A path analysis of factors influencing health behaviors among persons with prediabetes in Vietnam

Abstract

This cross-sectional study aimed to examine health behaviors and test the causal relationships among health literacy, delay discounting, family and friends support, perceived benefits, perceived barriers, self-efficacy, and health behaviors among prediabetes persons in Vietnam. The conceptual framework was developed based on the Health Promotion Model and relevant literature. Multistage sampling was employed. The sample consisted of 419 prediabetes persons from three hospitals located in the northern, central, and southern regions of Vietnam. The research instruments included a demographic data form and questionnaires on health literacy, delay discounting, family and friends support, perceived benefits, perceived barriers, self-efficacy, and health behaviors. Data were collected between November and December 2025. Path-analysis was conducted using SPSS and Mplus. The findings revealed that 1) The majority of participants (84.2%) were classified as having low levels of health behaviors, while 12.7% were at the average level and only 3.1% were categorized as having high levels of health behaviors. 2) The Final model fit the empirical data well and explained (The χ²/df ratio was 1.46 with χ² =1488.760 and df =1018), RMSEA= 0.033, SRMR=0. 046, CFI= 0.952, TLI=0.949). Health literacy had a positive direct effect on health behaviors (β = 0.119, p = 0.045). Delay discounting had a negative direct effect on health behaviors (β = -0.098, p = 0.020) and had a negative indirect effect on health behaviors through self-efficacy (β = -0.013, p = 0.046). Family and friend support had a positive direct effect on health behaviors (β = 0.459, p < 0.001) and an indirect effect on health behaviors through self-efficacy (β = 0.262, p = 0.005). Perceived benefits had a positive direct effect on health behaviors (β = 0.108, p = 0.040). Self-efficacy had a positive direct effect on health behaviors (β = 0.153, p = 0.002). This study demonstrates that health literacy, delay discounting, family and friends support, perceived benefits, self-efficacy are important factors influencing health behaviors among adults with prediabetes in Vietnam. These findings may provide useful evidence for developing nursing interventions aimed at promoting healthy behaviors and preventing progression to type 2 diabetes.