# Determinants of proactive health behaviors in individuals at high risks of stroke: a structural equation model analysis

## TL;DR

This study identifies key factors influencing proactive health behaviors in people at high risk of stroke, using a model based on motivation theory.

## Contribution

The study introduces a structural equation model to clarify how variables like health literacy and risk perception influence proactive health behaviors in stroke-prone individuals.

## Key findings

- Proactive health behaviors are positively correlated with chronic illness resources, health literacy, stroke risk perception, and self-efficacy.
- Risk perception of stroke and self-efficacy partially mediate the relationship between other variables and proactive health behaviors.
- The structural model demonstrated good fit, confirming the interrelationships among the studied factors.

## Abstract

To explore the influencing factors of proactive health behaviors in individuals at high risks of stroke based on the theory of the proactive motivation model, and to clarify the interrelationship among these variables.

A cross-sectional study using the convenience sampling method was conducted in one community in Shanghai, China. Between November 2024 and February 2025, a total of 309 individuals at high risks of stroke completed the general information questionnaire, the Self-Rated Abilities for Health Practices scale, the Chronic Illness Resources Survey, the Risk Perception Questionnaire for individuals at high risks of stroke, the 16-item European Health Literacy Survey Questionnaire, and the self-designed Proactive Health Behavior Scale for individuals at high risks of stroke. Descriptive statistics, univariate analysis, correlation analysis, and path analysis were used to identify the influencing factors and mechanisms of proactive health behaviors.

The structural model showed good model fit. There was a positive correlation between proactive health behaviors with chronic illness resources, health literacy, risk perception of stroke, and self-efficacy. Risk perception of stroke and self-efficacy both exerted a partial mediation effect between these variables and proactive health behaviors.

Chronic illness resources, health literacy, risk perception of stroke, and self-efficacy are key factors associated with proactive health behaviors among individuals at high risks of stroke.