Stage of change for general health promotion action and health-related lifestyle practices in Chinese adults

Background: We propose general health promotion action (GHPA) to represent the general intention and actual practices aimed to promote health. The transtheoretical model (TTM) has not been applied to GHPA. The objectives of this study were to determine whether TTM can be applied to Chinese adults by measuring the subjects' stage of change for GHPA, and to study whether stage for GHPA is associated with health-related lifestyle practices. Methods: Randomly selected Hong Kong Chinese subjects (3233) aged 18-64 were interviewed in telephone survey. Results: Thirty-nine percent had not taken any health promotion actions and had no intention to do so (precontemplation). Twelve percent had taken action but had no intention to continue (at-risk for relapse). Three percent had not taken any actions and intended to do so in the next 6 months, but not in the next 1 month (contemplation). Eleven percent had not taken any actions but intended to do so in the next 1 month (preparation). Fifteen percent had been taking action for less than 6 months and intended to continue (action). Twenty-one percent had been taking action for at least 6 months and intended to continue (maintenance). Precontemplators were less likely than maintainers to be never smokers (OR = 0.62; 95% CI = 0.49-0.80), exercisers (0.097; 0.077-0.12), to eat fruit twice a day (0.53; 0.41-0.69) and remove fat when eating (0.72; 0.54-0.95), with increasing trends in the odds of reporting these practices from precontemplation to maintenance. Conclusions: Our findings have provided preliminary findings on the applicability of TTM on GHPA in Chinese adults with evidences of concurrent criterion validity.