{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T21:47:20Z","timestamp":1782078440241,"version":"3.54.5"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100012456","name":"National Social Science Fund of China","doi-asserted-by":"publisher","award":["21BGL235"],"award-info":[{"award-number":["21BGL235"]}],"id":[{"id":"10.13039\/501100012456","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Health Promot"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the pathways through which preconception health knowledge relates to preconception health behaviors via behavioral skills among Chinese reproductive-aged individuals and couples using the Information\u2013Motivation\u2013Behavioral Skills model, and to assess dyadic partner effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study with individual-level mediation and dyadic path models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Population-based survey in Zhejiang Province, China (July\u2013September 2023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>1991 individuals (1086 women; 905 men), including 458 heterosexual couples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Preconception health behavior score (0-100) summing &gt;20 guideline-recommended behaviors; preconception health knowledge; behavioral skills; sociodemographics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>\n                      Individual-level mediation estimated with Sobel\u2013Goodman tests; dyadic effects estimated using Actor\u2013Partner Interdependence Model extended to Mediation (APIMeM) via path analysis; two-sided tests with\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean behavior scores: women 71.27 \u00b1 9.03; men 71.12 \u00b1 9.96. Women: total effect of knowledge on behaviors 0.896 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001); direct 0.785 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003); indirect via skills 0.111 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.033). Men: total 1.731 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); direct 1.313 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); indirect 0.418 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Dyadic analyses showed partner skill-to-behavior effects: women\u2019s skills \u2192 men\u2019s behaviors \u03b2 = 0.127 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003); men\u2019s skills \u2192 women\u2019s behaviors \u03b2 = 0.153 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preconception knowledge and behavioral skills are linked to healthier preconception behaviors, with meaningful partner interdependence. Couple-centered, skill-building interventions may improve preconception health and pregnancy outcomes. Cross-sectional design limits causal inference; self-reported behaviors may introduce bias; findings from one province may limit generalizability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08901171261459924","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:25:07Z","timestamp":1781767507000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Knowledge and Skills With Preconception Health Behaviors Based on the Information-Motivation-Behavioral Skills Model: An Integrated Individual and Dyadic Mediation Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6707-5600","authenticated-orcid":false,"given":"Ruyu","family":"Sun","sequence":"first","affiliation":[{"name":"Zhejiang University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9477-7093","authenticated-orcid":false,"given":"Lu","family":"Li","sequence":"additional","affiliation":[{"name":"Zhejiang University"},{"name":"Zhejiang Shuren University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7345-1588","authenticated-orcid":false,"given":"Hanqian","family":"Wang","sequence":"additional","affiliation":[{"name":"Zhejiang University"},{"name":"Policy Research Office, Zhejiang Provincial Center for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30311-8"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-11-S3-S3"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-11-S1-S1"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-016-2089-7"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/9780470753552"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1748190"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2016.11.022"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2023.107707"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.2196\/35108"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-025-02015-z"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpnec.2024.100250"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2005.08.006"},{"key":"e_1_3_9_14_2","doi-asserted-by":"publisher","DOI":"10.1037\/14344-003"},{"key":"e_1_3_9_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2011.607099"},{"key":"e_1_3_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2025.108363"},{"key":"e_1_3_9_17_2","volume-title":"Meeting to Develop a Global Consensus on Preconception Care to Reduce Maternal and Childhood Mortality and Morbidity: World Health Organization Headquarters, Geneva, 6\u20137 February 2012: Meeting Report","author":"World Health Organization","year":"2013","unstructured":"World Health Organization. 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