Differential Associations Among Social Support, Health Promoting Behaviors, Health-related Quality of Life and Subjective Well-being in Older and Younger Persons: a Structural Equation Modelling Approach

Overview

Journal Health Qual Life Outcomes

Publisher Biomed Central

Specialty Public Health

Date 2022 Mar 5

PMID 35246166

Authors

Phoenix K H Mo

Eliza L Y Wong

Nelson C Y Yeung

Samuel Y S Wong

Roger Y Chung

Alan C Y Tong

Chris C Y Ko

Jia Li

Eng-Kiong Yeoh

Affiliations

Soon will be listed here.

Abstract

Background: Extensive studies have confirmed social support as a critical protective factor of people's health-related quality of life (HRQoL) and subjective well-being (SWB). However, health promoting behaviors as a potential mechanism and age differences in this mechanism has received fewer attention. This study aims to examine the associations among social support, health promoting behaviors, HRQoL and SWB in older and younger persons in Hong Kong.

Method: A convenience sample of both younger (12-35 years old) and older persons (55 years old and above) were recruited from three non-government organizations to complete a survey. Structural Equation Model (SEM) was conducted to test both the measurement model and structural models to examine the relationship between social support, health promoting behaviors, HRQoL and SWB. Multi-group SEM was also performed and compared to test whether there were significant age differences in the pathways between the key variables.

Results: A final sample of 408 participants (older-persons: N = 200 (mean age: 71.63 (8.16); 180/200 female), younger-persons: N = 208 (mean age: 18.10 (5.04); 155/208 female) were included in the final analysis. Results showed that social support was positively associated with SWB directly and indirectly through health promoting behaviors for the whole sample (CFI = .95, IFI = .94, RMSEA = .07, SRMR = 0.056). Results suggested that the association between the variables differed across age samples. While social support showed a positive association with health promoting behaviors for both younger and older persons, how each of them associated with HRQoL and SWB was different.

Conclusion: Findings suggest that the pathway which social support linked with HRQoL and SWB might differ across age groups. Age-specific strategies should be considered when promoting HRQoL and SWB among the younger and older population.

Citing Articles

Latent profile analysis of fear of progression in obstructive sleep apnea hypoventilation syndrome patients: a cross-sectional study.

Ge Y, Ge D, Guo Z, Wang Y, Wang X, Wang C BMC Psychol. 2025; 13(1):217.

PMID: 40057814 PMC: 11889845. DOI: 10.1186/s40359-025-02543-0.

Exploring the relationship between social capital and hedonic well-being in sport and physical activity contexts: a scoping review.

Zhang Y, Kinoshita K, Sato S Front Psychol. 2025; 16:1540907.

PMID: 40018000 PMC: 11865239. DOI: 10.3389/fpsyg.2025.1540907.

The mediating role of psychological capital in health behaviors among elderly nursing home residents.

Liao L, Li Y, Tian F, Wu J, Zhong J, He T Front Psychol. 2025; 16:1534124.

PMID: 39911995 PMC: 11794268. DOI: 10.3389/fpsyg.2025.1534124.

The social support, healthy lifestyle, subjective well-being, and health-related quality of life among university students.

Ifroh R, Gai X, Rabiautsani M, Han X J Educ Health Promot. 2025; 13():427.

PMID: 39811850 PMC: 11731252. DOI: 10.4103/jehp.jehp_1988_23.

Sickle cell disease and adolescents' perspectives on self-care management resources.

Clayton-Jones D, Hamilton J, Haglund K, Ong L, Kennedy K, Pena S Health Care Transit. 2024; 1:100026.

PMID: 39713001 PMC: 11657168. DOI: 10.1016/j.hctj.2023.100026.

References

Reeves D, Blickem C, Vassilev I, Brooks H, Kennedy A, Richardson G . The contribution of social networks to the health and self-management of patients with long-term conditions: a longitudinal study. PLoS One. 2014; 9(6):e98340. PMC: 4041782. DOI: 10.1371/journal.pone.0098340. View

Thoits P . Mechanisms linking social ties and support to physical and mental health. J Health Soc Behav. 2011; 52(2):145-61. DOI: 10.1177/0022146510395592. View

Yim H, Park H, Kang J, Kim K, Cho Y, Hur Y . Marital Status and Health Behavior in Middle-aged Korean Adults. Korean J Fam Med. 2012; 33(6):390-7. PMC: 3526722. DOI: 10.4082/kjfm.2012.33.6.390. View

