Health Beliefs and Bahaviors of Mainland Chinese: A Pilot Study and Implications for Health Education

Background and Rationale: With economic development, the leading causes of death in China are increasingly associated with lifestyle choices related to smoking, nutrition, and physical activity. The prevalence of stroke is at critical levels and associated with significant societal and economic burdens. An understanding of the health beliefs and behaviors of mainland Chinese will help us design and target health education campaigns for stroke prevention. Purpose: To elucidate stroke-related knowledge and health beliefs and behaviors associated with stroke in an adult Chinese population. Methods: A cross sectional survey questionnaire study (52 items) was conducted in 835 people (54% men and 45% women) in three urban areas in mainland China. Results: Some 28.3% of respondents identified hypertension as a leading risk factor for stroke, with lower percentages for other risk factors. Dizziness (29.2%), numbness (20.2%) and headache (17.1%) were reported as the most common warning signs. Family and friends (21.1%) and the media (television 19.4% and the newspaper 17.8%) were reported as being primary sources of stroke information. Over one-third reported being overweight and over half of the sample reported being smokers. Although the majority of respondents reported activity levels consistent with health (77% experienced moderately intense exercise on alternate days), most reported being sedentary for several hours on weekdays. Daily consumption of grains, fruits, and vegetables was reported to be consistent with food guides for good health, however, added salt (3.7 tsp) and sugar (3.9 tsp) appeared higher than recommended. The majority consumed fast food less than once a week, and 29.6% reported consuming it at least 1-2x/week. Of stressors, work- and health-related stress (and sickness in the family) affected over 70% of respondents and overall stress was reported to be moderately intense. Although smoking abstinence and physical activity were reported to be highly important for good health, the consumption of whole grains, and fruit and vegetables, were not rated as high in importance. Conclusion: The knowledge of mainland Chinese in our sample regarding stroke could be improved to help reduce stroke risk. Health behaviors related to nutrition in particular could be enhanced. Furthermore, interculturally appropriate and effective communication strategies should be adopted to reach these two goals.