Healthy LifeStyle Practice and Its Associated Factors among Public Servants in Fiche Town, Ethiopia

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Living a healthy lifestyle reduces the likelihood of developing a severe illness or passing away too soon. Public officials frequently lead unhealthy lifestyles because they are time-pressed and face many challenges that could negatively impact their health. However, there is limited evidence on the level of healthy lifestyle practice and factors associated with unhealthy lifestyle practice among public servants. Objective: This study aimed to assess healthy lifestyle practice level and associated factors among public servants working in Fiche Town, Oromia, Ethiopia. Methods : From April 1 to 30, 2022, 630 public servants participated in an institutional-based cross-sectional study. A self-administered, structured questionnaire was used to collect data from the participants. The data were entered into Epi-Data version 4.6 and then exported to SPSS version 26 for analysis. Descriptive statistics such as frequency, percentages, mean, and standard deviation were used to summarize the data. Variables that scored a p-value of less than 0.2 during the bivariate analysis were included in multilevel logistic regression. The odd ratio with a 95% confidence interval was estimated at the level of significance set at 0.05. Result: - The magnitude of poor health lifestyle practice among Fiche town public servants was 45.2% with a 95% confidence interval (CI) (41.4, 49.4). The study participants had poor attitude (23.7%), poor health lifestyle knowledge (55.4%), and poor physical activities (40.2%). The study participants who had a poor attitude, poor knowledge, poor physical activities, avoided extra salt from their diet, and knew about chronic non-communicable diseases were factors significantly associated with healthy lifestyle practice. Conclusion : Generally, a healthy lifestyle practice among public servants was poor in Fiche Town. Therefore, public servants should be educated and counselled on the recommended healthy lifestyle practices that may help them avoid chronic non-communicable diseases and premature death. Healthy lifestyles Healthy behaviors and Public Servants Figures Figure 1 Figure 2 Introduction A healthy lifestyle is one that helps keep and improve health and well-being. Lifestyle includes daily routines that become habitual and affect physical and mental health ( 1 – 7 ). It contributed to positive benefits throughout the life span of people living in various corners of the world. Besides controlling risk factors in lifestyle and healthy habits, healthy lifestyle practices can reduce early deaths by half ( 8 ). Unhealthy lifestyles and behaviors were the cause of 60% of the morbidity and death of non-communicable illnesses. Millions of people have unhealthy lifestyles that can lead to disease, disability, and even death. An unhealthy lifestyle can lead to cardiovascular illnesses, hypertension, obesity, and other conditions ( 1 ) Around 41 million peoples death annually in the world due to Non-communicable diseases (NCDs) which is, equivalent to 71% of all deaths globally. Among NCDs, account for more than 80% of all premature NCD deaths include cardiovascular diseases, cancers, respiratory diseases, and diabetes. There has been a surge in the burden of NCDs in sub-Saharan Africa over the past two decades, driven by an increasing incidence of cardiovascular risk factors such as unhealthy diets and reduced physical activity ( 9 ). The epidemiological shift from communicable to non-communicable diseases is occurring in many low- and middle-income nations. This hinders the development of their human capital and places an increasing financial strain on their societies. Although practicing a healthy lifestyle is important in preventing NCDs and saving the national economy, a considerable proportion of people are not practicing a healthy lifestyle ( 7 ). Public servants are among the group of population that is less likely to practice a healthy lifestyle, which prone those to a higher risk of NCDs ( 8 ). Moreover, although the impact of unhealthy lifestyles on people's health and the national economy is documented, there is limited evidence on the level of health lifestyle practice and its associated factors among public servants. Ethiopia is among the setups where such information is scarce. Furthermore, there is no strong study that reported on the level of healthy lifestyle practice and its associated factors. Therefore, this study aims to determine the level of healthy lifestyle practice and its associated factors among public servants who are working in different public organizations in Fiche town, Ethiopia. Methods Study area and Period This study was conducted in Fiche town. Fiche town is the administrative city of North Shoa zone which is found Oromia region states, Ethiopia. It located at north to Addis Ababa on 114km. The town has four kebeles, the smallest administrative branch, and a total of 50,040 estimated populations reside in the town. There are 42 public organization including banks. The total 1105 of public servants were working in government organization and 343 bank workers. The study was conducted from April 1–30, 2022. Study design Institutional based cross-sectional study was conducted Population All public servants who were working in public sectors and banks were included in this study. Thus, workers who were working in public organizations and in private were a study population of this study. Public servants who were on leave, seriously ill, and in long-term training during the data collection were excluded. Sample size determination The sample size was determined using a single population proportion sample size estimation method by assuming 50% of unhealthy lifestyle practice population proportion, 95% confidence level and 5% margin of error. The sample size was further increased by considering design effect 1.5 due to clustering nature of the public servants within the selected public organization related to healthy lifestyle practice. After considering 10% contingency sample for non-response rate. Then the total sample sizes was calculated to be 636. Sampling procedure Out of 42 public organizations and private banks; 21 organizations were selected by simple random sampling method. An individual participant was selected by proportionate systematic random sampling method by using a roster of participants name after 2 intervals. K calculated by the formula k = N/n. Where, k is the interval of inclusion, N the total public servants in the selected organization and n is the proportion of sample size in a given organization (Fig-1). Data Collection tools and Procedures Data were collected by using a self-administered questionnaire adapted from related articles ( 1 , 2 , 10 – 14 ). To ensure the consistency of the questionnaires, the English version was translated into Afaan Oromo for data collection and retranslated into English by a professional language translator. The questionnaires contained questions on socio-demographic characteristics and healthy lifestyle. Data collectors were strictly supervised. At the end of each day, the questionnaire was reviewed and checked for completeness by the supervisors, who took corrections. Data quality management To ensure the data quality before starting data collection, the questionnaires were pretested in Dagam district town in order to checked questioners clearness, completeness and consistence. Then, after the necessary comments and feedback were incorporated, some modification was done in the final tool. The reliability of questionnaires for each variable was measured using the Cronbach’s coefficient alpha (0.79). The data was carefully entered and cleaned before the main analysis. The completeness and accuracy of the collected data were checked carefully on a regular basis. The data collectors were trained to facilitate data collection. The collected data could be checked every day by investigators for its completeness. Data processing and analysis The cleaned data was exported into the statistical package for social science (SPSS) in 26 versions for analysis. Descriptive statistics such as proportion, frequency, means, median, standard deviation, and range were used to describe the socio-demographic distribution. Binary logistic regression with a multilevel logistic regression model was computed to see the association between each independent variable and level of healthy lifestyle practice using crude odds ratio (COR) 95% CI. The model goodness-of-fit test was checked by the Hosmer-Lemeshow goodness of fit, and the p-value of the model fitness test was 0.87. Multi-collinearity and confounding effects were checked by using the standard error, which was not inflated, and no collinearity exists between the independent variables. Variables that had a p-value p < 0.25 in bivariate analysis were taken to multilevel logistic analysis in final models. Multilevel logistic regression model was computed to identify predictor variables associated with healthy lifestyle practice using an adjusted odds ratio (AOR) with a 95% CI. Variables in the multilevel logistic analysis with a p-value < 0.05 were considered statistically significant. Results Socio demographic characteristics of Public Servants A total of 630 respondents participated in this study, making a response rate of 99%. Out of these