Health beliefs mediates the association between the number of non-communicable diseases and preventive behaviors in middle-aged and older adults in southern China.

Background: The triadic relationship among the number of NCDs, preventive behaviors and health beliefs has not been fully explored, especially the role of health beliefs.

Aims: To explore the association between the number of NCDs and preventive behaviors, as well as the mediating effect of health beliefs and its dimensions among middle-aged and older adults. Provide scientific evidence for developing targeted behavior intervention.

Methods: Data from 2095 middle-aged and older adults who completed demographic information, health beliefs and preventive behaviors questionnaire. Mediation analysis was used to explore the association of health beliefs and its dimensions between the number of NCDs and preventive behaviors.

Results: Health beliefs and self-efficacy positively impacted preventive behaviors, whereas perceived severity, while perceived barriers had negative effects. Health beliefs (β = - 0.1809, 95% CI - 0.2658 to - 0.0960) and its dimensions(Perceived barriers:β = - 0.0881, 95% CI - 0.1533 to - 0.0232, self-efficacy: β = - 0.2706, 95% CI - 0.3592 to - 0.1892) partially mediated the associations between the number of NCDs and preventive behaviors. The negative mediation effects indicates that as the number of NCDs increases, preventive behaviors decrease, partly due to a decline in health beliefs and self-efficacy, as well as an increase in perceived barriers (scored inversely, meaning higher barriers). These mediation pathways exhibited modest strength, highlighting the importance of health beliefs on behavior change.

Conclusions: An increasing number of NCDs is associated with reduced engagement in preventive behaviors. Health beliefs and its dimensions play a partial mediating role in this relationship. Effective intervention targeting health beliefs may help promote positive behavioral changes.