Relationship Between Health Self-Efficacy and Healthy Lifestyle among Young Adults in Malaysia

Objective: This study aimed to examine the relationship between health self-efficacy and healthy lifestyle behaviours among young adults in Malaysia. It specifically sought to explore how individuals’ confidence in managing their health influences their engagement in behaviours such as regular physical activity, balanced nutrition, and other health-promoting practices. By investigating this association, the study aims to provide insights that can inform the development of targeted interventions and strategies to enhance self-efficacy and support the adoption of sustainable healthy lifestyles in this population.
Methods: A quantitative cross-sectional survey design was employed. Data were collected from 166 young adults in Perak, Malaysia using purposive sampling. Participants completed a self-administered questionnaire comprising socio-demographic items, the Health-Specific Self-Efficacy Scale (HSSES), and the Healthy Lifestyle Screening Tool (HLST). Descriptive statistics and correlation analyses were conducted.
Results: Descriptive analyses showed that male participants and those with tertiary education reported higher mean scores for health self-efficacy and healthy lifestyle behaviours compared to female participants and those with secondary education; however, these differences were not statistically significant. Correlation analysis revealed a moderate and statistically significant positive association between health self-efficacy and healthy lifestyle behaviours (r (164) = 0.568, p < .001). No significant differences were observed in health self-efficacy or healthy lifestyle behaviours based on gender or level of education.
Conclusion: Health self-efficacy was significantly associated with healthy lifestyle behaviours among Malaysian young adults. The findings highlight the importance of incorporating self-efficacy enhancing strategies in health promotion interventions targeting young adults. This study contributes to the limited empirical evidence in the Malaysian context and provides support for developing evidence-based approaches to encourage healthier lifestyle practices among young adults.

health self-efficacy, health behaviour change, young adults

1. Abbasi, S., Kamali, K., Sepehrinia, M., & Mehdizade, S. (2020). The relationship between self-efficacy and health-promoting lifestyle in students. Journal of Holistic Nursing And Midwifery, 159-165. https://doi.org/10.32598/jhnm.30.3.2019 [Google Scholar] [Crossref]

2. Alomari, A., Alananzeh, I., Lord, H., & Fernandez, R. (2021). The adherence to healthy lifestyle among Arab patients with cardiovascular disease: Mixed-method review. Journal of Transcultural Nursing, 33(1), 33-40. https://doi.org/10.1177/10436596211035176 [Google Scholar] [Crossref]

3. Amiri, M., Chaman, R., & Khosravi, A. (2019). The relationship between health-promoting lifestyle and its related factors with self-efficacy and well-being of students. Osong Public Health and Research Perspectives, 10(4), 221-227. https://doi.org/10.24171/j.phrp.2019.10.4.04 [Google Scholar] [Crossref]

4. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-t [Google Scholar] [Crossref]

5. Açıkgöz Çepni, S., & Kitiş, Y. (2016). Relationship between healthy lifestyle behaviors and health locus of control and health-specific self-efficacy in university students. Japan Journal of Nursing Science, 14(3), 231-239. https://doi.org/10.1111/jjns.12154 [Google Scholar] [Crossref]

6. Bandura, A. 1997. Self Efficacy: The Exercise of Control. New York: Freeman. [Google Scholar] [Crossref]

7. Bazrafkan, L., Bayati, T., Dehghan, A., & Bonyadi, F. (2018). Investigating the effect of education on health literacy and its relation to health-promoting behaviors in health center. Journal of Education and Health Promotion, 7(1), 127. https://doi.org/10.4103/jehp.jehp_65_18 [Google Scholar] [Crossref]

8. Bektas, İ., Kudubeş, A. A., Ayar, D., & Bektas, M. (2021). Predicting the healthy lifestyle behaviors of Turkish adolescents based on their health literacy and self-efficacy levels. Journal of Pediatric Nursing, 59, e20-e25. https://doi.org/10.1016/j.pedn.2021.01.016 [Google Scholar] [Crossref]

9. Borillo, C. J., Tamanal, J. M., & Kim, C. H. (2020). Determining the cut off score of the healthy lifestyle screening tool among high school students. Journal of Lifestyle Medicine, 10(2), 92-101. https://doi.org/10.15280/jlm.2020.10.2.92 [Google Scholar] [Crossref]