respondents, 219 (34.8%) were females. The age of the respondents ranged from 18 to 65 years. The mean age of the respondents was found to be 34.07 ± 7.4 years. The largest age group was 25–34 years, with a total of 330 respondents (52.4%). Regarding their marital status, the majority (63%) were married. Concerning the educational status, 44.8% had attended a degree and above. Out of the total study subjects, 33.5% had high wealth status, and 209 (33.2%) had less wealth status (Table 1 ). Table 1 The socio demographic characteristics of public servant respondents (N = 636). Variable Category Frequency Percent Sex Male 411 65.2 Female 219 34.8 Age 18–24 40 6.3 25–34 330 52.4 35–44 190 30.2 45–54 68 10.8 55–64 2 .3 Marital Status Married 397 63.0 Single 157 24.9 Widowed 29 4.6 Divorced 47 7.7 Educational status No formal education 8 1.3 Elementary school 16 2.5 Secondary school 73 11.6 Certificate 52 8.3 Diploma 199 31.6 Degree and above 282 44.8 Work experience ≤ 5 150 23.8 6 to 10 258 41.0 11 to 14 104 16.5 ≥ 15 118 18.7 Wealth index High wealth index 211 33.5 Medium wealth index 210 33.3 Low Wealth index 209 33.2 Knowledge of public servant about health lifestyle Four thousand forty-five (70.1%) of the respondents stated that they have gotten information about chronic non-communicable diseases and healthy lifestyles. From those, more than three-fourths (76%) were informed by health professionals. 344 (54.6%) knew about the difference between communicable and non-communicable diseases. Five hundred twenty-five (65.1% of the respondents) knew at least one risk factor that predisposes to chronic non-communicable diseases from choices of unhealthy diet, smoking, heavy alcohol consumption, and not doing physical exercise. 389 (61.7%) believe that non-communicable diseases can be prevented by practicing healthy lifestyles. In this study, 30.9% of participants perceived that they were at risk of developing CNDs, and of these, 76 (40%), 56 (29.5%), and 58 (30.5%) of them mentioned their reasons as avoiding heavy alcohol, unhealthy diet, and being physically inactive, respectively. Generally, 55.4% of the respondents had poor knowledge about healthy lifestyle practices. Magnitude of healthy lifestyle measures among Public Servants In this study, 45% of study participants had poor health lifestyle practices (Fig. 1 ). Among the study participants, fruit & vegetables, cereals & legumes, meat, and animal products were mentioned as common diets by 99 (15.7%), 319 (50.6%), and 92 (14.7%), respectively. Nearly one-third (31.1%) of the participants eat fruit and vegetables three times a week, and 92 (14.6%) didn’t eat any fruit and vegetables in a typical week. The major reasons mentioned for not eating fruits and vegetables at least once a week were that they are not easily available (6.3%) and their cost is high (8.1%). In this study, healthy diet participants who had a good healthy diet were 4 times more likely to have a good healthy lifestyle compared to poor health diet practice. In this study, 253 (40.2%) of the respondents were poor in physical activity. In this study, females had performed better physical activity (34.1%) than male respondents. Physical activity research shows that physical activity declines with age. In the study, the age group less than 40 years had better (34.6%) physical activity than those ages above 40 years of age. Among the study participants, only 92 (14.6%) of the participants practice regular physical exercise greater than 30 minutes per day for most of the days in a week (Table 2 ). Table 2 Frequency distribution of consuming fruits and vegetables, alcohol consumption and physical activity per day among public servants Fiche town, August 2022 (N = 636). variables frequency percentage Frequency of consuming fruits and vegetables Every day 121 19.2 Three times a week 196 31.1 Twice a week 25 4.0 Once a week 193 30.6 I do not eat 92 14.6 Others specify 3 .5 Frequency of alcohol consumption at least one per day Every day 95 15.1 1 to 3 per week 67 10.6 4 to 6 per week 70 11.1 Occasionally 50 7.9 Frequency of physical exercise in a minutes per day Less than 10 minutes 137 21.7 10–20 minutes 84 13.3 20–30 minutes 63 10.0 Greater than 30 minutes 92 14.6 Four hundred twenty-four (52.2%) and 356 (44.1%) of the respondents (57.6% males) were ever alcohol consumers and current consumers, respectively. And more than half of the current alcohol consumers were 185 (52.1%) drink occasionally, 78 (21.8%) take alcohol at least once a week, and 46 (12.9%) drink on a daily basis. The most common type of alcoholic beverage consumed was beer, as reported by 56.5% of respondents, and 49 (13.8%) were local alcohol consumers. 190 (17.2%) of the study participants stated that they have consumed 4/5 drinks at a time at least once a week. This means 25.4% of males and 6.5% of females were binge drinkers. The proportions of ever smokers, current smokers, and ex-smokers were 63 (10%), 51 (8.1%), and 24 (4.4%), respectively. Out of the current smokers, 90.2% were daily smokers, 3.9% weekly, and the rest, 5.9%, were occasional smokers. The majority of current smokers, 31 (60.7%), smoke 10 or more cigarettes per day. Twenty-eight (54.9%) of current smokers have mentioned that they want to stop smoking, and about 34.1% were very concerned about the consequences of cigarette smoking. Smoking didn’t show an association with other independent variables. Factors associated with healthy lifestyle among Public Servants We conducted bi-variable logistic regression using a multilevel logistic regression model for every independent variable. For those variables with a p-value < 0.25 in the bi-variable logistic regression, they were taken to multivariable logistic regression with multilevel logistic analysis in the final models. Since all values were significant and had a p-value < 0.25 in bi-variable logistic regression with a multilevel logistic regression model, they were entered into multivariable logistic regression with a multilevel logistic regression model. The results from the bivariate logistic regression indicate that males had more healthy lifestyle practice than females (COR: 1.37, 95% CI: 0.98–1.91). The odds of a healthy lifestyle increase with an increase in work experience: ≥15 years (COR: 0.68, 95% CI: 0.40–1.12). A more healthy lifestyle practice was observed among middle wealth status groups (COR: 1.43, 95% CI: 0.97–2.10); a statistically significant trend was also observed among the higher wealth status groups (COR: 1.90, 95% CI: 1.34–2.94) (Table 3 ). The result of multivariable logistic regression with the multilevel logistic regression model showed that participants who had more than or equal to 15 years’ work experience were 60% less likely to practice a good lifestyle than those who had ≤ 5 years’ work experience (AOR = 0.4, 95% CI: 0.27–0.78). The study also showed that participants who had good knowledge of CNCDs had 2 times higher odds of practicing a healthy lifestyle compared to those who had poor knowledge of CNCDs (AOR = 2.25, 95% CI: 1.3–3.8). According to this study, participants who avoided extra salt were 2.43 times more likely to practice a healthy lifestyle than those who had not avoided extra salt (AOR = 2.43, 95% CI: 1.54–3.84). On the other hand, the result of this study shows that participants who had good knowledge in practicing a healthy lifestyle were 7 times more likely to practice a good lifestyle as compared with poor knowledge (AOR = 6.8, 95% CI: 3.3–14.4). Similarly, the current study found that participants who had a good attitude about practicing a healthy lifestyle were 5 times more likely to have a good healthy lifestyle as compared to those who had a poor attitude (AOR = 4.97, 95% CI: 2.07–11.9) (Table 3 ). The result obtained from multivariable logistic regression with the multilevel logistic model indicated that work experience AOR = 0.4, 95% CI (0.27–0.78); knowing about CNCDs AOR = 2.25, 95% CI (1.3–3.8); avoiding extra salt AOR = 2.43, 95% CI (1.54–3.84); knowledge AOR = 6.8, 95% CI (3.3–14.4); and attitude AOR = 4.97, 95% CI (2.07–11.9) were significantly related to healthy lifestyle practice in the final multilevel logistic regression model (Table 3 ). Table 3 Multilevel logistic model analysis among Factors associated with healthy lifestyle among Public Servants (N = 636). Variables Healthy life style practice COR (95%CI) AOR 995%CI Poor Good Sex Male 164(40.0%) 246(60.0%) 1.37 (0.98, 1.91) 1.52 (0.78, 2.81) Female 105(47.7%) 115(52.3%) 1 Marital status Married 163(41.1%) 234(58.9%) 1 Divorced 17(36.2%) 30(63.8%) 1.76 (0.82,3.77) 2.12 (0.89, 3.56) Single 73(46.5%) 84(53.5%) 2.17 (0.84,5.57) 2.45 (0.91, 4.64) Widowed 16(55.2%) 13(44.8%) 1.45 (0.64, 3.14) 1.67 (0.32, 2.89) Occupation Public Servants 119(49%) 124(51%) 0.58 (0.40,0.84) 0.62 (0.25, 1.45) Bankers 69(57.8%) 49(42.2%) 1 Work experience ≤5 years 56(37.3%) 94(66.7%) 1 1 6–10 years 111(43%) 147(57%) 0.31(0.05,1.95) 0.76 (0.44,1.28) 11–14years 53(16.7%) 51(83.3%) 0.94(0.60,1.46) 0.56 (0.29,1.13) ≥ 15 years 49(41.5%) 69(58.5%) 0.68(0.40,1.12) 0.4 (0.27,0.78)* Wealth index High wealth status 73(34.6%) 138(76.4%) 1.90(1.34,2.94) 1.46 (0.76, 2.45) Medium wealth status 89(42.4%) 121(57.6%) 1.43(0.97,2.10) 1.12 (0.98, 3.78) Low wealth status 107(51.2%) 102(48.8%) 1 Source information Yes 140(38.8%) 221(61.2%) 1 No 129(48.0%) 140(52.0%) 0.69(0.50,0.96) 0.42 (0.09, 1.27) Know CNCDs Poor 126(68.1%) 59(31.9%) 1 Good 