Factors influencing health-promoting behavior among single mothers in Northeastern Malaysia: a cross-sectional study

Introduction Health-promoting behaviors (HPB) play a vital role in maintaining and enhancing overall well-being. Single mothers are at higher risk of cardiovascular disease (CVD) and less involvement in HPB due to psychosocial disadvantages. Objective This study aimed to determine the HPB scores and factors influencing HPB among single mothers in Kelantan (Northeastern, Malaysia). Methods This study employed a cross-sectional design, selecting 242 single mothers from Kelantan through proportional stratified sampling. Data were gathered through questionnaires covering sociodemographic details, the Health-Promoting Lifestyle Profile-II (HPLP-II), the Malay Version of Health Beliefs Related to Cardiovascular Disease (HBCVD-M), and Multidimensional Perceived Social Support (MPSS). The relationships between the dependent variable (HPB) and independent variables were analyzed using multivariable linear regression models. Results The respondents achieved an average HPB score of 118.03 (SD = 19.2), with the highest mean scores in spiritual growth (22.46 [SD = 3.70]) and interpersonal relationships (22.05 [SD = 3.67]). Physical activity had the lowest mean score at 15.09 (SD = 4.62). Significant positive associations were found between HPB and perceived severity of CVD (adjusted β = 1.60; 95% CI [0.68–2.53]; p < 0.001) as well as perceived social support (adjusted β = 0.63; 95% CI [0.37–0.90]; p < 0.001). Conversely, educational level (adjusted β = −10.36; 95% CI [−16.06 to −4.67]; p < 0.001) and perceived benefits of reducing CVD risk (adjusted β = −1.43; 95% CI [−2.37 to −0.48]; p < 0.001) were negatively associated with HPB. Conclusions The findings highlight the importance of health beliefs, social support, and education in shaping HPB among single mothers. Community health initiatives targeting this population should develop strategies to strengthen individuals’ health beliefs and promote a supportive environment.