Journal List > Korean J Adult Nurs > v.32(1) > 1142902

Jang and Song: A Structural Model Explaining the Health Behaviors among Adults with Metabolic Syndrome: Theory of Planned Behavior Approach



This study aimed to identify the factors explaining the performance of health behaviors among adults with metabolic syndrome based on the theory of planned behavior.


A total of 218 adults with metabolic syndrome were recruited for the study from September to December, 2017. Data were analyzed using SPSS/WIN 22.0 and AMOS 24.0.


The hypothetical model appeared to fit the data with χ2/df=2.65, SRMR (Standardized Root Mean Residual)=.07, PNFI (Parsimonious Normed Fit Index)=.67. Attitude toward health behavior, subjective norm and perceived behavioral control explained 32.3% of variance in intention toward health behavior. Perceived behavioral control showed significant direct effects and mediating effect through intention on health behavior (γ=.57, t=5.85). Family support also had significant direct effects on health behavior (γ=.38, t=4.75). Attitude toward health behavior, subjective norm, perceived behavioral control, and family support were the significant factors explaining 56.3% of variance in the performance of health behaviors among patients with metabolic syndrome.


Health promotion programs for behavioral modification in this population should focus on these factors to lead to better health outcomes. Further studies are warranted to test the health promotion strategies based on theory of planned behavior for long-term change toward a healthy lifestyle among individuals with metabolic syndrome.

Figures and Tables

Figure 1

Conceptual framework of the study.

Figure 2

Path diagram for the hypothetical model.

Table 1

Descriptive statistics and Convergent Validity of Measured Variables (N=218)


AVE=average variance extracted; CCR=composite construct reliability; SD=standard deviation.

Table 2

Fit Index of the Hypothetical Model (N=218)


CFI=comparative fit index; GFI=goodness of fit index; PNFI=parsimonious normed fit index; RMSEA=root mean squared error of approximation; SRMR=standardized root mean residual; TLI=turker lewis index.

Table 3

Direct Effect, Indirect Effect, and Total Effect in the Hypothetical Model (N=218)


CR=critical ratio; SMC=squared multiple correlation; SRW=standardized regression weight.


This article is a revision of the first author's doctoral dissertation from Chungnam National University.


CONFLICTS OF INTEREST The authors declared no conflict of interest.


  • Study conception and design acquisition - JT and SR.

  • Data collection - JT.

  • Analysis and interpretation of the data - JT and SR.

  • Drafting and critical revision of the manuscript - JT and SR.


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Taejeong Jang

Rhayun Song

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