The influence of knowledge about endocrine-disrupting chemicals on motivation for health behaviors and the mediating role of perceived illness sensitivity: A cross-sectional analysis of women in South Korea

Environmental endocrine disruptors (EDCs) are chemicals that disrupt the endocrine system and pose significant health risks. Perceived sensitivity to illness refers to the heightened susceptibility of an individual due to genetic or environmental factors. This study aims to examine how the awareness of women on EDCs influences their motivation to adopt health behaviors, focusing on the mediating role of perceived illness sensitivity. From October to November 2024, we conducted a cross-sectional survey of 200 adult women in Seoul and Gyeonggi Province, South Korea. Participants were recruited from community-based institutions and completed an online questionnaire assessing their EDCs knowledge, perceived illness sensitivity, and motivation for health behaviors. Data were analyzed using descriptive statistics, parametric tests (t-test, ANOVA) for normally distributed variables, and nonparametric tests (Mann-Whitney U, Kruskal-Wallis) for non-normally distributed variables. Pearson correlations and mediation analysis were also performed. The average knowledge score on EDCs was 65.9 (SD = 20.7). Perceived illness sensitivity averaged 49.5 (SD = 7.4), and health behavior motivation was 45.2 (SD = 7.5). Significant differences in EDCs knowledge, perceived illness sensitivity, and health behavior motivation were observed based on age, marital status, education level, and menopausal status. EDCs knowledge positively correlated with perceived illness sensitivity and motivation. Perceived illness sensitivity was also positively linked to motivation. Mediation analysis revealed that perceived sensitivity partially mediated the relationship between EDCs knowledge and motivation. These findings suggest that knowledge alone may not be sufficient to promote behavior change; cognitive and emotional awareness of illness risk plays a key mediating role. Therefore, effective interventions should combine education with strategies to enhance perceived illness sensitivity.