146(32.1%) 302(77.9%) 4.51(3.12,6.5) 2.25(1.3,3.80)* Avoid extra salt Poor 220(56%) 173(44%) 1 1 Good 49(47.2%) 188(52.8%) 2.43(1.54, 3.84) 2.43(1.54, 3.84)* Knowledge Not Sufficient 220(63.0%) 129(27.0%) 1 Sufficient 49(17.4%) 232(82.6%) 8.07(5.54,11.77) 6.8(3.3,14.40)* Attitude Not favorable 113(75.6%) 36(24.4%) 1 Favorable 156(32.4%) 325(67.6%) 6.54(4.29,9.96) 4.97(2.07,11.90)* * Significantly associated p-value < 0.05 Discussion A healthy lifestyle is a valuable source of decreasing the prevalence and effect of health problems; promoting health, coping with stressors, and improving the quality of life ( 1 , 6 , 12 , 14 , 15 ). Therefore, considering the effective role of public servants as valuable human resources in delivering services, this study was conducted to assess the healthy lifestyle practice and its association factors among public servants in Fiche town. This study revealed that work experience was significantly associated with healthy lifestyle practice. Participants who had work experience of more than or equal to fifteen years were less likely to practice a healthy lifestyle than those who had work experience of less than or equal to five. This finding was in line with the results of the studies in Hamadan (Iran) ( 3 ). This could be due to the workers with more years of work experience tending to adopt a more sedentary lifestyle and high stress. In the current study, avoiding extra salt was a factor that showed a significant association with healthy lifestyle practice. Participants who avoided extra salt had better healthy lifestyle practices than those who had not avoided extra salt. This finding was higher than a study done in Saudi Arabia, but this finding is lower than the finding of a study done in Jimma University Specialized Hospital (Ethiopia). In addition, a study done in the United States showed low salt diet practices among African Americans ( 3 , 16 ). This may be due to the socio-cultural practice of the community and the improvement in awareness creation on the respondents’ part towards these habits or practices. This study found that 44.6% had sufficient knowledge regarding healthy lifestyle practice, which is similar to the study done on lifestyle modification practice in Hosanna, which was 44.9%, and the finding is higher than the study done in the Nigerian suburban community, which was 42% ( 17 ). This might be the sample size and the study time, respectively. The study revealed that participants who had sufficient knowledge in practicing a healthy lifestyle were more likely to practice a good lifestyle as compared with those who did not have sufficient knowledge. From the participants, 89.7% abstained from alcohol drinking. This is less than the study finding in Durame (Ethiopia) ( 18 ). This could be due to social and cultural practices that discourage alcohol drinking and smoking. The result of this study revealed that 76.3% had a positive attitude towards healthy lifestyle practice. while a study done in Kenya indicated that 41% of the respondents had not a positive attitude towards adopting healthier lifestyles ( 19 ). The possible reason for having a higher proportion of respondents with a favorable attitude could be due to better sources of health information among study participants and differences in the scoring system. In this study the percentage of respondents with good healthy lifestyle practice (57.3%) was higher than the respondents in Kenya, where 41% of them had good health lifestyle practices. The possible reason for the difference could be that in Kenya, the study only considered dietary practice and regular exercise as criteria to classify the respondents as having good or bad practice, but in this study, healthy diet, smoking, alcohol consumption, and physical exercise were measured ( 19 ). In this study, 8.09% of the respondents were current smokers, which was 97% males and 3% females, and this study was higher than the finding done among civil servants in Sidama Zone and less than the study done in Butajira, which was 4.4% and 12.8%, respectively. The possible explanation for the result in Butajira, the age range of the study subject was above 15 with more than therefore it is expected to be high among younger study populations, and the study in Sidama may be due to the difference in sample size & due to the time gap the two studies were carried out ( 20 ). In the current study, from the current smokers, 31 (0.04%) smoke 10 or more cigarettes per day. Twenty-eight (54.9%) of current smokers have mentioned that they want to stop smoking, whereas about 34.1% were very concerned about the consequences of cigarette smoking. Which was less than the study done in Iran and Norway, which indicated that 2.8% smoked more than 10 cigarettes a day among the Iranian employees, and the Norwegian study shows that smokers who smoke more than 10 cigarettes were 3.2% ( 8 ). This may be due to the urbanization and industrialization-related factors. Results of our study revealed that only 76.7% of respondents consume less than the recommended five servings of fruits and vegetables. This result is consistent with many other lower- and middle-income countries, such as Bangladesh, Mexico, and Thailand, where fruits and vegetables are produced mainly to export to other countries and which less than the study done in South Africa are. This may be due to the economic status of the country. In this study, only 19.2% of the respondents eat fruits and vegetables at least once a day, which is greater than the study in Addis abeba 14.6% didn’t eat fruit and vegetables within a week. This is somewhat similar to finding among bank employees and teachers in A.A., where one third of the participants reported no fruit & vegetable in their usual diet in a week (38). In this study, the cost (55.4%) and lack of availability (43.5%) were the two major reasons for not eating fruit or vegetables frequently. Concerning alcohol consumption, 44.8% of the respondents were current alcohol consumers, and this was lower than the finding in Addis Ababa, where 61.9% of the study participants reported as being current alcohol consumers. From the participants, 89.7% abstained from alcohol drinking. This is less than the study finding in Durame (Ethiopia) ( 18 ). This could be due to social and cultural practices that discourage alcohol drinking. The study showed that the prevalence of binge drinking was 46.8%; this had a share of 29.9% males & 6.7% females. This is high when it is compared to the prevalence of binge drinking among adults in A.A., which was 10% in males & Malawi 19% in males & 2.3% in females (28, 46). This might be due to the prohibition of alcohol drinking in those big towns. From this study, the majority of participants, 33.4%, drink daily, and 24.8% drink alcohol 4 to 6 times per week. The mean units of alcohol consumed on a day they used alcohol was 2.24 bottles (+ 1.13 SD).This result similar 32% in India ( 21 ) and higher in Malaysia ( 7 ). Among the study participants, only 16.1% of the participants practice regular exercise for 30 min per day for most of the days in a week, which was lower than 89% and 43.7% physically active in studies done in India and Addis Ababa, respectively ( 18 , 22 ). A possible explanation could be a lack of organized setups that are favorable for exercise. A similar study done in Saudi Arabia showed that only 11.1% practiced physical activity most of the days in a week. Another study was done in the USA on African Americans that also showed the majority of the practiced physical activity that is higher than this study’s finding. This could be poor knowledge on the importance of physical activity in the management of chronic diseases. The study found that 36.3. % of public servants had done physical exercise. This is better than the study done in Sidama zone which was found that 32.58% of civil servants had done physical exercise ( 20 ). According to this study, participants who were public servants were found to be more physically active (33.6%) than bankers (30.3%) because the bank workers spent more hours sitting than the government employees. In this study, occupation had shown no statistically significant association with healthy lifestyle practice. In studies conducted independently, the odds of poor lifestyle practice were higher among the bank workers. In those studies it is explained that bankers’ workers were more stressed and sedentary. In our study, respondents who were good at knowing CNCDs were 2-fold greater than those who were poor at knowing CNCDs. This is consistent with findings from studies conducted in Jimma and Pakistan ( 23 , 24 ). This may be associated with the fact that knowing the health benefits would motivate them to exercise regularly. Therefore, from this study, 363 respondents (57.3%) were practicing the above four healthy lifestyle measures. This finding is lower than a study done in China and Saudi Arabia in which (70%) and (48.6%), respectively ( 16 , 25 ). This might be due to the level of their economy and level of awareness about healthy lifestyle practice and its advantages. This result showed that merely having good knowledge and a favorable attitude may not lead to one's owning certain behavior changes in a healthy lifestyle, but additionally the reinforcing & enabling factors should be fulfilled. Limitation The nature of the study design recall bias and tend to collect data on a limited number of variables