Associated factors of health-promoting lifestyle of the elderly based on the theory of social ecosystem

OBJECT: To explore the factors related to health-promoting lifestyles of the elderly based on social-ecosystem theory. DESIGN: A cross-sectional survey study was carried out to include 627 elderly people in communities in three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou) from October 2021 to January 2022 for questionnaire survey (601 validly returned cases). VENUE: Three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou). PARTICIPANTS: 627 elderly people. INTERVENTIONS: A cross-sectional survey study. MAIN MEASUREMENTS: The questionnaire survey was conducted by using the general demographic data, health promotion life scale, frailty scale, general self-efficacy scale, health engagement scale, General Self-Efficacy Scale, The family Adaptability, Partnership, Growth, Affection, and Resolve scale, and Perceived Social Support Scale. RESULTS: The total health promotion lifestyle score for the elderly was 100.20 ± 16.21, which was at the lower limit of the good level, with the highest mean score for nutrition (2.71 ± 0.51) and the lowest mean score for physical activity (2.25 ± 0.56). Stepwise linear regression showed that exercise frequency (95% confidence interval (CI) 1.304–3.885), smoking status (95% CI −4.190 to −1.556), self-efficacy (95% CI 0.071–0.185), health management (95% CI 0.306–0.590), frailty (95% CI −3.327 to −1.162) in the microsystem, marital status (95% CI 0.677–3.660), children's attention to the elderly health (95% CI 4.866–11.305), family care in the mesosystem (95% CI 1.365–4.968), and pre-retirement occupation (95% CI 2.065–3.894), living area (95% CI 0.813–3.912), whether receive community-based chronic disease prevention and management services (95% CI 2.035–8.149), social support (95% CI 1.667–6.493) in the macrosystem were the main factors affecting health promotion of life in the elderly (P < 0.05). Hierarchical regression analysis showed the microsystem accounted for 17.2%, the mesosystem accounted for 7.1%, and the macrosystem accounted for 11.4%. CONCLUSION: The health promotion lifestyle of the elderly in Hebei Province was at the lower limit of good level. Among them, exercise frequency, children's attention to the elderly health, and pre-retirement occupation played a major role in relation to the health-promoting lifestyle of the elderly. Hence, it needs the joint action of individuals, families, and society to promote the elderly to adopt the health promotion lifestyle and realize healthy aging.