Path analysis to identify factors associated with health behavior in patients with stroke: Evidence from a cross-sectional and correlational survey

Objective: To explore the relationship between environmental and personal factors and health behavior in patients with stroke through pathway analysis. Methods: A path analysis was performed to consider the relationships between social support, healthcare payment, residence, self-regulatory fatigue (SRF), and health literacy (HL) and health behavior. Results: Social support and residence were directly and indirectly associated with health behavior through the SRF and/or HL. Healthcare payment was associated with health behavior through HL. Compared to patients with stroke under 65, those aged 65 and above demonstrated a more significant decline in HL with increasing SRF, and the relationship between healthcare payment and HL was also more notable within this older population. Conclusion: The associations between environmental and personal factors in patients with stroke and health behavior were complicated, with age group serving as an important moderator. These findings would inform the design and implementation of health behavioral interventions among patients with stroke, particularly encouraging attention to the SRF and medical insurance status of elderly patients. (c) 2025 Published by Elsevier Inc.