Digital Health Literacy, Health Literacy, and Self-Care Behaviors for PM2.5 Protection: Implications for Sustainable Well-Being in Thailand

Fine particulate matter with an aerodynamic diameter of 2.5 μm or smaller (PM2.5) is a major environmental health risk that threatens individuals’ health, quality of life, and sustainable well-being. In the digital era, protective behaviors are increasingly shaped by people’s ability to access, evaluate, and use health information from online sources. This cross-sectional descriptive correlational study examined the levels of health literacy, digital health literacy, and self-care behaviors for PM2.5 protection and examined their associations with self-care behaviors among adults in Mueang District, Samut Songkhram Province, Thailand. A proportionate stratified sample of 375 adults from 11 subdistricts completed structured questionnaires. Data were analyzed using descriptive statistics and multiple linear regression. Most participants had moderate health literacy (55.2%), digital health literacy (52.0%), and self-care behaviors for PM2.5 protection (56.3%). The health literacy and digital health literacy dimensions jointly explained 28.1% of the variance in self-care behaviors. Using digital information for health decision-making showed the largest unique association with self-care behaviors (β = 0.31), followed by decision-making for PM2.5 protection (β = 0.26) and evaluation of information credibility (β = 0.24). Understanding PM2.5 information did not contribute independently after the other literacy dimensions were considered. PM2.5 risk communication should therefore move beyond information provision and strengthen credibility assessment, information appraisal, and action-oriented decision-making while addressing socioeconomic and digital-access barriers.