The Gendered Mediation Effects of Social Support on Fertility Intentions Among Childless Adults of Reproductive Age in China: National Cross-Sectional Study

Background: China is currently facing a low fertility rate, making it crucial to explore the influence of psychosocial factors on fertility intentions to address demographic structural challenges. Social support, as a potentially significant influencing factor, is not yet fully understood in terms of its specific pathways and gender differences. Objective: This study aimed to explore how social support impacts fertility intentions among Chinese adults aged 20-49 years, with an emphasis on gender-specific differences and the mediating roles of self-efficacy and conscientiousness. Methods: Data were obtained from the Psychology and Behavior Investigation of Chinese Residents (PBICR). This study included 2653 childless adults of reproductive age. A decision tree model was used to identify key factors influencing fertility intentions. A mediation analysis was conducted to explore the mediating effects of self-efficacy and conscientiousness while controlling for demographic confounders. Results: Among all 2653 participants, 71.3% (1892/2653) had fertility intentions. The proportion was significantly higher in men (weighted 79%, 95% CI 76.5%-81.3%) than in women (weighted 64.5%, 95% CI 61.8-67.1; P