10. Brydges C. R. (2019). Effect Size Guidelines, Sample Size Calculations, and Statistical Power in Gerontology. Innovation in aging, 3(4), igz036. https://doi.org/10.1093/geroni/igz036 [Google Scholar] [Crossref]

11. Carmel, S. (2019). Health and well-being in late life: Gender differences worldwide. Frontiers in Medicine, 6. https://doi.org/10.3389/fmed.2019.00218 [Google Scholar] [Crossref]

12. Cena, H., & Calder, P. C. (2020). Defining a healthy diet: Evidence for the role of contemporary dietary patterns in health and disease. Nutrients, 12(2), 334. https://doi.org/10.3390/nu12020334 [Google Scholar] [Crossref]

13. Che Zulkifli, N. I., & Mohamed, N. F. (2020). A Study of relationship between mental health and smoking among adolescences in Tanjong Malim District. Jurnal Pendidikan Bitara UPSI, 13(2), 48-57. https://doi.org/10.37134/bitara.vol13.2.5.2020 [Google Scholar] [Crossref]

14. Cheng, L. A., Mendonça, G., Lucena, J., Rech, C. R., & Farias, J. C. (2020). Is the association between sociodemographic variables and physical activity levels in adolescents mediated by social support and self-efficacy? Jornal de Pediatria, 96(1), 46-52. https://doi.org/10.1016/j.jped.2018.08.003 [Google Scholar] [Crossref]

15. Cheong, A. T., Tong, S. F., Chinna, K., Khoo, E. M., & Liew, S. M. (2020). Gender differences in factors influencing intention to undergo cardiovascular disease health checks: A cross-sectional survey. PLOS ONE, 15(9), e0239679. https://doi.org/10.1371/journal.pone.0239679 [Google Scholar] [Crossref]

16. Denieffe, S. (2020). Commentary: Purposive sampling: complex or simple? Research case examples. Journal of Research in Nursing, 25(8), 662-663. https://doi.org/10.1177/1744987120928156 [Google Scholar] [Crossref]

17. Department of Statistics Malaysia. (2025). Statistics on causes of death, Malaysia, 2025. Putrajaya: DOSM. https://www.dosm.gov.my [Google Scholar] [Crossref]

18. Godin, G., & Kok, G. (1996). The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion, 11(2), 87-98. https://doi.org/10.4278/0890-1171-11.2.87 [Google Scholar] [Crossref]

19. Grzymisławska, M., Puch, E., Zawada, A., & Grzymisławski, M. (2020). Do nutritional behaviors depend on biological sex and cultural gender? Advances in Clinical and Experimental Medicine, 29(1), 165-172. https://doi.org/10.17219/acem/111817 [Google Scholar] [Crossref]

20. Jiang, X., Jiang, H., Li, M., Lu, Y., Liu, K., & Sun, X. (2019). The mediating role of self‐efficacy in shaping self‐management behaviors among adults with type 2 diabetes. Worldviews on Evidence-Based Nursing, 16(2), 151-160. https://doi.org/10.1111/wvn.12354 [Google Scholar] [Crossref]

21. Kaminsky, L. A., German, C., Imboden, M., Ozemek, C., Peterman, J. E., & Brubaker, P. H. (2022). The importance of healthy lifestyle behaviors in the prevention of cardiovascular disease. Progress in Cardiovascular Diseases, 70, 8-15. https://doi.org/10.1016/j.pcad.2021.12.001 [Google Scholar] [Crossref]

22. Kankaanpää, A., Tolvanen, A., Heikkinen, A., Kaprio, J., Ollikainen, M., & Sillanpää, E. (2022). National Institutes of Health/National Heart, Lung, and Blood Institute (grant HL104125. The Role of Adolescent Lifestyle Habits in Biological Aging: A Prospective Twin Study, 11. https://doi.org/10.7554/eLife.80729 [Google Scholar] [Crossref]

23. Kent Baker, H., Pandey, N., Kumar, S., & Haldar, A. (2020). A bibliometric analysis of board diversity: Current status, development, and future research directions. Journal of Business Research, 108, 232-246. https://doi.org/10.1016/j.jbusres.2019.11.025 [Google Scholar] [Crossref]

24. Kim, C. H., & Kang, K. (2019). The validity and reliability of the healthy lifestyle screening tool. Physical Therapy Rehabilitation Science, 8(2), 99-111. https://doi.org/10.14474/ptrs.2019.8.2.99 [Google Scholar] [Crossref]

