ArticleBMC public health2025
The role of moderating variables in the relationship between health literacy and healthy living awareness among health program students: a cross-sectional study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWithin the framework of Pender's Health Promotion Model, health literacy is a cognitive process that enhances healthy lifestyle awareness and facilitates behavior change through perceived benefits, barriers, and self-efficacy. However, how this relationship varies according to individual and behavioral characteristics among health sciences students remains unclear. This study aims to contribute to the existing knowledge by exploring the moderating influences of selected personal and behavioral variables the linkage connecting health literacy to individuals' awareness of healthy lifestyles.
methodsThis quantitative, cross-sectional study was conducted from April to July 2025 among students enroled in their first and second academic year registered in four programs (First and Emergency Aid, Dialysis, Anesthesia, and Operating Room Services) at the School of Health Services, Cappadocia University. A full census method was applied. Of 396 eligible students, valid data were obtained from 384 participants (97% participation rate), exceeding the threshold required for the minimum sample size (n = 203). Data were gathered through in-person administration of the Personal Information Form, the Turkish Health Literacy Scale-32, and the Healthy Living Awareness Scale. Statistical analyses were performed through IBM SPSS Statistics 20.0 and Jamovi 2.5.3 software, including correlation, regression, and moderation analyses.
resultsThe average age of participants was 20.71 ± 2.34 years; 74.2% were female and 54.7% were first-year students. The mean health literacy score was 32.32 ± 9.68, and the mean healthy lifestyle awareness score was 57.81 ± 12.08. Overall, 89% of students demonstrated adequate or excellent health literacy. Correlation and regression analyses revealed a statistically meaningful positive link connecting health literacy to healthy lifestyle awareness (p < 0.001). The interaction term for snack frequency reached statistical significance (β= -0.086, 95% CI [- 0.171, - 0.001], p = 0.048), indicating that the positive effect of health literacy on awareness weakened with lower snack frequency.
conclusionsFindings revealed a statistically significant positive link connecting health literacy to health program students' awareness of healthy lifestyles. Snack frequency was the only significant moderator (p = 0.048); however, its borderline significance suggests the effect may be limited. As snack frequency declined, the beneficial influence of health literacy on awareness diminished. These results suggest that health education programs should incorporate behavioral awareness strategies to strengthen the impact of health literacy on the development of healthy lifestyle behaviors among learners.
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