Construction of a healthy lifestyle index system for Chinese adults: a modified Delphi study

Lifestyle is the most powerful predictor of health and mortality. Evaluating healthy lifestyles among adults can facilitate their popularization and practice and improve their overall health. The four cornerstones of health proposed by the World Health Organization (WHO) were used as the dimensional basis, and the index system was established based on the contents of China’s health-related policy documents. The modified Delphi method was used to solicit opinions from 50 experts. The Analytic Hierarchy Process (AHP) was used to calculate the weights of the indicators, and the scale reliability and validity were examined through a questionnaire. The Chinese adult healthy lifestyle index system consists of 4 dimensions with 22 items. The effective response rates for the three rounds of expert consultation were 60%, 90%, and 66.67%, respectively. The expert authority coefficients for the three rounds of consultation were 0.906, 0.899, and 0.904, respectively. The Kendall Harmony Coefficient in the third round of consultation was 0.342. The weights of the four dimensions are obtained as 0.286, 0.286, 0.286, and 0.143, respectively. All of the results passed the consistency test. Exploratory factor analysis identified six robust factors accounting for 62.337% of total variance, refining the initial four-dimensional framework through the natural differentiation of dietary and risk behavior subdomains. The Cronbach’s alpha coefficient for the scale was 0.819, indicating acceptable internal consistency. The Chinese Adult Healthy Lifestyle Index System demonstrates scientific rigor and content validity in its constructed indicators. This tool provides a culturally adapted framework for assessing healthy lifestyle behaviors among Chinese adults.