25. König, L.M., Krukowski, R.A., Kuntsche, E. et al. Reducing intervention- and research-induced inequalities to tackle the digital divide in health promotion. Int J Equity Health 22, 249 (2023). https://doi.org/10.1186/s12939-023-02055-6 [Google Scholar] [Crossref]

26. Kris-Etherton, P. M., Petersen, K. S., Després, J., Braun, L., De Ferranti, S. D., Furie, K. L., Lear, S. A., Lobelo, F., Morris, P. B., & Sacks, F. M. (2021). Special considerations for healthy lifestyle promotion across the life span in clinical settings: A science advisory from the American Heart Association. Circulation, 144(24). https://doi.org/10.1161/cir.0000000000001014 [Google Scholar] [Crossref]

27. Lai, P., Wu, S. V., Alizargar, J., Pranata, S., Tsai, J., & Hsieh, N. (2021). Factors influencing self-efficacy and self-management among patients with pre-end-Stage renal disease (Pre-ESRD). Healthcare, 9(3), 266. https://doi.org/10.3390/healthcare9030266 [Google Scholar] [Crossref]

28. Lim, B. C., Kueh, Y. C., Arifin, W. N., & Ng, K. H. (2021). Modelling knowledge, health beliefs, and health-promoting behaviours related to cardiovascular disease prevention among Malaysian university students. PLOS ONE, 16(4), e0250627. https://doi.org/10.1371/journal.pone.0250627 [Google Scholar] [Crossref]

29. Liu, C., Wang, D., Liu, C., Jiang, J., Wang, X., Chen, H., Ju, X., & Zhang, X. (2020). What is the meaning of health literacy? A systematic review and qualitative synthesis. Family Medicine and Community Health, 8(2), e000351. https://doi.org/10.1136/fmch-2020-000351 [Google Scholar] [Crossref]

30. Lu, M., Xia, H., Ma, J., Lin, Y., Zhang, X., Shen, Y., & Hravnak, M. (2019). Relationship between adherence to secondary prevention and health literacy, self-efficacy and disease knowledge among patients with coronary artery disease in China. European Journal of Cardiovascular Nursing, 19(3), 230-237. https://doi.org/10.1177/1474515119880059 [Google Scholar] [Crossref]

31. Magnani, J. W., Mujahid, M. S., Aronow, H. D., Cené, C. W., Dickson, V. V., Havranek, E., Morgenstern, L. B., Paasche-Orlow, M. K., Pollak, A., & Willey, J. Z. (2018). Health literacy and cardiovascular disease: Fundamental relevance to primary and secondary prevention: A scientific statement from the American Heart Association. Circulation, 138(2). https://doi.org/10.1161/cir.0000000000000579 [Google Scholar] [Crossref]

32. Mohd Talmizi, N., Ali, N., & Teriman, S. (2021). A Review On Socio-Demographic Factors Influencing Physical Activities. Malaysian Journal Of Sustainable Environment, 8(1), 75-90. doi:10.24191/myse.v8i2.13237 [Google Scholar] [Crossref]

33. Monzon, A., Julio, R., & Garcia-Martinez, A. (2020). Hybrid methodology for improving response rates and data quality in mobility surveys. Travel Behaviour and Society, 20, 155-164. https://doi.org/10.1016/j.tbs.2020.03.012 [Google Scholar] [Crossref]

34. Ng, R., Sutradhar, R., Yao, Z., Wodchis, W. P., & Rosella, L. C. (2019). Smoking, drinking, diet and physical activity—modifiable lifestyle risk factors and their associations with age to first chronic disease. International Journal of Epidemiology, 49(1), 113-130. https://doi.org/10.1093/ije/dyz078 [Google Scholar] [Crossref]

35. Popkin, B. M., Adair, L. S., & Ng, S. W. (2012). Global nutrition transition and the pandemic of obesity in developing countries. Nutrition Reviews, 70(1), 3-21. https://doi.org/10.1111/j.1753-4887.2011.00456.x [Google Scholar] [Crossref]

36. Saghafi-Asl, M., Aliasgharzadeh, S., & Asghari-Jafarabadi, M. (2020). Factors influencing weight management behavior among college students: An application of the health belief model. PLOS ONE, 15(2), e0228058. https://doi.org/10.1371/journal.pone.0228058 [Google Scholar] [Crossref]

