The Role of Health Beliefs and Health Literacy in Healthy Behaviors in Women Based on the Health Beliefs Model: A Descriptive Study | BMC Women’s Health
In the present study, the HL score was measured to be 52.71 out of 100. The highest HL was related to menstruation and the lowest was related to physical activity. In the study of Saeedi Kopaei in Iran, city of Isfahan, the total health literacy score of high school girls was 42.6 out of 100. The HL of menstrual health was 68.12 out of 100; it was 54.5% for breast self-examination, 48.5% for iron deficiency anemia, 81.23% for physical activity and 77.36% for LH nutrition . The lowest level of health literacy was related to anemia and breast self-exam, and the highest score was related to physical activity. But in our study, the lowest score was for physical activity. The difference in this result can be attributed to the age of the participants (17.4 years versus 23.5 years) and the level of high school compared to university. The large volume of lessons may have reduced the physical activity of the students.
In the study conducted by Ahmadi et al. on female students, the HL score was 67.28 out of 100 . In another study by Dehghankar et al. of female students, up to 65.6% of girls in the study had adequate and excellent health . In a national study conducted on the general population in Iran, the average HL score was 69.02 in the general population in Iran. . The results of these studies also show moderate health literacy which is almost similar to the results of this study.
Although the results of the aforementioned study, compared to those of our study, indicate that, contrary to what is expected, the university students in our study are in poorer health than the general population, in another national study conducted by Haghdoost et al., HL in the general population was 51%, and it was close to the results of our study . Different factors such as differences in study populations, sampling methods and assessment tools for LH can cause differences in the results of different studies. Moreover, in the study conducted by Tavousi  et al., it has been reported that with age (up to 44 years) LH tends to increase; The LH was higher for people aged 35 to 44 and those aged 18 to 24. This is likely to explain the difference between the results of our study and those of the study conducted by Tavousi et al. .
In this study, there is a significant correlation between total HL and healthy behaviors; when HL increases, the conduct of these behaviors also increases. Like our study, a correlation between LH and health-promoting behaviors was indicated in the study conducted (on 375 female students at Imam Khomeini International University in Qazvin, Iran) by Panahi et al. also . The study by Mahdavi et al. conducted among 500 women referred to the family health unit in Tehran, Iran, also confirmed the results of our study on the correlation between HL and preventive behaviors . 48.6% of participants had a low level of health literacy, 24.4% had a marginal level and only 27% had an adequate level of health literacy .
Therefore, it appears that promoting public NS through mass media, social networks, and academic programs is likely to lead to an increase in health-promoting behaviors. It is suggested that in designing, implementing and evaluating educational programs based on risk factors and reducing the burden of disease in universities, special attention be paid to the health of female students.
In addition, given the correlation between LS and behaviors favorable to health and the existence of a significant relationship between behaviors favorable to health and age, the level of education (bachelor’s, master, etc. ) and father’s job, it can be hypothesized that HL has a significant relationship with these factors as well. This has already been indicated in previous studies [25,26,27,28]. Moreover, considering the presentation of similar results in several studies on the low level of health knowledge of Iranian women regarding diseases and health-promoting behaviors, the necessary planning should be carried out by the Legal Office of the women’s health in the country.
According to the results of the present study, self-efficacy, action signals and perceived susceptibility are the most powerful predictors of health-promoting behaviors. Likewise, in a study by Kenari et al. (on Rasht’s students), perceived self-efficacy was identified as the most important predictor of health behaviors. In the study by Kenari et al., Action signals and benefits were recognized as the next important predictors . To confirm our results, a study by Ahmadian et al. (on students in Malaysia) indicated that perceived self-efficacy was the most important predictor of behavior. Additionally, in the aforementioned study, perceived barriers were reported as a negative factor in predicting behaviors. . Given the correlation between the health belief model and health-promoting behaviors, some studies have indicated that education based on a health belief model is likely to increase health-promoting behaviors. For example, in a study of pre-college girls in Tehran, it was reported that perceived self-efficacy increased significantly after providing model-based education. This education has been shown to be effective on preventive behaviors . In a study by Karimi et al. (on nutritional behaviors of pregnant women), perceived benefits were found to have the highest correlation. After perceived benefits, perceived barriers, susceptibility, severity, and self-efficacy were then shown to correlate with nutritional behaviors. . The type of health-promoting behavior appears to be correlated with different components of the health belief model. For example, although in our study, perceived self-efficacy (as a whole) was the most correlated with health-promoting behaviors, it was also partially indicated that a healthy diet, as a health-promoting behavior, is more correlated with perceived benefits, according to the results of Table 2. This was indicated in the study conducted by Karimi et al. also . In addition, physical activity behavior is more correlated with action signals. Thus, these differences must be attributed to differences in the type of behavior. In a study by Shirzad et al. (on girls living in daycare centers in Tehran), susceptibility, perceived benefits and barriers have been shown to be the most important predictors of health-promoting behaviors . These differences may be due to differences in the social status of the statistical population compared to the population of our study.
The electronic response to the questionnaire has both weaknesses and strengths. Its strengths include faster data collection, ensuring data is confidential and anonymous, and providing honest answers due to the researcher’s absence. However, in the absence of the researcher, they can ask their friends for answers to some questions or search for other sources upon completion.
In addition, one of its strengths is the application of a health belief model to assess student beliefs and perceptions. In general, it is suggested that intervention programs based on behavior change theories (such as the health belief model and self-efficacy theory) be considered by relevant university officials in the process. aim to promote the NS and self-efficacy of students to perform health promotion actions. student behaviors. Because by promoting students’ beliefs (perceived susceptibility and severity) about illnesses and increasing the benefits and removing barriers to health-promoting behaviors, in addition to increasing self-efficacy, their literacy in these matters. health will also increase and, as a result, behavior will change.