at a single time point, which may not capture the complexity of the issue being studied. The cross-sectional study design is that because the exposure and outcome are simultaneously measured, there is generally no evidence of a temporal relationship between exposure and outcome which could not enable to investigate the cause-effect relationship. Conclusion In Fiche Town, there were few public employees that led healthy lifestyles. As a result, public employees ought to get education and guidance on healthy lifestyle choices that can prevent chronic non-communicable diseases and early mortality. Abbreviations AOR- Adjusted Odds Ratio, BMI- Body Mass Index, CI- Confidence Interval, CNCD-Chronic Non Communicable diseases, COR –Crude Odds Ratio, CVDs- Cardiovascular diseases, DALYs- Disability adjusted life years, DM- Diabetes Miletus, EDHS – Ethiopian Demographic Health Survey, FMOH- Federal Ministry of Health, HMIS – Health Management Information System, NCD - Non Communicable Disease, OR- Odds Ratio, QOL- Quality of life, SPSS- Statistical Package for Social Sciences, USA - United States of America, WHO - World Health organization Declarations Acknowledgements The authors would like to thank Salale University and the Fitch town health office. Furthermore, we would like to express our heartfelt gratitude to the Fiche town Public Service Office for providing the necessary information on the study area and facilitating conditions, as well as to the study respondents for their cooperation. Authors contribution GHM- conceptualization, data curation, formal analysis, investigation, funding acquisition, methodology, editing the manuscript; TE- conceptualization, data curation, writing a review and editing the manuscript; HHT and BS- Conceptualization, formal analysis, investigation, funding acquisition, methodology, project administration, resources, software, supervision, validation, visualization, writing a review Funding No funding. Data Availability All the data used for this study is included in this manuscript and available from the corresponding author upon reasonable request. Ethics approval and consent to participate Ethical clearance was obtained from the Institutional Review Committee (IRC) of Salale University on March 20, 2022. We requested permission from the Fiche town health office and Fiche Town Public Service offices and obtained permission. 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Int J Prev Med. 2014;5(2):S171–8. Phillips JA. Dietary Guidelines for Americans, 2020–2025. Vol. 69, Workplace Health and Safety. 2021. p. 395. Schüz J, Espina C, Wild CP. Primary prevention: a need for concerted action. Mol Oncol. 2019;13(3):567–78. Ibrahim Elbur A. Level of Adherence To Lifestyle Changes and Medications Among Male Hypertensive Patients in Two Hospitals in Taif; Kingdom of Saudi Arabia. Int J Pharm Pharm Sci. 2015;7(4, 2015). Salawu MM, Erakhaiwu JE, Bamgboye EA, Sani MU. Differentials in lifestyle practices and determinants among hypertensive adults from three geopolitical zones in Nigeria. Buda ES, Hanfore LK, Fite RO, Buda AS. Lifestyle modification practice and associated factors among diagnosed hypertensive patients in selected hospitals, South Ethiopia. Clin Hypertens. 2017;23(1):1–9. Kiberenge MW, Ndegwa ZM, Njenga EW, Muchemi EW. Knowledge, attitude and practices related to diabetes among community members in four provinces in Kenya: a cross-sectional study. Pan Afr Med J. 2010;7:2. Badego B, Yoseph A, Astatkie A. Prevalence and risk factors of hypertension among civil servants in Sidama Zone, south Ethiopia. PLoS One [Internet]. 2020;15(6 June 2020):1–17. Available from: http://dx.doi.org/10.1371/journal.pone.0234485 Vanitha D, Anitha Rani M. Knowledge and practice on lifestyle modifications among males with hypertension. Indian J Community Heal. 2015;27(1):143–9. Grimason AM, Masangwi SJ, Morse TD, Jabu GC, Beattie TK, Taulo SE, et al. Knowledge, awareness and practice of the importance of hand-washing amongst children attending state run primary schools in rural Malawi. Int J Environ Health Res. 2014;24(1):31–43. Garemo M, Elamin A, Gardner A. Weight status and food habits of preschool children in Abu Dhabi, United Arab Emirates: NOPLAS project. Asia Pac J Clin Nutr. 2018;27(6):1302–14. Bhawra J and, Kirkpatrick. Patterns and correlates of nutrition knowledge across five countries in the 2018 international food policy study. Nutr J [Internet]. 2023;22(1):1–12. Available from: https://doi.org/10.1186/s12937-023-00844-x Ng N, Hakimi M, Van Minh H, Juvekar S, Razzaque A, Ashraf A, et al. Prevalence of physical inactivity in nine rural indepth health and demographic surveillance systems in five asian countries. Glob Health Action. 2009;2(1):44–53. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5552669","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":450586790,"identity":"80438dc5-e50c-4a46-8c86-0314e2e86f1f","order_by":0,"name":"Getaneh Haile Minda","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/0lEQVRIiWNgGAWjYPCCAwkMzMwNjB8qgGwgg4BqZpgWxgZmiTMgAUZitTAAVfK2gTgEtMi79x/8XFBxJ4+/nbHxgeS82mggo4HhR8U2nFoMzxxmlp5x5lmxxGHGZoPCbcdzZxxmbGDsOXMbt5YZyQzSvG2HExsOM7ZJSG47lgtkNDAztuHRMv8x82/ef4cT5x9mbP/BO+dY7nxCWuQlmNmkeRsOJ24A2sLA21CTu4GQFgOeZDNrnmOHEzcC/SItcexALpDRcBCfX+TbDz6+zVNzOHHe+cMHP36oqcsFMR78qMBjywFU/mEweQBDHbItDaj8OnyKR8EoGAWjYIQCAOc9Yh3CI4YSAAAAAElFTkSuQmCC","orcid":"","institution":"Salale University","correspondingAuthor":true,"prefix":"","firstName":"Getaneh","middleName":"Haile","lastName":"Minda","suffix":""},{"id":450586791,"identity":"1d369b8d-c005-4ae3-981f-b71ea5524042","order_by":1,"name":"Tewodrose Endale","email":"","orcid":"","institution":"Salale University","correspondingAuthor":false,"prefix":"","firstName":"Tewodrose","middleName":"","lastName":"Endale","suffix":""},{"id":450586792,"identity":"fd8d2d14-7139-41c6-a248-a2b022e8b2a1","order_by":2,"name":"Birhanu Senbeta Deriba","email":"","orcid":"","institution":"Salale University","correspondingAuthor":false,"prefix":"","firstName":"Birhanu","middleName":"Senbeta","lastName":"Deriba","suffix":""},{"id":450586793,"identity":"14855d11-29b0-417f-b061-a5f8f7a4b2b4","order_by":3,"name":"Habiteyes Hailu Hailu Tola1","email":"","orcid":"","institution":"Salale University","correspondingAuthor":false,"prefix":"","firstName":"Habiteyes","middleName":"Hailu Hailu","lastName":"Tola1","suffix":""}],"badges":[],"createdAt":"2024-11-30 06:38:05","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5552669/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5552669/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-025-24402-8","type":"published","date":"2025-08-27T15:58:06+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":82048115,"identity":"6d59760d-c7ad-46a4-8e98-3ce4a0da8b04","added_by":"auto","created_at":"2025-05-06 09:45:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":43731,"visible":true,"origin":"","legend":"\u003cp\u003eSchematic Presentation of the Sampling Procedure for the study on healthy life Style and its associated factors among public servants in Fiche Town, Oromia ,Ethiopia, 2022.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5552669/v1/ca193bde745d9b2c14757d52.png"},{"id":82045609,"identity":"869c6813-081b-4a02-97fd-f327aef3786a","added_by":"auto","created_at":"2025-05-06 09:37:21","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":125198,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 1:-Shows health life style practice among public servant in Fiche town, Oromia, Ethiopia, 2022.\u003c/p\u003e","description":"","filename":"01.png","url":"https://assets-eu.researchsquare.com/files/rs-5552669/v1/5433b39227c9c6d74f132b3a.png"},{"id":90344923,"identity":"d48c0c03-0835-4042-8a71-cf42b8adcb1a","added_by":"auto","created_at":"2025-09-01 16:07:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":998776,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5552669/v1/77e8d09f-3bd5-4619-86bb-2a92f6d63554.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Healthy LifeStyle Practice and Its Associated Factors among Public Servants in Fiche Town, Ethiopia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eA healthy lifestyle is one that helps keep and improve health and well-being. Lifestyle includes daily routines that become habitual and affect physical and mental health (\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). It contributed to positive benefits throughout the life span of people living in various corners of the world. Besides controlling risk factors in lifestyle and healthy habits, healthy lifestyle practices can reduce early deaths by half (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Unhealthy lifestyles and behaviors were the cause of 60% of the morbidity and death of non-communicable illnesses. Millions of people have unhealthy lifestyles that can lead to disease, disability, and even death. An unhealthy lifestyle can lead to cardiovascular illnesses, hypertension, obesity, and other conditions (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eAround 41\u0026nbsp;million peoples death annually in the world due to Non-communicable diseases (NCDs) which is, equivalent to 71% of all deaths globally. Among NCDs, account for more than 80% of all premature NCD deaths include cardiovascular diseases, cancers, respiratory diseases, and diabetes. There has been a surge in the burden of NCDs in sub-Saharan Africa over the past two