TY - JOUR
T1 - Country-specific key lifestyle factors and health outcomes for resource allocation in the general population
T2 - a network analysis across 29 countries
AU - Li, Jiaying
AU - Fong, Daniel Yee Tak
AU - Lok, Kris Yuet Wan
AU - Wong, Janet Yuen Ha
AU - Ho, Mandy Man
AU - Choi, Edmond Pui Hang
AU - Pandian, Vinciya
AU - Davidson, Patricia M.
AU - Duan, Wenjie
AU - Tarrant, Marie
AU - Lee, Jung Jae
AU - Lin, Chia Chin
AU - Akingbade, Oluwadamilare
AU - Alabdulwahhab, Khalid M.
AU - Ahmad, Mohammad Shakil
AU - Alboraie, Mohamed
AU - Alzahrani, Meshari A.
AU - Bilimale, Anil S.
AU - Boonpatcharanon, Sawitree
AU - Byiringiro, Samuel
AU - Hasan, Muhammad Kamil Che
AU - Schettini, Luisa Clausi
AU - Corzo, Walter
AU - De Leon, Josephine M.
AU - De Leon, Anjanette S.
AU - Deek, Hiba
AU - Efficace, Fabio
AU - El Nayal, Mayssah A.
AU - El-Raey, Fathiya
AU - Ensaldo-Carrasco, Eduardo
AU - Escotorin, Pilar
AU - Fadodun, Oluwadamilola Agnes
AU - Fawole, Israel Opeyemi
AU - Goh, Yong Shian Shawn
AU - Irawan, Devi
AU - Khan, Naimah Ebrahim
AU - Koirala, Binu
AU - Krishna, Ashish
AU - Kwok, Cannas
AU - Le, Tung Thanh
AU - Leal, Daniela Giambruno
AU - Lezana-Fernández, Miguel Ángel
AU - Manirambona, Emery
AU - Mantoani, Leandro Cruz
AU - Meneses-González, Fernando
AU - Mohamed, Iman Elmahdi
AU - Mukeshimana, Madeleine
AU - Nguyen, Chinh Thi Minh
AU - Nguyen, Huong Thi Thanh
AU - Nguyen, Khanh Thi
AU - Nguyen, Son Truong
AU - Nurumal, Mohd Said
AU - Nzabonimana, Aimable
AU - Omer, Nagla Abdelrahim Mohamed Ahmed
AU - Ogungbe, Oluwabunmi
AU - Poon, Angela Chiu Yin
AU - Reséndiz-Rodriguez, Areli
AU - Puang-Ngern, Busayasachee
AU - Sagun, Ceryl G.
AU - Shaik, Riyaz Ahmed
AU - Shankar, Nikhil Gauri
AU - Sommer, Kathrin
AU - Toro, Edgardo
AU - Tran, Hanh Thi Hong
AU - Urgel, Elvira L.
AU - Uwiringiyimana, Emmanuel
AU - Vanichbuncha, Tita
AU - Youssef, Naglaa
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2025
Y1 - 2025
N2 - 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 16461 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.
AB - 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 16461 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.
KW - across-country comparisons
KW - global
KW - health outcomes
KW - lifestyle
KW - network analysis
UR - http://www.scopus.com/inward/record.url?scp=85214894649&partnerID=8YFLogxK
U2 - 10.7189/jogh.15.04011
DO - 10.7189/jogh.15.04011
M3 - Article
C2 - 39791329
AN - SCOPUS:85214894649
SN - 2047-2978
VL - 15
JO - Journal of Global Health
JF - Journal of Global Health
M1 - 04011
ER -