Proactive Health Profiling and Classification of Older Adults with Multimorbidity in Rural China: A Qualitative Study

Our study aimed to identify and classify proactive health management patterns among rural older adults with multimorbidity using a user persona approach. We conducted a descriptive qualitative study with user persona methodology in a rural area of South China from February to May 2025, where 33 rural adults aged ≥60 years with ≥2 chronic conditions were recruited via purposive sampling. We used semi-structured interviews to explore key dimensions of proactive health management, including health cognition, resource use, and information acquisition; we coded and analyzed interview data using NVivo 12 to extract behavioral characteristics and construct persona categories. Our analysis of the interview data from 33 participants identified 5 typical user personas: tradition-oriented self-management, low perceived risk management, family-delegated management, resource-constrained striving, and actively learning management. The findings indicate that rural older adults with multimorbidity exhibit diverse proactive health management patterns shaped by cultural beliefs, family dynamics, and resource constraints. Recognizing this heterogeneity is essential for moving beyond uniform health promotion approaches and supporting more responsive chronic disease management.