Health Promoting Behaviors, Health Needs and Associated Factors among Older Adults in Jordan: A Cross-Sectional Study

Document Type: Original Article


1 Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan

2 Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan;


Background: Several factors affect older adults’ engagement in HPBs. This study aimed to examine
HPBs, health needs, and associated factors among older adults in Jordan.
Methods: A cross-sectional study was conducted on 220 older adults at one governmental and one
university hospital, which were selected using convenience sampling for geographical closeness to the
researchers. All older adults with no cognitive or communication problems who attended the outpatient
clinics of the two hospitals from December 2018 to April 2019 were included in the study. This time
period was chosen based on the convenience of the participants and researchers. Data were collected by
An Arabic version of the Health-Promoting Lifestyle Profile (HPLP) and a demographic questionnaire.
The Statistical Package for Social Science (SPSS) 25.0 software was used for the descriptive and
inferential analysis of the study data. The level of significance was set at p <0.05.
Results: The mean score of the total HPLP was 125.33±19.09. The marital status and educational level
of the participants were associated with the total HPLP (p <0.001) in all its dimensions, except for the
dimension of interpersonal relations. Participants with chronic diseases had lower scores than those
without diseases for the total HPLP (p <0.001) in all the six dimensions. Family income was positively
correlated with the dimensions of nutrition (P=0.007) and exercise (P=0.002).
Conclusion: Despite the good overall mean score of older adults for total HPLP and some of its
subscales, their levels of exercise and physical activity need to be promoted. The scores of older adults
were related to various demographic and clinical factors.


