The Willingness to Change Risky Health Behaviors among Chinese Rural Residents: What We Learned from a Population-Based Esophageal Cancer Cohort Study

BACKGROUND The effectiveness of health interventions can be impaired by low socio-economic status and poor living conditions of the target population. However, the specifics of this problem in rural China are still unclear, and appropriate strategies should be explored. METHODS In 2013, we conducted a questionnaire-based investigation among 410 participants from a population-based esophageal cancer cohort study in rural Anyang, China. Information regarding their demographic characteristics, levels of exposure to four health-risk behaviors, including smoking, alcohol consumption, risky dietary behaviors and poor hygiene, as well as willingness to change these behaviors, and data on potential predictors of willingness to change behaviors were collected. RESULTS In this study, 33.3% (23/69), 25.0% (13/52), 60.7% (68/112) and 62.2% (237/381) of respondents reported that they were willing to change smoking, alcohol consumption, risky dietary behaviors and poor hygiene, respectively. Older people had higher exposure levels and less willingness to change these four health-risk behaviors. The levels of these four health-risk behaviors were negatively associated with willingness to change, while faith in people and behavioral change in surrounding people increased willingness to change risky behaviors. CONCLUSIONS In behavior-intervention-based health-promotion programs in rural China, the elderly and highly exposed populations should be the most difficult part and community- or household-based intervention would be more efficient.