目的 基于结构方程模型探讨原发性骨质疏松症高危女性健康促进行为的影响因素，为制订有效干预方案提供理论参考。方法 2023年2-5月，采用便利抽样法选取衡阳市4所社区卫生服务中心的400名原发性骨质疏松症高危女性为研究对象，采用一般资料调查表、电子健康素养量表、领悟社会支持量表、骨质疏松症自我效能量表和健康促进生活方式量表Ⅱ对其进行调查，采用结构方程模型进行影响因素分析。结果 工作状态、文化程度、疾病认知程度、领悟社会支持、自我效能直接影响健康促进行为（效应值分别为0.199、0.109、0.155、0.263、0.207）；电子健康素养不仅直接影响，还可通过领悟社会支持和自我效能的部分中介作用影响健康促进行为（直接效应值为0.515，总中介效应值为0.231）。结论 原发性骨质疏松症高危女性的健康促进行为受多种因素协同影响。社区医务人员应重点关注在职、文化程度与疾病认知程度较低者，可通过开展电子健康干预、调动社会支持系统、增强自我效能，以提升其健康促进行为水平。

Objective To explore the influencing factors of health promoting behavior in women at high risk of primary osteoporosis based on structural equation model,and to provide reference for developing effective intervention programs.Methods Convenience sampling method was used to select a total of 400 women at high risk of primary osteoporosis from four community health service centers in Hengyang from February to May 2023 as survey objects.They were surveyed by using a General Information Questionnaire,E-Health Literacy Scale,Perceived Social Support Scale,Osteoporosis Self-efficacy Scale and Health Promoting Lifestyle Profile-Ⅱ.The structural equation model was used to analyze the influencing factors.Results Working status,literacy,disease cognition level,perceived social support and self-efficacy had a direct positive effect on health promoting behavior of women at high risk of primary osteoporosis (the effect values were 0.199,0.109,0.155,0.263 and 0.207, respectively).E-health literacy not only directly influenced health promoting behavior,but also caused partial mediating effects through perceived social support and self-efficacy (with the direct effect value of 0.515 and the total mediating effect value of 0.231).Conclusions The health promoting behavior of women at high risk of primary osteoporosis is comprehensively affected by various factors.Community healthcare workers should focus on those who are on the job and those with low education level and disease cognition level.Their health promoting behavior can be improved by carrying out E-health intervention,mobilizing social support system and enhancing self-efficacy.

R473.6

湖南省自然科学基金科卫联合项目 （2022JJ70057）