  1. Amjad H, Mulcahy J, Kasper JD, et al. Do Caregiving Factors Affect Hospitalization Risk Among Disabled Older Adults? Journal of the American Geriatrics Society. 2020. [online]
  2. Rababa M. Association of Comorbid Burden and Patient Outcomes of Residents With Dementia in Jordanian Nursing Homes. Journal of Gerontological Nursing. 2018;44:50-8.
  3. Lake JH. An Integrative Paradigm for Mental Health Care: Ideas and Methods Shaping the Future. 1st ed. Germany: Springer; 2019.
  4. Hamdan-Mansour A. Psychosocial and sociodemographic predictors of depression among older persons in Jordan. Open Journal of Nursing. 2016;6:532-40.
  5. Courtin E, Knapp M. Social isolation, loneliness and health in old age: a scoping review. Health & Social Care in the Community. 2017;25:799-812.
  6. Lelli D, Tolone S, Pulignano G, et al. Nutritional status is associated with physical function and disability in older adults with chronic heart failure. European Journal of Internal Medicine. 2020;74:73-8.
  7. Artaud F, Dugravot A, Sabia S, et al. Unhealthy behaviours and disability in older adults: Three-City Dijon cohort study. BMJ. 2013;347:f4240.
  8. Fleming ML, Baldwin L. Health Promotion in the 21st Century: New approaches to achieving health for all. 1st ed. UK: Routledge; 2020.
  9. Kara B, İşcan B. Predictors of health behaviors in Turkish female nursing students. Asian Nursing Research. 2016;10:75-81.
10.Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice. 5th ed. US: Prentice Hall; 2005.
11.Zanjani S, Tol A, Mohebbi B, et al. Determinants of healthy lifestyle and its related factors among elderly people. Journal of Education and Health Promotion. 2015;4:103.
12.Giena VP, Thongpat S, Nitirat P. Predictors of health-promoting behaviour among older adults with hypertension in Indonesia. International Journal of Nursing Sciences. 2018;5:201-5.
13.Khami L, Motalebi SA, Mohammadi F, et al. Can social support predict health-promoting behaviors among community-dwelling older adults? Social Health and Behavior. 2020;3:22-6.
14.Eshah NF. Lifestyle and health promoting behaviours in Jordanian subjects without prior history of coronary heart disease. International Journal of Nursing Practice. 2011;17:27-35.
15.Haddad LG, Al-Ma’Aitah RM, Umlauf MG. Health promotion behaviors among Jordanians. International Quarterly of Community Health Education. 1998;18:223-35.
16.World Health Organization, High Health Concil. The National Strategy for Health Sector in Jordan, 2015-2019. Geneva, Jordan: World Health Organization, High Health Concil; 2017.
17.Mansoor K, Khuwaja HMA. The Effectiveness of a Chronic Disease Self-Management Program for Elderly People: a Systematic Review. Elderly Health Journal. 2020;6:51-63.
18.Haddad LG, Al‐Ma’aitah RM, Cameron SJ, Armstrong‐Stassen M. An Arabic language version of the health promotion lifestyle profile. Public Health Nursing. 1998;15:74-81.
19.Zhang C, Zheng X, Zhu R, et al. The effectiveness of the “SMG” model for health-promoting lifestyles among empty nesters: a community intervention trial. Health and Quality of Life Outcomes. 2019;17:168.
20.Montag C, Sindermann C, Lester D, Davis KL. Linking individual differences in satisfaction with each of Maslow’s needs to the Big Five personality traits and Panksepp’s primary emotional systems. Heliyon. 2020;6:e04325.
21.Ammouri AA. Demographic differences in health promoting lifestyle of adult Jordanians. Jordan Medical Journal. 2008;42:220-8.
22.Fanning J, Rejeski WJ, Chen SH, et al. Relationships Between Profiles of Physical Activity and Major Mobility Disability in the LIFE Study. Journal of the American Geriatrics Society. 2020;68:1476-83.
23.Rasool AJ, Khalifa MF. Evaluation of Health Promotion Behaviors for Elderly Population at Geriatric Homes in Baghdad City: Comparative Study. International Journal of Scientific and Research Publications. 2016;6:369-76.
24.König K, Raue M, D’Ambrosio LA, Coughlin JF. Physical and emotional support of the neighborhood for older adults: A comparison of the United States and Germany. Journal of Environmental Psychology. 2019;62:84-94.
25.Belchior GF, Kirk B, da Silva EAP, Duque G. Osteosarcopenia: beyond age-related muscle and bone loss. European Geriatric Medicine. 2020. doi:10.1007/s41999-020-00355-6 [online]
26.Mirghafourvand M, Sehhati F, Rahimi M. Health-promoting lifestyle and its demographic predictors in infertile couples referred to infertility clinic of Tabriz Al-Zahra Hospital, 2013. Journal of Caring Sciences. 2014;3:175-84.
27.Dahlheim-Englund AC, Carlsson G, Nyström M, et al. Life without professional work: perceptions about one’s self, interpersonal relations and social life after retirement. Healthy Aging Research. 2019;8:2.
28.Beliran SP, Legaspi MS. Health-promoting behaviors and quality of life of Filipino older persons. Asia Pacific Journal of Education, Arts and Sciences. 2014;1:11-20.
29.Rababa M, Hammouri AM, Hweidi IM, Ellis JL. Association of nurses’ level of knowledge and attitudes to ageism toward older adults: Cross‐sectional study. Nursing & Health Sciences. 2020;22:593-601.
30.Smith ML, Bergeron CD, Lachenmayr S, et al. A Brief Intervention for Malnutrition among Older Adults: Stepping Up Your Nutrition. International Journal of Environmental Research and Public Health. 2020;17:3590.
31.Mosleh SM, Darawad M. Patients’ adherence to healthy behavior in coronary heart disease: risk factor management among Jordanian patients. Journal of Cardiovascular Nursing. 2015;30:471-8.
32.Conklin AI, Maguire ER, Monsivais P. Economic determinants of diet in older adults: systematic review. Journal of Epidemiology and Community Health. 2013;67:721-7.
33.Mohamad N, Mulud ZA, Ibrahim M, Damanhuri NF. The Relationship between Self-Efficacy and Health Promoting Behaviour among Older Adults with Chronic Illness. Environment-Behaviour Proceedings Journal. 2019;4:73-8.
34.Korkmaz Aslan G, Kartal A, Özen Çınar İ, Koştu N. The relationship between attitudes toward aging and health‐promoting behaviours in older adults. International Journal of Nursing Practice. 2017;23(6).
35.Luo M, Ding D, Bauman A, et al. Social engagement pattern, health behaviors and subjective well-being of older adults: an international perspective using WHO-SAGE survey data. BMC Public Health. 2020;20:99.
36.Ulley J, Harrop D, Ali A, et al. Deprescribing interventions and their impact on medication adherence in community-dwelling older adults with polypharmacy: a systematic review. BMC Geriatrics. 2019;19:15.
37.Thorpe MG, Milte CM, Crawford D, McNaughton SA. Education and lifestyle predict change in dietary patterns and diet quality of adults 55 years and over. Nutrition Journal. 2019;18:67.
38.Alley SJ, Vandelanotte C, Duncan MJ, et al. Should I sit or stand: likelihood of adherence to messages about reducing sitting time. BMC Public Health. 2019;19:871.
39.Świątoniowska N, Sarzyńska K, Szymańska-Chabowska A, Jankowska-Polańska B. The role of education in type 2 diabetes treatment. Diabetes Research and Clinical Practice. 2019;151:237-46.
40.Kamphuis CBM, de Bekker-Grob EW, van Lenthe FJ. Factors affecting food choices of older adults from high and low socioeconomic groups: a discrete choice experiment. The American Journal of Clinical Nutrition. 2015;101:768-74.
41.Prioreschi A, Wrottesley SV, Norris SA. Physical Activity Levels, Food Insecurity and Dietary Behaviours in Women from Soweto, South Africa. Journal of Community Health. 2020. doi:10.1007/s10900-020-00861-5 [online]
42.Bernardelli LV, Pereira C, Kortt MA. The economic and social determinants of participation in physical activity in Brazil. International Review of Applied Economics. 2020;34:252-66.. doi: 10.30476/ijcbnm.2020.87493.1443.