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Background <p>Perimenopause is a critical transitional stage in women’s lives and is characterized by substantial physiological and psychological changes that may influence health behaviors and long-term health outcomes. Health-promoting behaviors play an important role in preventing chronic diseases and improving quality of life among perimenopausal women. However, these behaviors may vary considerably across individuals, and the psychosocial factors underlying different behavioral patterns remain unclear. Guided by the Capability–Opportunity–Motivation–Behaviors (COM-B) model, this study aimed to identify latent profiles of health-promoting behaviors among perimenopausal women and to examine their associated factors.</p> Methods <p>This cross-sectional study included 500 women aged 40–55 years who were recruited by convenience sampling from the gynecology outpatient clinic of Dongguan Maternal and Child Health Hospital, China. Perimenopausal status was determined by a gynecologist with reference to STRAW + 10 menstrual criteria, defined as a persistent difference of at least 7 days in consecutive cycle lengths or an amenorrhea interval of at least 60 days but less than 12 months. Health-promoting behavior was assessed using the revised Chinese Health-Promoting Lifestyle Profile II. Latent profile analysis was conducted using six dimension scores. Theory-informed ordinal logistic regression examined associations of eHealth literacy, Family APGAR score, general self-efficacy, and prespecified covariates with profile level; a sensitivity model additionally adjusted for self-rated health, sleep quality, and body mass index category.</p> Results <p>Three ordered profiles of health-promoting behavior were identified: low-level (32.8%), moderate-level (46.4%), and high-level (20.8%). Their broadly parallel patterns across the six HPLP-II-R dimensions indicated primarily graded differences in overall health-promoting behavior. Higher eHealth literacy (OR = 1.266, 95% CI: 1.198–1.338), Family APGAR scores (OR = 1.137, 95% CI: 1.041–1.242), and general self-efficacy (OR = 1.125, 95% CI: 1.081–1.170) were associated with greater odds of membership in a higher-level profile.</p> Conclusions <p>Health-promoting behaviors among perimenopausal women show substantial heterogeneity. Higher eHealth literacy, Family APGAR scores, and general self-efficacy—reflecting selected aspects of psychological capability, social opportunity, and reflective motivation within the COM-B framework—were associated with greater odds of membership in a higher-level health-promoting behavior profile. These may provide reference evidence for the importance of developing targeted health promotion strategies to support perimenopausal women in adopting healthier lifestyles.</p>

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Health-promoting behaviors in perimenopausal women based on the COM-B model: a latent profile analysis

  • 期刊论文

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  • 发表日期：

    2026年7月31日

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  • Yayin Fu,
  • Lin Jin,
  • Qiaoxuan Zhou,
  • Xuemin Yang,
  • Wanxia Liang,
  • Zheng’ai Cui,
  • Ying’ai Cui,
  • Dongmei Duan

摘要

Background

Perimenopause is a critical transitional stage in women’s lives and is characterized by substantial physiological and psychological changes that may influence health behaviors and long-term health outcomes. Health-promoting behaviors play an important role in preventing chronic diseases and improving quality of life among perimenopausal women. However, these behaviors may vary considerably across individuals, and the psychosocial factors underlying different behavioral patterns remain unclear. Guided by the Capability–Opportunity–Motivation–Behaviors (COM-B) model, this study aimed to identify latent profiles of health-promoting behaviors among perimenopausal women and to examine their associated factors.

Methods

This cross-sectional study included 500 women aged 40–55 years who were recruited by convenience sampling from the gynecology outpatient clinic of Dongguan Maternal and Child Health Hospital, China. Perimenopausal status was determined by a gynecologist with reference to STRAW + 10 menstrual criteria, defined as a persistent difference of at least 7 days in consecutive cycle lengths or an amenorrhea interval of at least 60 days but less than 12 months. Health-promoting behavior was assessed using the revised Chinese Health-Promoting Lifestyle Profile II. Latent profile analysis was conducted using six dimension scores. Theory-informed ordinal logistic regression examined associations of eHealth literacy, Family APGAR score, general self-efficacy, and prespecified covariates with profile level; a sensitivity model additionally adjusted for self-rated health, sleep quality, and body mass index category.

Results

Three ordered profiles of health-promoting behavior were identified: low-level (32.8%), moderate-level (46.4%), and high-level (20.8%). Their broadly parallel patterns across the six HPLP-II-R dimensions indicated primarily graded differences in overall health-promoting behavior. Higher eHealth literacy (OR = 1.266, 95% CI: 1.198–1.338), Family APGAR scores (OR = 1.137, 95% CI: 1.041–1.242), and general self-efficacy (OR = 1.125, 95% CI: 1.081–1.170) were associated with greater odds of membership in a higher-level profile.

Conclusions

Health-promoting behaviors among perimenopausal women show substantial heterogeneity. Higher eHealth literacy, Family APGAR scores, and general self-efficacy—reflecting selected aspects of psychological capability, social opportunity, and reflective motivation within the COM-B framework—were associated with greater odds of membership in a higher-level health-promoting behavior profile. These may provide reference evidence for the importance of developing targeted health promotion strategies to support perimenopausal women in adopting healthier lifestyles.