decades, driven by an increasing incidence of cardiovascular risk factors such as unhealthy diets and reduced physical activity (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe epidemiological shift from communicable to non-communicable diseases is occurring in many low- and middle-income nations. This hinders the development of their human capital and places an increasing financial strain on their societies. Although practicing a healthy lifestyle is important in preventing NCDs and saving the national economy, a considerable proportion of people are not practicing a healthy lifestyle (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Public servants are among the group of population that is less likely to practice a healthy lifestyle, which prone those to a higher risk of NCDs (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMoreover, although the impact of unhealthy lifestyles on people's health and the national economy is documented, there is limited evidence on the level of health lifestyle practice and its associated factors among public servants. Ethiopia is among the setups where such information is scarce. Furthermore, there is no strong study that reported on the level of healthy lifestyle practice and its associated factors. Therefore, this study aims to determine the level of healthy lifestyle practice and its associated factors among public servants who are working in different public organizations in Fiche town, Ethiopia.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy area and Period\u003c/h2\u003e\n \u003cp\u003eThis study was conducted in Fiche town. Fiche town is the administrative city of North Shoa zone which is found Oromia region states, Ethiopia. It located at north to Addis Ababa on 114km. The town has four kebeles, the smallest administrative branch, and a total of 50,040 estimated populations reside in the town. There are 42 public organization including banks. The total 1105 of public servants were working in government organization and 343 bank workers. The study was conducted from April 1\u0026ndash;30, 2022.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eStudy design\u003c/h3\u003e\n\u003cp\u003eInstitutional based cross-sectional study was conducted\u003c/p\u003e\n\u003ch3\u003ePopulation\u003c/h3\u003e\n\u003cp\u003eAll public servants who were working in public sectors and banks were included in this study. Thus, workers who were working in public organizations and in private were a study population of this study. Public servants who were on leave, seriously ill, and in long-term training during the data collection were excluded.\u003c/p\u003e\n\u003ch3\u003eSample size determination\u003c/h3\u003e\n\u003cp\u003eThe sample size was determined using a single population proportion sample size estimation method by assuming 50% of unhealthy lifestyle practice population proportion, 95% confidence level and 5% margin of error. The sample size was further increased by considering design effect 1.5 due to clustering nature of the public servants within the selected public organization related to healthy lifestyle practice. After considering 10% contingency sample for non-response rate. Then the total sample sizes was calculated to be 636.\u003c/p\u003e\n\u003ch3\u003eSampling procedure\u003c/h3\u003e\n\u003cp\u003eOut of 42 public organizations and private banks; 21 organizations were selected by simple random sampling method. An individual participant was selected by proportionate systematic random sampling method by using a roster of participants name after 2 intervals. K calculated by the formula k\u0026thinsp;=\u0026thinsp;N/n. Where, k is the interval of inclusion, N the total public servants in the selected organization and n is the proportion of sample size in a given organization (Fig-1).\u003c/p\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eData Collection tools and Procedures\u003c/h2\u003e\n \u003cp\u003eData were collected by using a self-administered questionnaire adapted from related articles (\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e). To ensure the consistency of the questionnaires, the English version was translated into Afaan Oromo for data collection and retranslated into English by a professional language translator. The questionnaires contained questions on socio-demographic characteristics and healthy lifestyle. Data collectors were strictly supervised. At the end of each day, the questionnaire was reviewed and checked for completeness by the supervisors, who took corrections.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eData quality management\u003c/h3\u003e\n\u003cp\u003eTo ensure the data quality before starting data collection, the questionnaires were pretested in Dagam district town in order to checked questioners clearness, completeness and consistence. Then, after the necessary comments and feedback were incorporated, some modification was done in the final tool. The reliability of questionnaires for each variable was measured using the Cronbach\u0026rsquo;s coefficient alpha (0.79). The data was carefully entered and cleaned before the main analysis. The completeness and accuracy of the collected data were checked carefully on a regular basis. The data collectors were trained to facilitate data collection. The collected data could be checked every day by investigators for its completeness.\u003c/p\u003e\n\u003ch3\u003eData processing and analysis\u003c/h3\u003e\n\u003cp\u003eThe cleaned data was exported into the statistical package for social science (SPSS) in 26 versions for analysis. Descriptive statistics such as proportion, frequency, means, median, standard deviation, and range were used to describe the socio-demographic distribution. Binary logistic regression with a multilevel logistic regression model was computed to see the association between each independent variable and level of healthy lifestyle practice using crude odds ratio (COR) 95% CI. The model goodness-of-fit test was checked by the Hosmer-Lemeshow goodness of fit, and the p-value of the model fitness test was 0.87. Multi-collinearity and confounding effects were checked by using the standard error, which was not inflated, and no collinearity exists between the independent variables. Variables that had a p-value p\u0026thinsp;\u0026lt;\u0026thinsp;0.25 in bivariate analysis were taken to multilevel logistic analysis in final models. Multilevel logistic regression model was computed to identify predictor variables associated with healthy lifestyle practice using an adjusted odds ratio (AOR) with a 95% CI. Variables in the multilevel logistic analysis with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSocio demographic characteristics of Public Servants\u003c/h2\u003e \u003cp\u003eA total of 630 respondents participated in this study, making a response rate of 99%. Out of these respondents, 219 (34.8%) were females. The age of the respondents ranged from 18 to 65 years. The mean age of the respondents was found to be 34.07\u0026thinsp;\u0026plusmn;\u0026thinsp;7.4 years. The largest age group was 25\u0026ndash;34 years, with a total of 330 respondents (52.4%). Regarding their marital status, the majority (63%) were married. Concerning the educational status, 44.8% had attended a degree and above. Out of the total study subjects, 33.5% had high wealth status, and 209 (33.2%) had less wealth status (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe socio demographic characteristics of public servant respondents (N\u0026thinsp;=\u0026thinsp;636).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e411\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e397\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eElementary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCertificate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDegree and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eWork experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 to 10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 to 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWealth index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh wealth index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedium wealth index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow Wealth index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge of public servant about health lifestyle\u003c/h2\u003e \u003cp\u003eFour thousand forty-five (70.1%) of the respondents stated that they have gotten information about chronic non-communicable diseases and healthy lifestyles. From those, more than three-fourths (76%) were informed by health professionals. 344 (54.6%) knew about the difference between communicable and non-communicable diseases. Five hundred twenty-five (65.1% of the respondents) knew at least one risk factor that predisposes to chronic non-communicable diseases from choices of unhealthy diet, smoking, heavy alcohol consumption, and not doing physical exercise. 389 (61.7%) believe that non-communicable diseases can be prevented by practicing healthy lifestyles. In this study, 30.9% of participants perceived that they were at risk of developing CNDs, and of these, 76 (40%), 56 (29.5%), and 58 (30.5%) of them mentioned their reasons as avoiding heavy alcohol, unhealthy diet, and being physically inactive, respectively. Generally, 55.4% of the respondents had poor knowledge about healthy lifestyle practices.