Assessment of the health literacy mediating role in the relationship between fatalistic tendency and family planning among women.

Promoting family planning is an essential public health goal for improving maternal and infant health; however, sociocultural barriers-particularly fatalism-continue to shape women's behaviors and attitudes. This study examined the mediating role of health literacy in the relationship between women's fatalistic tendencies and their family planning attitudes. Using a cross-sectional correlational design, data were collected from 657 married women aged 18-49 in Kırşehir, Türkiye, through 30-cluster sampling. Data were collected through face-to-face interviews conducted during home visits between February 28 and June 1, 2022, using structured questionnaires. Measures included the Fatalistic Tendency Scale, Family Planning Attitude Scale, and the Turkey Health Literacy Scale-32. Data were analyzed using IBM SPSS Statistics v23. Mediation analysis was conducted using PROCESS v3.5 with 5,000 bootstrap samples. Fatalistic tendency was negatively associated with health literacy, while health literacy showed a positive association with family planning attitudes. An indirect effect of fatalistic tendency on family planning attitudes through health literacy was identified. Findings highlight the importance of improving health literacy to mitigate fatalistic beliefs and support informed reproductive decision-making, emphasizing culturally sensitive, interdisciplinary interventions.