The role of self-efficacy and self-care agency as mediating factors in the link between health literacy and health-promoting lifestyle among older adults post covid 19 era: A multiple mediator model.

Health-promoting lifestyle is poor in older adults during COVID-19 pandemic. Elucidate the underlying mechanisms between health literacy and health-promoting lifestyle is important. Therefore, we investigated the mediating effect of self-efficacy and self-care agency in relation between health literacy and health-promoting lifestyle among older adults post covid 19 era. A cross-sectional descriptive survey on 200 older adults with the mean age of 68.3 were recruited from Lecai urban community in China, through convenience sampling. Information was assessed using Health literacy Assessment Scale for Infectious Diseases of Chinese Residents, the General Self Efficacy Scale, Chinese version of the Elderly Self-care Ability Scale, and the Health-Promoting Lifestyle Profile-Chinese Elderly. A serial multiple mediation modeling was tested using the PROCESS macro for SPSS to validate the pathways. Results indicated that positive correlations were found between health literacy, self-efficacy, self-care agency and health-promoting lifestyle in older adults. Meanwhile, health literacy was linked to enhanced health-promoting lifestyle through two pathways: (1) self-efficacy; (2) chain combination of self-efficacy and self-care agency. Self-efficacy and self-care agency mediated the relationship between health literacy and health-promoting lifestyle in older adults. Therefore, attention to improving self-efficacy, self-care agency and health literacy should be considered crucial for improving health-promoting lifestyle.