Facilitators and barriers of adopting healthy lifestyle in rural China: a qualitative analysis through social capital perspectives

Non-communicable diseases (NCDs) are the major public health concerns in China. However, little has been known yet about the background social factors that influence lifestyles as possible NCD risk factors. This qualitative study aimed to explore facilitators and barriers of adopting healthy lifestyles among residents in a rural community of China. Three age-stratified focus group discussions (FGDs) were conducted in Fangshan district of Beijing in 2013. A FGD guide was designed to elicit the participants' perception and experience regarding their lifestyles. The audio-records were transcribed, and data were qualitatively analyzed through thematic approach. Through social capital framework with bonding, bridging, and linking classifications, we identified the following facilitators and barriers to adopt healthy lifestyles. (1) Facilitators: mutual support from family/friends and motivation to participate in regular exercises (bonding); cooperative relationships with community health workers (bridging); and nationwide high level of healthy lifestyle awareness (linking). (2) Barriers: negative influence from family/friends, insufficient support from family/friends, peer pressure and tolerance towards unhealthy lifestyles (bonding); insufficient support from health professionals (bridging); and inequity in allocation of public resources (linking). This study revealed that bonding, bridging and linking social capital would work as facilitators and barriers to adopt healthy lifestyles among rural residents in China.