Factors Associated With Health Literacy Among Women in Menopause in Western Iran: A Cross-Sectional Study

BACKGROUND: There is a lack of information regarding health literacy in homemaker menopausal women in the western Iran. The aim of this study was to investigate factors associated with health literacy among women in menopause who are homemakers in western Iran. METHODS: This cross-sectional study was conducted from February 5, 2025 to August 20, 2025, among 350 women in menopause attending comprehensive health service centers in Hamadan, western Iran. The participants were recruited via systematic random sampling. The data collection instruments consisted of a demographic and midwifery information questionnaire, the Health Literacy for Iranian Adults, the Perceived Stress Scale, and the Multidimensional Scale of Perceived Social Support. A p value of < .05 was considered statistically significant. Independent t-tests and one-way ANOVA (analysis of variance) were used to compare mean health literacy across categorical variables. Pearson's correlation coefficient was applied to examine the relationships among social support, perceived stress, and health literacy. In addition, to identify independent predictors of health literacy, a multivariable linear regression model was constructed. All analyses were conducted using Stata version 14. RESULTS: The health literacy levels show that the majority (267; 76.29%) have inadequate health literacy. The mean health literacy was significantly associated with participants' education (p < .001), occupation (p < .001), husbands' occupation (p < .001), and economic status (p < .001). The significant negative correlation was observed between health literacy and perceived stress (r = −0.86), suggesting that higher health literacy was associated with lower levels of perceived stress. Moreover, health literacy was positively correlated with social support (r = 0.77), indicating that individuals with greater health literacy tended to report higher levels of social support. The multivariable linear regression model identified higher perceived stress (β = −2.05, p < .001) and older age (β = −1.40, p = .03) as significant negative predictors of health literacy, while greater social support (β = 1.46, p < .001) was a significant positive predictor. CONCLUSION: The findings of the present study revealed that the majority of the women had an inadequate level of health literacy, and this variable had a negative relationship with perceived stress and a positive relationship with social support. The results of this research emphasize the importance of psychosocial factors in promoting health literacy women in menopause. Perceived stress and social support are two key variables that can either facilitate or hinder the path to understanding and utilizing health information. Designing interventions aimed at reducing stress and strengthening social support, and examining their impact on health literacy, could enrich the empirical knowledge base. Furthermore, investigating the role of mediating variables such as health self-efficacy, self-esteem, coping styles, and attitudes toward health could lead to a deeper understanding of the psychological mechanisms affecting health literacy. Qualitative or mixed-methods research would also be capable of clarifying the cultural dimensions, lived experiences, and subjective meanings associated with menopause, providing a foundation for designing localized educational programs.