Country-specific key lifestyle factors and health outcomes for resource allocation in the general population: a network analysis across 29 countries

Li, Jiaying and Fong, Daniel Yee Tak and Lok, Kris Yuet Wan and Wong, Janet Yuen Ha and Ho, Mandy Man and Choi, Edmond Pui Hang and Pandian, Vinciya and Davidson, Patricia M and Duan, Wenjie and Tarrant, Marie and Lee, Jung Jae and Lin, Chia-Chin and Akingbade, Oluwadamilare and Alabdulwahhab, Khalid M and Ahmad, Mohammad Shakil and Alboraie, Mohamed and Alzahrani, Meshari A and Bilimale, Anil S and Boonpatcharanon, Sawitree and Byiringiro, Samuel and Che Hasan, Muhammad Kamil and Schettini, Luisa Clausi and Corzo, Walter and De Leon, Josephine M and De Leon, Anjanette S and Deek, Hiba and Efficace, Fabio and Nayal, Mayssah A El and El-Raey, Fathiya and Ensaldo-Carrasco, Eduardo and Escotorin, Pilar and Fadodun, Oluwadamilola Agnes and Fawole, Israel Opeyemi and Goh, Yong-Shian Shawn and Irawan, Devi and Khan, Naimah Ebrahim and Koirala, Binu and Krishna, Ashish and Kwok, Cannas and Le, Tung Thanh and Leal, Daniela Giambruno and Lezana-Fernández, Miguel Ángel and Manirambona, Emery and Mantoani, Leandro Cruz and Meneses-González, Fernando and Mohamed, Iman Elmahdi and Mukeshimana, Madeleine and Nguyen, Chinh Thi Minh and Nguyen, Huong Thi Thanh and Nguyen, Khanh Thi and Nguyen, Son Truong and Nurumal, Mohd Said and Nzabonimana, Aimable and Omer, Nagla Abdelrahim Mohamed Ahmed and Ogungbe, Oluwabunmi and Poon, Angela Chiu Yin and Reséndiz-Rodriguez, Areli and Puang-Ngern, Busayasachee and Sagun, Ceryl G and Shaik, Riyaz Ahmed and Shankar, Nikhil Gauri and Sommer, Kathrin and Toro, Edgardo and Tran, Hanh Thi Hong and Urgel, Elvira L and Uwiringiyimana, Emmanuel and Vanichbuncha, Tita and Youssef, Naglaa (2025) Country-specific key lifestyle factors and health outcomes for resource allocation in the general population: a network analysis across 29 countries. Journal of Global Health, 15. pp. 1-12. ISSN 2047-2978 E-ISSN 2047-2986

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Abstract

Background We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements. Methods From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network. Results Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). Conclusions In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study's cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research.

Item Type:	Article (Journal)
Uncontrolled Keywords:	global; across-country comparisons; lifestyle; health outcomes; network analysis
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RT Nursing
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Nursing
Depositing User:	Dr Muhammad Kamil Che Hasan
Date Deposited:	15 Jan 2025 07:43
Last Modified:	15 Jan 2025 07:43
URI:	http://irep.iium.edu.my/id/eprint/118646

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