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eMagnitude of healthy lifestyle measures among Public Servants\u003c/h2\u003e \u003cp\u003eIn this study, 45% of study participants had poor health lifestyle practices (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Among the study participants, fruit \u0026amp; vegetables, cereals \u0026amp; legumes, meat, and animal products were mentioned as common diets by 99 (15.7%), 319 (50.6%), and 92 (14.7%), respectively. Nearly one-third (31.1%) of the participants eat fruit and vegetables three times a week, and 92 (14.6%) didn\u0026rsquo;t eat any fruit and vegetables in a typical week. The major reasons mentioned for not eating fruits and vegetables at least once a week were that they are not easily available (6.3%) and their cost is high (8.1%). In this study, healthy diet participants who had a good healthy diet were 4 times more likely to have a good healthy lifestyle compared to poor health diet practice.\u003c/p\u003e \u003cp\u003eIn this study, 253 (40.2%) of the respondents were poor in physical activity. In this study, females had performed better physical activity (34.1%) than male respondents. Physical activity research shows that physical activity declines with age. In the study, the age group less than 40 years had better (34.6%) physical activity than those ages above 40 years of age. Among the study participants, only 92 (14.6%) of the participants practice regular physical exercise greater than 30 minutes per day for most of the days in a week (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency distribution of consuming fruits and vegetables, alcohol consumption and physical activity per day among public servants Fiche town, August 2022 (N\u0026thinsp;=\u0026thinsp;636).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003evariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003efrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003epercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eFrequency of consuming fruits and vegetables\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThree times a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTwice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI do not eat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers specify\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eFrequency of alcohol consumption at least one per day\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 to 3 per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 to 6 per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eFrequency of physical exercise in a minutes per day\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than 10 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;20 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;30 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGreater than 30 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFour hundred twenty-four (52.2%) and 356 (44.1%) of the respondents (57.6% males) were ever alcohol consumers and current consumers, respectively. And more than half of the current alcohol consumers were 185 (52.1%) drink occasionally, 78 (21.8%) take alcohol at least once a week, and 46 (12.9%) drink on a daily basis. The most common type of alcoholic beverage consumed was beer, as reported by 56.5% of respondents, and 49 (13.8%) were local alcohol consumers. 190 (17.2%) of the study participants stated that they have consumed 4/5 drinks at a time at least once a week. This means 25.4% of males and 6.5% of females were binge drinkers. The proportions of ever smokers, current smokers, and ex-smokers were 63 (10%), 51 (8.1%), and 24 (4.4%), respectively. Out of the current smokers, 90.2% were daily smokers, 3.9% weekly, and the rest, 5.9%, were occasional smokers. The majority of current smokers, 31 (60.7%), smoke 10 or more cigarettes per day. Twenty-eight (54.9%) of current smokers have mentioned that they want to stop smoking, and about 34.1% were very concerned about the consequences of cigarette smoking. Smoking didn\u0026rsquo;t show an association with other independent variables.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eFactors associated with healthy lifestyle among Public Servants\u003c/h2\u003e \u003cp\u003eWe conducted bi-variable logistic regression using a multilevel logistic regression model for every independent variable. For those variables with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.25 in the bi-variable logistic regression, they were taken to multivariable logistic regression with multilevel logistic analysis in the final models. Since all values were significant and had a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.25 in bi-variable logistic regression with a multilevel logistic regression model, they were entered into multivariable logistic regression with a multilevel logistic regression model.\u003c/p\u003e \u003cp\u003eThe results from the bivariate logistic regression indicate that males had more healthy lifestyle practice than females (COR: 1.37, 95% CI: 0.98\u0026ndash;1.91). The odds of a healthy lifestyle increase with an increase in work experience: \u0026ge;15 years (COR: 0.68, 95% CI: 0.40\u0026ndash;1.12). A more healthy lifestyle practice was observed among middle wealth status groups (COR: 1.43, 95% CI: 0.97\u0026ndash;2.10); a statistically significant trend was also observed among the higher wealth status groups (COR: 1.90, 95% CI: 1.34\u0026ndash;2.94) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe result of multivariable logistic regression with the multilevel logistic regression model showed that participants who had more than or equal to 15 years\u0026rsquo; work experience were 60% less likely to practice a good lifestyle than those who had\u0026thinsp;\u0026le;\u0026thinsp;5 years\u0026rsquo; work experience (AOR\u0026thinsp;=\u0026thinsp;0.4, 95% CI: 0.27\u0026ndash;0.78). The study also showed that participants who had good knowledge of CNCDs had 2 times higher odds of practicing a healthy lifestyle compared to those who had poor knowledge of CNCDs (AOR\u0026thinsp;=\u0026thinsp;2.25, 95% CI: 1.3\u0026ndash;3.8).\u003c/p\u003e \u003cp\u003e According to this study, participants who avoided extra salt were 2.43 times more likely to practice a healthy lifestyle than those who had not avoided extra salt (AOR\u0026thinsp;=\u0026thinsp;2.43, 95% CI: 1.54\u0026ndash;3.84). On the other hand, the result of this study shows that participants who had good knowledge in practicing a healthy lifestyle were 7 times more likely to practice a good lifestyle as compared with poor knowledge (AOR\u0026thinsp;=\u0026thinsp;6.8, 95% CI: 3.3\u0026ndash;14.4). Similarly, the current study found that participants who had a good attitude about practicing a healthy lifestyle were 5 times more likely to have a good healthy lifestyle as compared to those who had a poor attitude (AOR\u0026thinsp;=\u0026thinsp;4.97, 95% CI: 2.07\u0026ndash;11.9) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe result obtained from multivariable logistic regression with the multilevel logistic model indicated that work experience AOR\u0026thinsp;=\u0026thinsp;0.4, 95% CI (0.27\u0026ndash;0.78); knowing about CNCDs AOR\u0026thinsp;=\u0026thinsp;2.25, 95% CI (1.3\u0026ndash;3.8); avoiding extra salt AOR\u0026thinsp;=\u0026thinsp;2.43, 95% CI (1.54\u0026ndash;3.84); knowledge AOR\u0026thinsp;=\u0026thinsp;6.8, 95% CI (3.3\u0026ndash;14.4); and attitude AOR\u0026thinsp;=\u0026thinsp;4.97, 95% CI (2.07\u0026ndash;11.9) were significantly related to healthy lifestyle practice in the final multilevel logistic regression model (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultilevel logistic model analysis among Factors associated with healthy lifestyle among Public Servants (N\u0026thinsp;=\u0026thinsp;636).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eHealthy life style practice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR (95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR\u003c/p\u003e \u003cp\u003e995%CI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e164(40.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e246(60.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.37 (0.98, 1.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.52 (0.78, 2.81)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105(47.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115(52.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e163(41.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e234(58.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17(36.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30(63.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.76 (0.82,3.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.12 (0.89, 3.56)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73(46.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e84(53.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.17 (0.84,5.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.45 (0.91, 4.64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(55.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13(44.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.45 (0.64, 3.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.67 (0.32, 2.89)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePublic Servants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119(49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e124(51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.58 (0.40,0.