水平而异。这项研究调查了PA的途径，从准则意识到行为，并进一步检查了它们是否因健康素养而有所不同。
方法：对7,000名20-69岁的日本参与者进行了横断面研究。参与者在一家互联网调查公司注册。参与者的意识，知识,信仰,以及关于日本PA指南的行为意图，中等强度至剧烈强度PA的体积，活动水平,和健康素养通过问卷调查。PA途径，从准则意识到行为，通过结构方程模型(SEM)进行检验，以PA行为为因变量。采用多组扫描电镜观察健康素养对PA通路的调节作用。在多组建模中，健康素养得分按中位数划分为高低组。
结果：SEM揭示，PA指南意识直接影响PA行为，并通过知识的调解具有一定的间接作用，信仰,和行为意图。此外，多组SEM显示，在高健康素养组中，间接效应（路径系数[PC]：0.11，95％置信区间[CI]：0.10-0.13）的比例高于直接效应（PC：0.07，95CI：0.03-0.11）。相比之下,在低健康素养组中,直接效应(PC:0.22,95CI:0.15-0.30)的比例高于间接效应(PC:0.06,95CI:0.05-0.07)。
结论：PA指南意识与PA行为直接或间接相关，由知识的心理途径介导，信仰,和行为意图，并受到健康素养的影响。这些结果表明，在实施基于PA指南的干预措施时应考虑健康素养。
方法：对7,000名20-69岁的日本参与者进行了横断面研究。参与者在一家互联网调查公司注册。参与者的意识，知识,信仰,以及关于日本PA指南的行为意图，中等强度至剧烈强度PA的体积，活动水平,和健康素养通过问卷调查。PA途径，从准则意识到行为，通过结构方程模型(SEM)进行检验，以PA行为为因变量。采用多组扫描电镜观察健康素养对PA通路的调节作用。在多组建模中，健康素养得分按中位数划分为高低组。
结果：SEM揭示，PA指南意识直接影响PA行为，并通过知识的调解具有一定的间接作用，信仰,和行为意图。此外，多组SEM显示，在高健康素养组中，间接效应（路径系数[PC]：0.11，95％置信区间[CI]：0.10-0.13）的比例高于直接效应（PC：0.07，95CI：0.03-0.11）。相比之下,在低健康素养组中,直接效应(PC:0.22,95CI:0.15-0.30)的比例高于间接效应(PC:0.06,95CI:0.05-0.07)。
结论：PA指南意识与PA行为直接或间接相关，由知识的心理途径介导，信仰,和行为意图，并受到健康素养的影响。这些结果表明，在实施基于PA指南的干预措施时应考虑健康素养。
