Structural model of health-promoting behavior in middle-aged Korean women with hypertension based on the Information–Motivation–Behavioral Skills model: a cross sectional study

Purpose: This study aimed to develop and evaluate a hypothetical model of health-promoting behaviors among middle-aged women with hypertension, guided by the Information–Motivation–Behavioral Skills (IMB) framework. The endogenous variables were self-efficacy in chronic disease management and health-promoting behaviors, and the exogenous variables were hypertension-related knowledge, eHealth literacy, health attitudes, and social support.Methods: This cross-sectional study used an online structured questionnaire. A total of 331 middle-aged women diagnosed with hypertension participated. Data were analyzed using IBM SPSS ver. 25.0 and IBM SPSS AMOS ver. 25.0 to test the hypothesized model and evaluate model fit.Results: The proposed model showed satisfactory fit to the data. Of the nine hypothesized pathways, six were statistically significant. Hypertension-related knowledge, social support, and self-efficacy in chronic disease management had significant direct effects on health-promoting behaviors. In contrast, eHealth literacy and health attitudes did not have statistically significant direct effects on health-promoting behaviors. Health attitudes and social support had significant indirect and total effects on health-promoting behaviors. The model explained 60.4% of the variance in health-promoting behaviors, indicating the importance of hypertension-related knowledge, health attitudes, social support, and self-efficacy in chronic disease management.Conclusion: The findings suggest that the proposed IMB-based model may help explain health-promoting behaviors among middle-aged women with hypertension. The results indicate that self-efficacy in chronic disease management may link motivational factors to behavioral outcomes and may inform future intervention research aimed at promoting health behavior change in this population.