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.62 (0.25, 1.45)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBankers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69(57.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49(42.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eWork experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56(37.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94(66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111(43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e147(57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.31(0.05,1.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.76 (0.44,1.28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u0026ndash;14years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53(16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51(83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.94(0.60,1.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.56 (0.29,1.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;15 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49(41.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69(58.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.68(0.40,1.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.4 (0.27,0.78)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWealth index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh wealth status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73(34.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e138(76.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.90(1.34,2.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.46 (0.76, 2.45)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedium wealth status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89(42.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e121(57.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.43(0.97,2.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.12 (0.98, 3.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow wealth status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e107(51.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102(48.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSource information\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e140(38.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e221(61.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e129(48.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e140(52.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.69(0.50,0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.42 (0.09, 1.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eKnow CNCDs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e126(68.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59(31.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e146(32.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e302(77.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.51(3.12,6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.25(1.3,3.80)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAvoid extra salt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e220(56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e173(44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49(47.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e188(52.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.43(1.54, 3.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.43(1.54, 3.84)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot Sufficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e220(63.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e129(27.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSufficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49(17.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e232(82.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.07(5.54,11.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.8(3.3,14.40)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot favorable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e113(75.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36(24.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFavorable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156(32.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e325(67.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.54(4.29,9.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.97(2.07,11.90)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e* Significantly associated p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/h2\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eA healthy lifestyle is a valuable source of decreasing the prevalence and effect of health problems; promoting health, coping with stressors, and improving the quality of life (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Therefore, considering the effective role of public servants as valuable human resources in delivering services, this study was conducted to assess the healthy lifestyle practice and its association factors among public servants in Fiche town. This study revealed that work experience was significantly associated with healthy lifestyle practice. Participants who had work experience of more than or equal to fifteen years were less likely to practice a healthy lifestyle than those who had work experience of less than or equal to five. This finding was in line with the results of the studies in Hamadan (Iran) (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). This could be due to the workers with more years of work experience tending to adopt a more sedentary lifestyle and high stress.\u003c/p\u003e \u003cp\u003eIn the current study, avoiding extra salt was a factor that showed a significant association with healthy lifestyle practice. Participants who avoided extra salt had better healthy lifestyle practices than those who had not avoided extra salt. This finding was higher than a study done in Saudi Arabia, but this finding is lower than the finding of a study done in Jimma University Specialized Hospital (Ethiopia). In addition, a study done in the United States showed low salt diet practices among African Americans (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). This may be due to the socio-cultural practice of the community and the improvement in awareness creation on the respondents\u0026rsquo; part towards these habits or practices.\u003c/p\u003e \u003cp\u003eThis study found that 44.6% had sufficient knowledge regarding healthy lifestyle practice, which is similar to the study done on lifestyle modification practice in Hosanna, which was 44.9%, and the finding is higher than the study done in the Nigerian suburban community, which was 42% (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). This might be the sample size and the study time, respectively.\u003c/p\u003e \u003cp\u003eThe study revealed that participants who had sufficient knowledge in practicing a healthy lifestyle were more likely to practice a good lifestyle as compared with those who did not have sufficient knowledge. From the participants, 89.7% abstained from alcohol drinking. This is less than the study finding in Durame (Ethiopia) (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This could be due to social and cultural practices that discourage alcohol drinking and smoking.\u003c/p\u003e \u003cp\u003eThe result of this study revealed that 76.3% had a positive attitude towards healthy lifestyle practice. while a study done in Kenya indicated that 41% of the respondents had not a positive attitude towards adopting healthier lifestyles (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). The possible reason for having a higher proportion of respondents with a favorable attitude could be due to better sources of health information among study participants and differences in the scoring system.\u003c/p\u003e \u003cp\u003eIn this study the percentage of respondents with good healthy lifestyle practice (57.3%) was higher than the respondents in Kenya, where 41% of them had good health lifestyle practices. The possible reason for the difference could be that in Kenya, the study only considered dietary practice and regular exercise as criteria to classify the respondents as having good or bad practice, but in this study, healthy diet, smoking, alcohol consumption, and physical exercise were measured (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn this study, 8.09% of the respondents were current smokers, which was 97% males and 3% females, and this study was higher than the finding done among civil servants in Sidama Zone and less than the study done in Butajira, which was 4.4% and 12.8%, respectively. The possible explanation for the result in Butajira, the age range of the study subject was above 15 with more than therefore it is expected to be high among younger study populations, and the study in Sidama may be due to the difference in sample size \u0026amp; due to the time gap the two studies were carried out (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the current study, from the current smokers, 31 (0.04%) smoke 10 or more cigarettes per day. Twenty-eight (54.9%) of current smokers have mentioned that they want to stop smoking, whereas about 34.1% were very concerned about the consequences of cigarette smoking. Which was less than the study done in Iran and Norway, which indicated that 2.8% smoked more than 10 cigarettes a day among the Iranian employees, and the Norwegian study shows that smokers who smoke more than 10 cigarettes were 3.2% (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). This may be due to the urbanization and industrialization-related factors.