ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1668760
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health Welfare, Volume IIView all 12 articles
The Proactive Health Behavior and Somatic Functional Status in Chinese Rural Chronic Patients: The Mediating Effects of Social Participation
Provisionally accepted
Yangzhen Huang1,2Hua Qing1Yangyang Pan1Chunying Wang1Heng Dong1
Jia Song1Kangkang Zhang1Yilin Wei1
Shangfeng Tang1,2*
Min Zhang3*- 1School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- 2Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
- 3Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China
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Background: As chronic diseases become more prevalent in rural China, maintaining health and functional capacity has become a major challenge. In this context, individual proactive health behaviors (PHB) may play a crucial role. However, the mechanisms through which PHB influence somatic functional status (SFS) are still unclear. Particularly, the role of social participation (SP) in this process remains unexplored. Methods: A cross-sectional survey was conducted among 3295 chronic disease patients in rural China. Data on PHB, SP and SFS was evaluated using validated Likert scales. Descriptive statistics were used to characterize the sample demographics and the distributions of key variables. Hierarchical regression analysis was performed to test the mediation effects. Results: The mean scores for participants were 24.98 ± 5.89 for PHB, 2.22 ± 1.21 for SP, and 43.33 ± 10.00 for SFS. Significant correlations were found between PHB and SP (r = 0.21, P < 0.001), SP and SFS (r = 0.23, P < 0.001), and PHB and SFS (r = 0.11, P < 0.001). Hierarchical regression and bootstrap analyses confirmed that SP partially mediated the relationship between PHB and SFS, explaining 42.01% of the total effect. Conclusions: Among rural patients with chronic diseases in China, individual health proactivity primarily enhances somatic function by promoting social participation. Therefore, integrated interventions that encourage both proactive health behaviors and social participation are recommended. These interventions can optimize chronic disease
Keywords: Proactive health behavior, Social Participation, somatic function status, Rural Health, Chronic disease management
Received: 18 Jul 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Huang, Qing, Pan, Wang, Dong, Song, Zhang, Wei, Tang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shangfeng Tang, School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
Min Zhang, Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, China
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