37. Schwarzer, R., & Renner, B. (2009). Health-specific self-efficacy scales. Freie Universität Berlin, 14, 2009 [Google Scholar] [Crossref]

38. Sood, R., Jenkins, S. M., Sood, A., & Clark, M. M. (2019). Gender differences in self-perception of health at a wellness center. American Journal of Health Behavior, 43(6), 1129-1135. https://doi.org/10.5993/ajhb.43.6.10 [Google Scholar] [Crossref]

39. Siti Munira Yasin, Mohamad Rodi Isa, Nurhuda Ismail, Leny Suzana Suddin, Mohammad Shahril Ahmad Saman, & Zaliha Ismail. (2020). The relationship between socioeconomic status and knowledge on cardiovascular risk factors and its preventive practices among urban dwellers in Selangor, Malaysia. Malaysian Journal of Public Health Medicine, 20(Special1), 292-298. https://doi.org/10.37268/mjphm/vol.20/no.special1/art.733 [Google Scholar] [Crossref]

40. Sun, Q., Yu, D., Fan, J., Yu, C., Guo, Y., Pei, P., Yang, L., Chen, Y., Du, H., Yang, X., Sansome, S., Wang, Y., Zhao, W., Chen, J., Chen, Z., Zhao, L., Lv, J., & Li, L. (2022). Healthy lifestyle and life expectancy at age 30 years in the Chinese population: an observational study. The Lancet Public Health, 7(12), e994–e1004. https://doi.org/10.1016/S2468-2667(22)00110-4 [Google Scholar] [Crossref]

41. Tsai, M., Lee, C., Liu, S., Tseng, P., & Chien, K. (2020). Combined healthy lifestyle factors are more beneficial in reducing cardiovascular disease in younger adults: A meta-analysis of prospective cohort studies. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-75314-z [Google Scholar] [Crossref]

42. Uysal, N., Ceylan, E., & Koç, A. (2019). Health literacy level and influencing factors in university students. Health & Social Care in the Community, 28(2), 505-511. https://doi.org/10.1111/hsc.12883 [Google Scholar] [Crossref]

43. Vamos, S., Okan, O., Sentell, T., & Rootman, I. (2020). Making a case for “Education for health literacy”: An international perspective. International Journal of Environmental Research and Public Health, 17(4), 1436. https://doi.org/10.3390/ijerph17041436 [Google Scholar] [Crossref]

44. Wang, Y., Xu, L., Qin, W., Zhang, J., Xia, Y., Jing, X., Lu, L., Jiao, A., & Li, Y. (2019). Gender difference in general self-efficacy among young-old elderly aged 60–74 in rural Shandong China: A cross-sectional survey. International Journal of Environmental Research and Public Health, 16(24), 5070. https://doi.org/10.3390/ijerph16245070 [Google Scholar] [Crossref]

45. Wilson, O. W., Bhuiyan, N., & Bopp, M. (2021). Factors contributing to gender inequities in physical activity and campus recreation facility use. Journal of American College Health, 1-9. https://doi.org/10.1080/07448481.2021.1965150 [Google Scholar] [Crossref]

46. Zhang, Y., Chen, C., Pan, X., Guo, J., Li, Y., Franco, O. H., Liu, G., & Pan, A. (2021). Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: Two prospective cohort studies. BMJ, n604. https://doi.org/10.1136/bmj.n604 [Google Scholar] [Crossref]

47. Zhu, R., Craciun, I., Bernhards-Werge, J., Jalo, E., Poppitt, S. D., Silvestre, M. P., Huttunen-Lenz, M., McNarry, M. A., Stratton, G., Handjiev, S., Handjieva-Darlenska, T., Navas-Carretero, S., Sundvall, J., Adam, T. C., Drummen, M., Simpson, E. J., Macdonald, I. A., Brand-Miller, J., Muirhead, R., & Lam, T. (2022). Age- and sex-specific effects of a long-term lifestyle intervention on body weight and cardiometabolic health markers in adults with prediabetes: results from the diabetes prevention study PREVIEW. Diabetologia, 65(8), 1262–1277. https://doi.org/10.1007/s00125-022-05716-3 [Google Scholar] [Crossref]

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