Determinants of the Health-Promoting Behaviors Among Community-Dwelling Older Adults with Non-communicable Diseases During the Post-Covid-19 Era

Abstract

Background: While research has explored the health-promoting behaviors (HPBs) of older adults on a global scale during the first and second waves of COVID-19, there is limited knowledge about the factors that influence HPBs among older adults with non-communicable diseases (NCDs) in the "new normal" following the COVID-19 era. Objectives: The aim of this study was to identify the factors that affect HPBs among community-dwelling older adults with NCDs. Methods: This cross-sectional study involved surveying 250 older adults with NCDs in both urban and rural communities within Ubon Ratchathani province, northeast Thailand, between September 10 and November 10, 2022, during the COVID-19 pandemic. Data collection was conducted using a self-administered questionnaire, which included the Self-rated Abilities Scale for Health Practice, Health Literacy Scale, Access to COVID-19 Preventive Material, Lubben Social Network Scale, and Health-Promoting Behaviors Scale. The analysis utilized descriptive statistics and hierarchical regression analysis, setting the significance level at P < 0.05 for all analyses. Results: Among the 250 older adults with NCDs surveyed, 65.60% had hypertension. These individuals demonstrated HPBs at a good level, along with a high level of perceived self-efficacy, good health literacy, adequate access to COVID-19 preventive materials, and greater social engagement. The analysis indicated that perceived self-efficacy (β = 0.343, P < 0.001), attitudes towards smoking (β = 0.226, P < 0.001), age (β = 0.204, P < 0.001), health literacy (β = 0.199, P = 0.016), and access to COVID-19 preventive materials (β = 0.123, P = 0.026) were significant predictors of HPBs in older adults with NCDs. Conclusions: The results suggest that improved access to COVID-19 preventive materials, enhanced health literacy, and increased self-efficacy contribute to better health-promoting behaviors among older adults with NCDs. Multidisciplinary healthcare teams should consider these factors in their intervention strategies to achieve a deeper understanding and better health outcomes. Future research should investigate the causal relationships among these variables and examine older adults’ perceptions of HPBs in long-term care settings, particularly in the "new normal" era.