Health behavior change trajectories and influencing factors in stroke patients

ZHANG Mengyu; XIE Yuying; ZHOU Xinxin; ZHAO Peng; GUO Yuanli; LIU Yanjin; GUO Li'na

doi:10.12102/j.issn.1009-6493.2026.02.016

Abstract：Objective:To explore the trajectory of health behavior changes in stroke patients and to analyze the influencing factors based on the capacity,opportunity,motivation-behavior(COM-B)model.Methods:A total of 186 stroke patients admitted to the department of neurology at a tertiary grade A hospital in Zhengzhou city were selected as the study subjects from January to October 2023.Data were collected using a general information questionnaire,the Health-Promoting Lifestyle Profile Ⅱ(HPLP Ⅱ),the Stroke Prevention Knowledge Questionnaire(SPKQ),the Stroke Health Belief Model Scale Short Form(SF-HBMS),and an environmental domain subscale.Latent growth mixture modeling(LGMM)was used to identify and analyze the health behavior change trajectories in patients,and Logistic regression analysis was employed to explore the influencing factors of different developmental trajectories.Results:Four subgroups of health behavior change trajectories were identified in stroke patients,namely unstable health behavior group(14.5%),fluctuating health behavior group(12.9%),stable health behavior group(40.9%),and continuously improving health behavior group(31.7%).Multivariate analysis results showed that Charlson Comorbidity Index(CCI),smoking history,health knowledge,health beliefs,and environmental satisfaction were influencing factors of the health behavior change trajectories in stroke patients(P<0.05).Conclusions:Individual differences exist in the developmental trajectories of health behaviors among stroke patients.Healthcare professionals could distinguish different populations based on influencing factors and implement precise,stratified interventions to promote the adoption of health behaviors.