Zhang Y, Yeager V, Hou S . The Impact of Community-Based Supports and Services on Quality of Life Among the Elderly in China: A Longitudinal Study. J Appl Gerontol. 2016; 37(10):1244-1269. PMC: 7091461. DOI: 10.1177/0733464816661945. View

Laforge R, Rossi J, Prochaska J, Velicer W, Levesque D, McHorney C . Stage of regular exercise and health-related quality of life. Prev Med. 1999; 28(4):349-60. DOI: 10.1006/pmed.1998.0429. View

Sterrett E, Jones D, McKee L, Kincaid C . Supportive non-parental adults and adolescent psychosocial functioning: using social support as a theoretical framework. Am J Community Psychol. 2011; 48(3-4):284-95. PMC: 4439201. DOI: 10.1007/s10464-011-9429-y. View

Mo P, Blake H, Batt M . Getting healthcare staff more active: the mediating role of self-efficacy. Br J Health Psychol. 2011; 16(4):690-706. DOI: 10.1111/j.2044-8287.2010.02007.x. View

Bowling A, Gabriel Z, Dykes J, Dowding L, Evans O, Fleissig A . Let's ask them: a national survey of definitions of quality of life and its enhancement among people aged 65 and over. Int J Aging Hum Dev. 2004; 56(4):269-306. DOI: 10.2190/BF8G-5J8L-YTRF-6404. View

Steptoe A, Mohabir A, Mahon N, McKenna W . Health related quality of life and psychological wellbeing in patients with dilated cardiomyopathy. Heart. 2000; 83(6):645-50. PMC: 1760850. DOI: 10.1136/heart.83.6.645. View

10.

Teng H, Yen M, Fetzer S . Health promotion lifestyle profile-II: Chinese version short form. J Adv Nurs. 2010; 66(8):1864-73. DOI: 10.1111/j.1365-2648.2010.05353.x. View

11.

LaRocca M, Scogin F . The Effect of Social Support on Quality of Life in Older Adults Receiving Cognitive Behavioral Therapy. Clin Gerontol. 2016; 38(2):131-148. PMC: 4801227. DOI: 10.1080/07317115.2014.990598. View

12.

Kim C, Schlenk E, Kim D, Kim M, Erlen J, Kim S . The role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in adults with type 2 diabetes. J Adv Nurs. 2015; 71(9):2164-75. DOI: 10.1111/jan.12682. View

13.

Karimi M, Brazier J . Health, Health-Related Quality of Life, and Quality of Life: What is the Difference?. Pharmacoeconomics. 2016; 34(7):645-9. DOI: 10.1007/s40273-016-0389-9. View

14.

Bentler P . Comparative fit indexes in structural models. Psychol Bull. 1990; 107(2):238-46. DOI: 10.1037/0033-2909.107.2.238. View

15.

Hua Y, Wang B, Wallen G, Shao P, Ni C, Hua Q . Health-promoting lifestyles and depression in urban elderly Chinese. PLoS One. 2015; 10(3):e0117998. PMC: 4363512. DOI: 10.1371/journal.pone.0117998. View

16.

Levasseur M, St-Cyr Tribble D, Desrosiers J . Meaning of quality of life for older adults: importance of human functioning components. Arch Gerontol Geriatr. 2008; 49(2):e91-e100. DOI: 10.1016/j.archger.2008.08.013. View

17.

Tessier P, Lelorain S, Bonnaud-Antignac A . A comparison of the clinical determinants of health-related quality of life and subjective well-being in long-term breast cancer survivors. Eur J Cancer Care (Engl). 2012; 21(5):692-700. DOI: 10.1111/j.1365-2354.2012.01344.x. View

18.

Verheijden M, Bakx J, van Weel C, Koelen M, van Staveren W . Role of social support in lifestyle-focused weight management interventions. Eur J Clin Nutr. 2005; 59 Suppl 1:S179-86. DOI: 10.1038/sj.ejcn.1602194. View

19.

Gillison F, Rouse P, Standage M, Sebire S, Ryan R . A meta-analysis of techniques to promote motivation for health behaviour change from a self-determination theory perspective. Health Psychol Rev. 2018; 13(1):110-130. DOI: 10.1080/17437199.2018.1534071. View

20.

Schmitz N, Kruse J, Kugler J . The association between physical exercises and health-related quality of life in subjects with mental disorders: results from a cross-sectional survey. Prev Med. 2004; 39(6):1200-7. DOI: 10.1016/j.ypmed.2004.04.034. View