Development of Health Behaviour Model for Overweight Prevention of Middle Age in Yun Cheng City, the People’s Republic of China

Abstract

Background and Aim: Overweight and obesity are chronic, multi-factorial metabolic diseases, with a rapidly increasing global prevalence that poses a significant threat to public health. Middle-aged populations in developing urban areas may face unique risk factors due to lifestyle and environmental transitions. The objective of this study was to develop and validate a comprehensive health behaviour model for the prevention of overweight among the middle-aged population in Yuncheng City, a mid-sized urban center in northern China.

Materials and Methods: This study employed a sequential mixed-methods design. The target population was middle-aged adults (aged 40-59 years, of both genders, and with a BMI ≥24 kg/m² as per Chinese criteria) residing in Yuncheng City. A multi-stage sampling process was used: first, a cross-sectional survey was conducted with a calculated sample size of 402 participants, selected through stratified random sampling based on residential districts. A structured questionnaire was administered to assess dietary habits, physical activity levels, sleep patterns, and health cognitions. Descriptive statistics (means, standard deviations) were used to identify key factors associated with overweight. Subsequently, purposive sampling was used to select five experts for in-depth interviews. The integrated findings informed a draft model, which was refined through a two-round Delphi consensus process involving a panel of 19 experts. Consensus was defined as an interquartile range ≤1 and a median score ≥4 on a 5-point Likert scale. Final validation was performed by a separate panel of seven experts.

Results: The survey response rate was 97.3% (402/413). Quantitative analysis revealed that overweight status was significantly associated with three primary factors: high daily caloric intake, low physical activity, and habitual late-night activities. The Delphi process achieved strong consensus on a final model comprising 28 elements across five dimensions: 1) Healthy Dietary Behaviour (7 elements), 2) Scientific Physical Activity (6 elements), 3) Psychological and Cognitive Adjustment (4 elements), 4) Sleep and Lifestyle Modification (4 elements), and 5) Social-Environmental Support (7 elements). All dimensions reached the predefined consensus threshold in the second round, indicating high expert agreement.

Conclusion: This study successfully developed a consensus-based health behaviour model specifically tailored for overweight prevention in Yuncheng City's middle-aged population. The model demonstrates high content validity and expert endorsement. It provides a structured, multi-dimensional framework for designing targeted community health interventions. Future research should focus on implementing and empirically testing the model's effectiveness in fostering sustainable behaviour change and reducing overweight incidence in this and similar populations.