Abstract
Purpose
To evaluate the pathways through which preconception health knowledge relates to preconception health behaviors via behavioral skills among Chinese reproductive-aged individuals and couples using the Information–Motivation–Behavioral Skills model, and to assess dyadic partner effects.
Design
Cross-sectional study with individual-level mediation and dyadic path models.
Setting
Population-based survey in Zhejiang Province, China (July–September 2023).
Sample
1991 individuals (1086 women; 905 men), including 458 heterosexual couples.
Measures
Preconception health behavior score (0-100) summing >20 guideline-recommended behaviors; preconception health knowledge; behavioral skills; sociodemographics.
Analysis
Individual-level mediation estimated with Sobel–Goodman tests; dyadic effects estimated using Actor–Partner Interdependence Model extended to Mediation (APIMeM) via path analysis; two-sided tests with P < 0.05.
Results
Mean behavior scores: women 71.27 ± 9.03; men 71.12 ± 9.96. Women: total effect of knowledge on behaviors 0.896 (P = 0.001); direct 0.785 (P = 0.003); indirect via skills 0.111 (P = 0.033). Men: total 1.731 (P < 0.001); direct 1.313 (P < 0.001); indirect 0.418 (P < 0.001). Dyadic analyses showed partner skill-to-behavior effects: women’s skills → men’s behaviors β = 0.127 (P = 0.003); men’s skills → women’s behaviors β = 0.153 (P = 0.001).
Conclusion
Preconception knowledge and behavioral skills are linked to healthier preconception behaviors, with meaningful partner interdependence. Couple-centered, skill-building interventions may improve preconception health and pregnancy outcomes. Cross-sectional design limits causal inference; self-reported behaviors may introduce bias; findings from one province may limit generalizability.
Keywords
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References
Supplementary Material
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