Developing a Health-Promoting Lifestyle Model for Parents of Slow-Learner Children Based on Biological Health, Marital Satisfaction, and Spiritual Vitality

Purpose: This study aimed to develop and test a structural model of health-promoting lifestyle among parents of slow-learner children based on biological health and marital satisfaction, with spiritual vitality as a mediating variable. Methods and Materials: This applied, quantitative, descriptive-correlational, cross-sectional study was conducted among parents of slow-learner children aged 6–14 years in Shiraz, Iran. Using a multistage sampling procedure, 400 parents, including 200 fathers and 200 mothers, were recruited. Data were collected using a demographic information form, the Afrouz Marital Satisfaction Questionnaire, the Afrouz Spiritual Vitality Questionnaire, the 52-item Health-Promoting Lifestyle Profile, and the Family Health Status Inventory. Data were analyzed using descriptive statistics, Pearson correlations, confirmatory factor analysis, and structural equation modeling in SPSS 21 and LISREL 8.80. Indirect effects were examined using the Sobel test and bootstrap resampling with 5,000 samples. Findings: All structural paths were statistically significant (p < .001). Biological health negatively predicted spiritual vitality (β = -.38) and health-promoting lifestyle (β = -.42), reflecting the reverse scoring of poorer health status. Marital satisfaction positively predicted spiritual vitality (β = .56) and health-promoting lifestyle (β = .38), while spiritual vitality positively predicted health-promoting lifestyle (β = .52). Spiritual vitality significantly mediated the relationship between biological health and health-promoting lifestyle (indirect effect = -.36, Sobel Z = 5.23, p < .001) and between marital satisfaction and health-promoting lifestyle (indirect effect = .25, Sobel Z = 6.52, p < .001). Bootstrap confidence intervals excluded zero. The final model demonstrated acceptable fit: χ²/df = 2.84, RMSEA = .068, SRMR = .052, CFI = .94, NFI = .91, IFI = .94, and GFI = .91. Conclusion: Health-promoting lifestyle among parents of slow-learner children is jointly associated with biological health, marital satisfaction, and spiritual vitality, with spiritual vitality functioning as a significant partial mediator, highlighting the value of integrated family-centered interventions addressing physical, relational, and spiritual resources.