Health literacy and health behaviors based on the 3E. 2S. 1T. framework among buddhist monks in Mueang District, Chiang Mai Province
Keywords:
health literacy, health behaviors, non-communicable diseases, 3E. 2S. 1T., Buddhist monksAbstract
Background: Buddhist monks are at risk of non-communicable diseases due to lifestyle constraints and dietary practices related to the monastic context. Health literacy is therefore important for promoting appropriate health behaviors. However, studies on health literacy and health behaviors based on the 3E. 2S. 1T. framework among Buddhist monks remain limited.
Objectives: To examine the levels of health literacy and health behaviors for the prevention of non-communicable diseases based on the 3E. 2S. 1T. framework, and to examine the association between these variables among Buddhist monks in Mueang District, Chiang Mai Province.
Methods: This quantitative cross-sectional study employed a descriptive correlational research design. A total of 369 Buddhist monks in Mueang District, Chiang Mai Province, were recruited. Data were collected using a questionnaire from January to February 2026, and analyzed using descriptive statistics and Spearman’s rank correlation coefficient.
Results: The participants had a mean age of 46.82 years (SD = 17.27). Most participants had moderate to good levels of health literacy, except for the decision-making domain. Overall health behaviors were at a moderate level (73.44%). All domains of health literacy were positively and significantly correlated with health behaviors at the 0.05 level. The self-management domain had the strongest correlation with health behaviors (r = 0.410, p < 0.001).
Conclusion: Health literacy was associated with health behaviors among Buddhist monks, particularly in the self-management domain. The findings can serve as baseline information for developing health promotion strategies appropriate to the monastic way of life.
References
World Health Organization. Noncommunicable diseases [Internet]. Geneva: World Health Organization; c2025 [updated 2025 Sep 25; cited 2025 Sep 27]. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
Division of Non-Communicable Diseases, Department of Disease Control, Ministry of Public Health. National plan for the prevention and control of non-communicable diseases (2023-2027), Thailand [Internet]. Nonthaburi: The Division; c2023 [cited 2025 May 17]. Available from: https://ddc.moph.go.th/uploads/publish/1625920241004031950.pdf [In Thai]
Sakaria N, Indongo N. Socioeconomic and behavioural factors that contribute to the co-occurrence of risk factors for noncommunicable diseases. BMC Public Health. 2025;25(1):165. doi: 10.1186/s12889-024-20993-w.
Tulpraneetkul N. Predicting factors for the risk of NCDs (diabetes and hypertension) among the working-age service receivers in health promotion hospital, regional health promotion center 5 ratchaburi. Region 4-5 Medical Journal. 2024;43(3):463-78. [In Thai]
Thai Health Promotion Foundation. To truly gain merit from making offerings to monks, choose healthy food [Internet]. 2023 [cited 2025 May 17]. Available from: https://resource.thaihealth.or.th/index.php/article/ทำบุญให้ได้บุญอย่างแท้จริง-เลือกอาหารเพื่อสุขภาพถวายพระสงฆ์ [In Thai]
Ministry of public health. Desirable health behaviors of religious leaders [Internet]. 2025 [cited 2025 May 17]. Available from: https://healthtemple.anamai.moph.go.th/home/index?byear=2568®ion=0&province=0&hur=0&tambon=0 [In Thai]
Sriwilas T, Thavichachat N. Factors related to depression in elderly monks in Bangkok Metropolis.. Chulalongkorn Medical Journal. 2013;57(1):93-105. [In Thai]
Kanittakul S. Surveying depression among monks: when depression is not limited to laypeople [Internet]. Bangkok: The MATTER; c2022 [updated 2022 Sep 2; cited 2025 May 17]. Available from: https://thematter.co/social/depression-in-buddhist-monk/184548. [In Thai]
Pengpid S, Peltzer K. Depressive symptoms among clients attending monk healers and primary care clinics in Thailand: a comparative follow-up study. Prim Health Care Res Dev. 2021;22:e38. doi: 10.1017/S1463423621000475.
Nutbeam D. The evolving concept of health literacy. Soc Sci Med. 2008;67(12):2072-8. doi: 10.1016/j.socscimed.2008.09.050.
Godin G, Kok G. The theory of planned behavior: a review of its applications to health-related behaviors. Am J Health Promot. 1996;11(2):87-98. doi: 10.4278/0890-1171-11.2.87.
Pitts PJ, Freeman E. Health literacy: The common denominator of healthcare progress. Patient. 2021;14(5):455-58. doi: 10.1007/s40271-021-00537-9.
Hongchai V, Chumkesornkolkit P, Ponrachom C. Health literacy and factors predicting health promotion behaviors among Buddhist monks in Nakhon Phanom Province. Journal of buddhist anthropology. 2021;6(11):529-43. [In Thai]
Panya N, Huaisai W, Unkaew T, Montreewong W. The relationship between health literacy and health behavior 3E 2S of monks among Khun Han District, Sisaket Province. Primary Health Care Journal (Northeastren Edition). 2024;39(1):1-11. [In Thai]
Srithong K, Jearajit C, Suksatit B, Promjittiphong C. Health literacy situation of monks in Thai society. Journal of MCU Peace Studies. 2021;9(5):1793-804. [In Thai]
Thai Health Promotion Foundation. 3E 2S disease prevention code [Internet]. c2024 [cited 2025 May 17]. Available from: https://resourcecenter.thaihealth.or.th/content/81223-media-3%20อ.%202%20ส.%20รหัสป้องกันโรค?t=1778059657095 [In Thai]
Department of Health. Department of Health suggests monks consume less sugar for dental health, emphasizing 6 ways to care for oral health [Internet]. Nonthaburi: The Department; c2019 [updated 2019 May 18; cited 2025 May 17]. Available from: https://multimedia.anamai.moph.go.th/news/news180562/ [In Thai]
Butsabong T, Kajonkiatsakul S, Nammontri O, Butkhot J. Attitude, self-efficacy, and oral health behaviors of monks in Phuwaing District, Khon Kaen Province. Thai Dental Nurse Journal. 2020;31(2):77-89. [In Thai]
Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970;30:607-10. doi: 10.1177/001316447003000308.
Tshopanja A, Kankhwao P, Kankhwao B. Health literacy and health behaviors (food, emotion, exercise, smoking, alcohol cessation and teeth) of monks and novices in Phrapariyattidhamma school, Nakhon Khon Kaen Metropolitan, Khon Kaen province. Journal of Council of Community Public Health. 2022;4(1):38-48. [In Thai]
Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. doi: 10.1186/1471-2458-12-80.
World Health Organization, Division of Health Promotion, Education, and Communication. Health promotion glossary [Internet]. Geneva: World Health Organization; 1998 [cited 2026 May 10]. Available from: https://iris.who.int/handle/10665/64546
Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000;15(3):259-67. doi: 10.1093/heapro/15.3.259.
Seemanee S, Mattavagkul C, Poomrittikul P, Ditajorn R, Trangkasant P. Factors related consumption behaviors of monks and foodstuff dedication behaviors to the monks of people in Phasicharoen district, Bangkok. Journal of Nursing, Siam University. 2018;19(37):22-38. [In Thai]
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Nakornping Hospital
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The articles that had been published in the journal is copyright of Journal of Nakornping Hospital, Chiang Mai.
Contents and comments in the articles in Journal of Nakornping hospital are at owner’s responsibilities that editor team may not totally agree with.
