Factors associated with health-promoting lifestyles among community-dwelling older adults in Zigong, China: a cross-sectional study

[Purpose] The aging population in China faces significant challenges in maintaining health-promoting lifestyles, with disparities between life expectancy and healthy life expectancy. In this study, we aimed to assess health-promoting lifestyles and identify factors associated with them among community-dwelling older adults in Zigong, China.[Methods] A cross-sectional study was conducted with 768 participants aged 60 years and older, selected via multistage stratified random sampling. Standardized instruments, including the Health-Promoting Lifestyle Profile II, the Health Literacy Scale-Short Form, and the General Self-Efficacy Scale, were used to assess health-promoting behaviors, health literacy, and self-efficacy. Statistical analyses included descriptive statistics and stepwise regression analyses.[Results] Participants demonstrated moderate levels of health-promoting lifestyles, with physical activity scoring the lowest among all domains. Policy awareness, health literacy, self-efficacy, and education level were notably associated with health-promoting lifestyles, collectively explaining 71.6 % of the variance.[Conclusion] The findings underscored the associations of policy awareness and psychological factors with healthy aging. Targeted interventions to enhance health literacy and self-efficacy, particularly among socioeconomically disadvantaged older adults, are recommended.