Associations Between Health Literacy, Environmental Factors, and Fall Prevention Behaviors Among Community-Dwelling Older Adults in Northern Thailand: A Cross-Sectional Study

Inadequate health literacy (HL) is a critical factor contributing to fall risk among older adults. However, evidence on how HL relates to home environment and fall prevention behaviors in Asian community settings remains limited. This study aimed to assess HL levels and examine their associations with sociodemographic characteristics, home environment, and fall prevention behaviors. A community-based cross-sectional study was conducted among 177 community-dwelling older adults aged 60 to 79 years. Data were collected through structured questionnaires assessing sociodemographic characteristics, home environment, fall prevention behaviors, and HL using the European Health Literacy Survey Questionnaire (HLS-EU-Q47), which cover three subdomains: healthcare, disease prevention, and health promotion. Multiple linear regression analysis was performed to examine the associations between sociodemographic factors, home environment, fall prevention behaviors, and HL. The HL score among older adults was 34.50 ± 7.50 (54.2% limited HL). A total HL score was positively associated with regular exercise (β = 2.73, 95% CI: 0.71, 4.74) and a sitting toilet (β = 6.38; 95% CI: 3.83, 8.92) and marginally associated with wearing properly fitting shoes (β = 2.54; 95% CI: 0.22, 4.86). Therefore, the health promotion aimed at improving HL in this population may benefit from concurrently promoting regular exercise, home safety modifications, and safe footwear practices.