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      The effect of family health on suboptimal health status: The parallel mediation role of sleep quality and health behaviour

      research-article
      1 , 2 , 3 , 4 , 5 , 2
      Journal of Global Health
      International Society of Global Health

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          Abstract

          Background

          The prevalence of suboptimal health status has been increasing worldwide, posing a significant challenge to public health. Meanwhile, family health has been recognised as an important factor influencing individual health outcomes. However, the mechanisms through which family health affects suboptimal health status remain unclear. We aimed to investigate the parallel mediation role of sleep quality and health behaviour in the relationship between family health and suboptimal health status.

          Methods

          We conducted a cross-sectional online survey with a sample of adults >18 years old from four provinces in China. The survey questionnaires queried their demographic characteristics, family health, suboptimal health status, sleep quality, and health behaviour. We assessed family health by the Family Health Scale-Short Form and suboptimal health status using the Suboptimal Health Status Questionnaire. We employed structural equation modelling to analyse the data and test the proposed mediation model.

          Results

          we collected 4918 valid questionnaires. The mean age of the participants was 30.1 years (standard deviation = 12.5). The correlation analysis demonstrated a significant negative association between family health and suboptimal health status (r = −0.44; P < 0.001). The results of the parallel mediation analysis showed that family health had a significant indirect effect on suboptimal health status through both sleep quality (β = -0.350; P < 0.001) and health behaviour (β = −0.137; P < 0.001). The total indirect effect of family health on suboptimal health status through both sleep quality and health behaviour was also significant (β = −0.569, P < 0.001).

          Conclusions

          This study highlights the significance of family health as a predictor of suboptimal health status and suggests that sleep quality and health behaviour are parallel mediators in this relationship. By understanding the role of family health, sleep quality, and health behaviour, interventions can be targeted to improve overall health outcomes.

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          Most cited references35

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          The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

          Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover 3 main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors, to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all 3 study designs and 4 are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available at http://www.annals.org and on the Web sites of PLoS Medicine and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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            Required sample size to detect the mediated effect.

            Mediation models are widely used, and there are many tests of the mediated effect. One of the most common questions that researchers have when planning mediation studies is, "How many subjects do I need to achieve adequate power when testing for mediation?" This article presents the necessary sample sizes for six of the most common and the most recommended tests of mediation for various combinations of parameters, to provide a guide for researchers when designing studies or applying for grants.
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              Understanding the Model Size Effect on SEM Fit Indices

              This study investigated the effect the number of observed variables (p) has on three structural equation modeling indices: the comparative fit index (CFI), the Tucker-Lewis index (TLI), and the root mean square error of approximation (RMSEA). The behaviors of the population fit indices and their sample estimates were compared under various conditions created by manipulating the number of observed variables, the types of model misspecification, the sample size, and the magnitude of factor loadings. The results showed that the effect of p on the population CFI and TLI depended on the type of specification error, whereas a higher p was associated with lower values of the population RMSEA regardless of the type of model misspecification. In finite samples, all three fit indices tended to yield estimates that suggested a worse fit than their population counterparts, which was more pronounced with a smaller sample size, higher p, and lower factor loading.
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                Author and article information

                Journal
                J Glob Health
                J Glob Health
                JGH
                Journal of Global Health
                International Society of Global Health
                2047-2978
                2047-2986
                5 April 2024
                2024
                : 14
                : 04071
                Affiliations
                [1 ]Research Management and Development Department, Kiang Wu Nursing College of Macau, Macao, China
                [2 ]Education Department, Kiang Wu Nursing College of Macau, Macao, China
                [3 ]Faculty of Health Sciences, University of Macau, Macao, China
                [4 ]School of Nursing, Yangzhou University, Yangzhou, China
                [5 ]Infectious Disease Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
                Author notes
                Correspondence to:
Yue Yi Li
Education Department, Kiang Wu Nursing College of Macau
Complexo de Cuidados de Saúde das Ilhas – Edifício do Instituto de Enfermagem Kiang Wu de Macau, Avenida do Hospital das Ilhas no.447, Coloane, RAEM
China
 selinali@ 123456kwnc.edu.mo
                Author information
                https://orcid.org/0000-0002-8727-0497
                https://orcid.org/0000-0003-2096-3114
                https://orcid.org/0000-0001-5856-0930
                https://orcid.org/0000-0002-3480-8249
                https://orcid.org/0000-0002-2530-7549
                https://orcid.org/0000-0002-6052-7408
                Article
                jogh-14-04071
                10.7189/jogh.14.04071
                10994672
                38574356
                6e4d697e-bcef-4259-80ee-36c455d5c795
                Copyright © 2024 by the Journal of Global Health. All rights reserved.

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                Page count
                Figures: 2, Tables: 4, Equations: 0, References: 38, Pages: 8
                Categories
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                Public health
                Public health

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