Pesticide health literacy and preventive behaviors among greenhouse operators in Northeastern Iran

Greenhouse operators face high pesticide exposure risks, yet the cognitive pathways translating health literacy (HL) into preventive behaviors remain unclear. This study examined the multidimensional construct of Pesticide Health Literacy (PHL) and its association with preventive behaviors among greenhouse operators. This cross-sectional census study was conducted among 115 greenhouse operators in Neyshabur County, Iran. Data were collected using validated PHL and preventive behavior questionnaires. Data were analyzed using descriptive statistics, independent samples t-tests, one-way analysis of variance (ANOVA), and hierarchical multiple regression. Participants exhibited moderate PHL (mean: 61.92 ± 16.96 out of 115) but significantly lower preventive behaviors (mean: 8.90 ± 1.74 out of 21). Hierarchical multiple regression revealed that PHL was the strongest independent factor associated with preventive behaviors ( β = 0.63, P < 0.001 ), followed by educational attainment ( β = 0.37, P < 0.001 ). Sociodemographic variables alone did not significantly explain variation in preventive behaviors (R 2 = 0.084 , P = 0.140 ). PHL, particularly the critical information assessment domain, showed a stronger association with preventive behaviors than the sociodemographic factors examined in this study. The findings suggest that interventions addressing pesticide safety should extend beyond basic information provision and include skills for critically evaluating pesticide-related information, particularly among operators with lower educational attainment. Such an approach may help address the gap in HL preventive behaviors in high-risk agricultural settings.