From knowledge to action: health literacy and health-promoting behaviors in parents of autistic children, a cross-sectional study in Iran

Children with Autism Spectrum Disorder (ASD) depend on their parents for their health and well-being, especially in Iran where formal services for children with ASD are limited and families play a central role in daily care. The most effective diagnostic and therapeutic interventions arise from the collaboration between parents and the healthcare system. Health literacy and health-promoting behaviors are crucial in managing the care needs of children with ASD. There is limited evidence regarding the relationship between health literacy and health-promoting behaviors in this population. Therefore, the present study was designed to examine the relationship between health literacy and health-promoting behaviors in parents of children with ASD. This cross-sectional study was conducted in Iran in 2024. A total of 178 parents of children with ASD were selected using convenience sampling. Data were collected through a demographic questionnaire, a health literacy questionnaire, and a health-promoting lifestyle questionnaire. Descriptive statistics, independent t-test, analysis of variance, and Pearson correlation coefficient were used to describe and analyze the data. The Strobe Checklist was used as the basis for this study. The parents demonstrated a mean health literacy score of 127.78 ± 20.07, while their mean score for health-promoting behaviors was 131.60 ± 24.42. There was a statistically significant positive correlation between health literacy and all dimensions of health-promoting behaviors ( P < 0.001). Among the various dimensions, the strongest correlation was observed in the domain of physical activity ( r = 0.55), whereas the weakest association was found in the domain of stress management ( r = 0.27). These findings indicate that enhancing parental health literacy can strengthen their ability to maintain health-promoting behaviors in a context with limited formal support. The results of this study underscore the critical role of health literacy in empowering parents to adopt and maintain health-promoting behaviors that improve their own and their children’s well-being and health. In Iran, where family caregivers are the primary source of care for children with ASD, enhancing parental health literacy may be a practical strategy to improve family-centered. The healthcare system can develop and implement interventions to enhance health literacy through providing educational programs, fostering cultural shifts toward self-care, and improving access to reliable health information.