Health Literacy and Health Behaviors Based on Lifestyle Medicine Pillars among Patients with Non-communicable Diseases in Mae Tha District, Lampang Province

Abstract

This cross-sectional analytical study aimed to assess the level of health literacy, health behaviors based on the six pillars of lifestyle medicine and identify predictors of health behaviors among patients with non-communicable disease (NCDs). The samples consisted of 473 patients with diabetes mellitus and/or hypertension, aged 20-79 years, who received care at Mae Tha Hospital, Lampang Province. Participants were selected using multi-stage random sampling. Data were collected using an interview questionnaire and analyzed using descriptive statistics, Pearson’s correlation coefficient, and stepwise multivariable regression analysis. The results showed that the participants had an overall health literacy score of 79.20%, which was classified as a moderate level. The overall health behavior score based on the six pillars of lifestyle medicine was 68.69%, which was classified as a very good level. When each pillar was considered separately, avoidance of risky substances and restorative sleep had the highest score, both at an excellent level, whereas nutrition and physical activity had the lowest scores, respectively, and were classified as average. Factors significantly associated with health behavior scores (p<0.05) included positive factors, namely health literacy (r=0.340), reinforcing factors (r=0.288) and enabling factors (r=0.186), while male sex was negatively associated with health behavior scores (r=-0.095). These four factors jointly explained 13.79% of the variance in health behaviors (adjusted R²=0.1379). The findings indicate that although the participants demonstrated a very good overall level of health behaviors, further improvement is needed particularly in nutrition and physical activity interventions aimed at improving these behaviors should focus on strengthening health literacy in conjunction with creating health-supportive environments and enhancing support from families and communities.