Preventive Health Behavior and Readiness for Self-Management in a Multilingual Adult Population: A Representative...

Background/Objectives: Preventive health behaviors are key to disease prevention and health system sustainability; however, population-level factors remain understudied in multilingual regions. South Tyrol, an autonomous multilingual province in Northern Italy, provides a unique setting to examine how sociodemographic and linguistic factors shape preventive behaviors. Methods: A stratified, population-representative survey of 2090 adults (aged ≥18 years) was conducted in South Tyrol in 2024. Preventive behavior was assessed using the validated 16-item Good Health Practices Scale (GHP-16). Key predictors included age, sex, education, living situation, language group, employment in the health/social sector, health literacy (HLS-EU-Q16), patient activation (PAM-10), and the mistrust of professional health information. Weighted statistics and multivariable linear regression were used to identify associations. Results: The GHP-16 scores varied significantly across sociodemographic and psychosocial strata. Female sex, older age, higher education, higher patient activation, and sufficient health literacy were independently associated with greater engagement in preventive behaviors. Patient activation showed the strongest graded effect (β = 1.739). The mistrust of health professionals was inversely associated with behavior (β = -0.050, 95% CI: -0.090 to -0.009). Italian speakers reported higher GHP-16 scores than German speakers (β = 0.377), even after adjusting for covariates. Item-level analysis revealed small but consistent differences, particularly in information-seeking and vaccination behavior. Conclusions: Preventive behaviors in South Tyrol are shaped by demographic, psychosocial, and linguistic factors. Patient activation and health literacy are key modifiable predictors, whereas language group differences suggest structural and trust-related disparities that require tailored public health strategies in multilingual settings.