Health Knowledge-Behavior Gap in Lifestyle Practices among University Students

Abstract

The gap between health-related information and real lifestyle practices of university students is the focal problem of modern research in the field of public health and health education. In spite of the availability of a complete health education curriculum through institutional courses, online media, and healthcare, university students around the world maintain inadequate diets, a sedentary lifestyle, irregular sleep, and high-risk health outcomes. This is known as the health knowledge -behavior gap and indicates the inherent weakness of models that consider information provision as the main determinant of behavioral change. A stringent quantitative cross-sectional survey design was used in the current research study in a sample of 200 enrolled Pakistani university students. The health knowledge, the intentions, and the actual practices of diet, physical activity, and sleep were assessed using a 5-point Likert scale in the form of a validated structured questionnaire. Descriptive statistics, Cronbach Alpha, Pearson, and full structural equation modeling (SEM) with bootstrapped mediation testing were analyzed using SmartPLS 3.0. Findings revealed a significant difference between mean health knowledge (M = 3.82, SD = 0.63) and total lifestyle practice scores (M = 2.67, SD = 0.69) with physical activity having the largest discrepancy ( 1.39). SEM found full mediation by behavioral intentions (indirect 0.201, 95% CI [0.142, 0.267]) but the direct knowledge-to-practice relationship was insignificant (0.09, p = 0.22). These results confirm that health interventions based on knowledge alone cannot be effective without simultaneous directing knowledge at intention formation, self-efficacy, and environmental support.