Health-promoting Behaviors among Urban and Rural Older Thai Adults with Hypertension: A Cross-sectional Study

Health-promoting behaviors are beneficial for enhancing the older adults' health, and several factors such as individual, culture, and social factors influence them. Previous studies have shown that their place of residence is associated with healthy lifestyles of older adults; however, the results are inconsistent. This study aimed to 1) compare health-promoting behaviors among urban and rural older Thai adults with hypertension, and 2) determine the predictability of individual characteristics (age, income, perceived health status), and perceived self-efficacy on their health-promoting behaviors. A cross-sectional survey was conducted among 420 older adults using a demographic questionnaire, the Self-Rated Abilities Scale for Health Practice, and the Health Promoting Lifestyle Profile II. Data analysis used descriptive statistics, Pearson's correlation, and hierarchical regression analysis. Results indicated that older adults in urban districts had higher perceived self-efficacy and health-promoting behaviors than those in rural locations. Perceived self-efficacy and income were predictors of health-promoting behaviors, accounting for 45.4% of the variance. Nurses can use these findings to develop health interventions aimed at increasing perceived self-efficacy through nursing support. Providing health education to improve older adults' self-confidence, reduce anxiety and distress may enhance their healthy lifestyle behaviors, particularly those with low income in rural areas who may require more support.