Digital Engagement and Health Behaviors Among Village Health Volunteers in Southern Thailand: A Cross-Sectional Study

Village Health Volunteers (VHVs) play an important role in Thailand's community-based public health system, yet limited evidence is available on how their digital engagement relates to their own health behaviors. This cross-sectional study examined associations between sociodemographic characteristics, digital use frequency, digital literacy, and health behavior scores among 426 VHVs in southern Thailand. Data were collected using an online questionnaire that included the Mobile Device Proficiency Questionnaire (MDPQ-16) and a 23-item health behavior measure based on the Thai 3A2S framework. The median health behavior score was 61.0 (IQR 13.25). After adjustment, rural residence was associated with higher health behavior scores (β = 1.97, p = 0.043), whereas frequent digital use was associated with lower scores than infrequent use (β = -2.72, p = 0.010). Digital literacy was not independently associated with health behavior scores. The final model explained 4% of the variance, suggesting that additional factors may influence VHVs' health behaviors. Overall, the findings indicate that digital literacy alone may not explain differences in health behaviors and that context may also play a role. Future research should examine these relationships using broader and more context-sensitive measures.