Aim: To assess the behavioral correlates of health literacy (HL) among university students of health sciences in Kosovo, irrespective of their sociodemographic characteristics.

Methods: This cross-sectional study, carried out in Kosovo in 2024, enrolled 470 students of health sciences from the universities of Prishtina and Gjakova (86% women; mean age: 20.7±2.7 years; response rate: 70%). We gathered HL data with the European Health Literacy Survey Questionnaire, as well as information on behavioral characteristics and sociodemographic factors. General linear model and binary logistic regression were used to assess the independent behavioral correlates of HL.

Results: In multivariable-adjusted general linear models controlling for all sociodemographic factors and behavioral characteristics, lower HL scores were positively associated with alcohol consumption (36 vs 38 in non-drinkers, P=0.024), low levels of physical exercise (36 vs 39 among students with high level of physical activity, P<0.001), obesity (35 vs 39 among normal-weight individuals, P=0.011), and a poorer health status (36 vs 37 among students with a better self-rated health status, P=0.031). Furthermore, fully adjusted logistic regression models revealed a positive and strong relationship of "inadequate and/or problematic HL" (scores: 0-33) with physical inactivity (OR=7.6, 95%CI=1.8-31.9) and especially obesity (OR=21.4, 95%CI=3.8-119.8).

Conclusions: Students with low HL may be more likely to engage in behaviors detrimental to health. There is need to enhance HL among future health professionals.

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