Role of Mental Stress and Workload on Health Behavior and Chronic Disease Prevention (A Pilot Study)

Background: Despite broad awareness of cardiovascular disease and cancer risk factors, their incidence remains high. This gap between knowledge and healthy behavior adoption raises questions about barriers to healthier lifestyles. This study investigated these underlying reasons and identified key factors influencing health behavior, particularly workload impact.

Methods: This pilot study used a survey-based design. A 36-question survey, refined via pretest, included elements on risk factor knowledge, situational considerations, and Health Belief Model components. Administered online and on paper, an exploratory factor analysis (EFA) identified underlying health behavior factors. Participants were divided into three workload groups: low (<29 hours/week), intermediate (29-45 hours/week), and high (>45 hours/week). Correlations among variables were established for each workload category. All analyses were conducted using RStudio (Version 2025.05).

Results: A total of 370 participants completed the survey (average age: 48 ± 17 years; 50.7% female; average work week: 34.6 ± 15.3 hours). Distinct patterns emerged across workload groups: the high-workload group (averaging 51 ± 7 hours/week) was predominantly male and reported lower health importance, frequently citing lack of time, stress, and mental burden as obstacles. The EFA identified eight distinct factors, with significant distribution differences across groups. For low-workload individuals, health responsibility, self-efficacy, and risk factor knowledge showed no correlation with mental stress, unlike high-workload individuals, where significant negative correlations were observed. This suggests mental stress can be especially detrimental to health with high workload. Furthermore, in low-workload individuals, mental stress correlated with perceived barriers, indicating potential barrier saturation with high workload. Interestingly, physical activity correlated negatively with mental stress, significantly in the intermediate group, and >3.5 hours of physical activity per week were associated with less mental stress in low and intermediate workload groups.

Conclusion: This pilot study indicates that mental stress, time constraints, and perceived mental burden are significant barriers to healthy lifestyles, especially for vulnerable individuals with high workloads. These findings underscore the importance of integrating stress management, resilience-building, and a stronger consideration of patients' life circumstances into future health promotion initiatives, such as promoting physical activity and shifting efforts beyond mere information dissemination. Addressing psychological aspects is vital for impactful public health initiatives that aim to prevent cardiovascular diseases and cancer more efficiently. Further research will focus on refining the questionnaire and expanding the sample size.