\u003c/p\u003e \u003cp\u003eResults of our study revealed that only 76.7% of respondents consume less than the recommended five servings of fruits and vegetables. This result is consistent with many other lower- and middle-income countries, such as Bangladesh, Mexico, and Thailand, where fruits and vegetables are produced mainly to export to other countries and which less than the study done in South Africa are. This may be due to the economic status of the country. In this study, only 19.2% of the respondents eat fruits and vegetables at least once a day, which is greater than the study in Addis abeba 14.6% didn\u0026rsquo;t eat fruit and vegetables within a week. This is somewhat similar to finding among bank employees and teachers in A.A., where one third of the participants reported no fruit \u0026amp; vegetable in their usual diet in a week (38). In this study, the cost (55.4%) and lack of availability (43.5%) were the two major reasons for not eating fruit or vegetables frequently.\u003c/p\u003e \u003cp\u003eConcerning alcohol consumption, 44.8% of the respondents were current alcohol consumers, and this was lower than the finding in Addis Ababa, where 61.9% of the study participants reported as being current alcohol consumers. From the participants, 89.7% abstained from alcohol drinking. This is less than the study finding in Durame (Ethiopia) (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This could be due to social and cultural practices that discourage alcohol drinking.\u003c/p\u003e \u003cp\u003eThe study showed that the prevalence of binge drinking was 46.8%; this had a share of 29.9% males \u0026amp; 6.7% females. This is high when it is compared to the prevalence of binge drinking among adults in A.A., which was 10% in males \u0026amp; Malawi 19% in males \u0026amp; 2.3% in females (28, 46). This might be due to the prohibition of alcohol drinking in those big towns.\u003c/p\u003e \u003cp\u003eFrom this study, the majority of participants, 33.4%, drink daily, and 24.8% drink alcohol 4 to 6 times per week. The mean units of alcohol consumed on a day they used alcohol was 2.24 bottles (+\u0026thinsp;1.13 SD).This result similar 32% in India (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) and higher in Malaysia (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Among the study participants, only 16.1% of the participants practice regular exercise for 30 min per day for most of the days in a week, which was lower than 89% and 43.7% physically active in studies done in India and Addis Ababa, respectively (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). A possible explanation could be a lack of organized setups that are favorable for exercise. A similar study done in Saudi Arabia showed that only 11.1% practiced physical activity most of the days in a week. Another study was done in the USA on African Americans that also showed the majority of the practiced physical activity that is higher than this study\u0026rsquo;s finding. This could be poor knowledge on the importance of physical activity in the management of chronic diseases.\u003c/p\u003e \u003cp\u003eThe study found that 36.3. % of public servants had done physical exercise. This is better than the study done in Sidama zone which was found that 32.58% of civil servants had done physical exercise (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccording to this study, participants who were public servants were found to be more physically active (33.6%) than bankers (30.3%) because the bank workers spent more hours sitting than the government employees. In this study, occupation had shown no statistically significant association with healthy lifestyle practice. In studies conducted independently, the odds of poor lifestyle practice were higher among the bank workers. In those studies it is explained that bankers\u0026rsquo; workers were more stressed and sedentary.\u003c/p\u003e \u003cp\u003eIn our study, respondents who were good at knowing CNCDs were 2-fold greater than those who were poor at knowing CNCDs. This is consistent with findings from studies conducted in Jimma and Pakistan (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). This may be associated with the fact that knowing the health benefits would motivate them to exercise regularly.\u003c/p\u003e \u003cp\u003eTherefore, from this study, 363 respondents (57.3%) were practicing the above four healthy lifestyle measures. This finding is lower than a study done in China and Saudi Arabia in which (70%) and (48.6%), respectively (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). This might be due to the level of their economy and level of awareness about healthy lifestyle practice and its advantages. This result showed that merely having good knowledge and a favorable attitude may not lead to one's owning certain behavior changes in a healthy lifestyle, but additionally the reinforcing \u0026amp; enabling factors should be fulfilled.\u003c/p\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLimitation\u003c/h2\u003e \u003cp\u003eThe nature of the study design recall bias and tend to collect data on a limited number of variables at a single time point, which may not capture the complexity of the issue being studied. The cross-sectional study design is that because the exposure and outcome are simultaneously measured, there is generally no evidence of a temporal relationship between exposure and outcome which could not enable to investigate the cause-effect relationship.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn Fiche Town, there were few public employees that led healthy lifestyles. As a result, public employees ought to get education and guidance on healthy lifestyle choices that can prevent chronic non-communicable diseases and early mortality.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAOR- Adjusted Odds Ratio, BMI- Body Mass Index, CI- Confidence Interval, CNCD-Chronic Non Communicable diseases, COR \u0026ndash;Crude Odds Ratio, CVDs- Cardiovascular diseases, DALYs- Disability adjusted life years, DM- Diabetes Miletus, EDHS \u0026ndash; Ethiopian Demographic Health Survey, FMOH- Federal Ministry of Health, HMIS \u0026ndash; Health Management Information System, NCD - Non Communicable Disease, OR- Odds Ratio, QOL- Quality of life, SPSS- Statistical Package for Social Sciences, USA - United States of America, WHO - World Health organization\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank Salale University and the Fitch town health office. Furthermore, we would like to express our heartfelt gratitude to the Fiche town Public Service Office for providing the necessary information on the study area and facilitating conditions, as well as to the study respondents for their cooperation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contribution\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGHM- conceptualization, data curation, formal analysis, investigation, funding acquisition, methodology, editing the manuscript; TE- conceptualization, data curation, writing a review and editing the manuscript; HHT and BS- Conceptualization, formal analysis, investigation, funding acquisition, methodology, project administration, resources, software, supervision, validation, visualization, writing a review\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the data used for this study is included in this manuscript and available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance was obtained from the Institutional Review Committee (IRC) of Salale University on March 20, 2022. We requested permission from the Fiche town health office and Fiche Town Public Service offices and obtained permission. Informed written consent was taken based on a full understanding of the study\u0026apos;s purpose, procedures, risks, benefits, and potential discomforts. Participants should be made aware that they can withdraw at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflict of interest\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAsemu MM, Yalew AW, Kabeta ND, Mekonnen D. Prevalence and risk factors of hypertension among adults: A community based study in Addis Ababa, Ethiopia. PLoS One [Internet]. 2021;16(4 April):1\u0026ndash;14. Available from: http://dx.doi.org/10.1371/journal.pone.0248934\u003c/li\u003e\n \u003cli\u003eDemirci N, To P, Demirci E. The Effects of Eating Habits , Physical Activity , Nutrition Knowledge and Self-efficacy Levels on Obesity i. Univers J Educ Res. 2018;6(7):1424\u0026ndash;30.\u003c/li\u003e\n \u003cli\u003eTesema S, Disasa B. Knowledge, Attitude and Practice Regarding Lifestyle Modification of Hypertensive Patients at Jimma University Specialized Hospital, Ethiopia. Prim Healthc Open Access. 2016;06(01):1\u0026ndash;4.\u003c/li\u003e\n \u003cli\u003eBenedetti I, Biggeri L, Laureti T, Secondi L. Exploring the Italians\u0026rsquo; Food Habits and Tendency towards a Sustainable Diet: The Mediterranean Eating Pattern. Agric Agric Sci Procedia. 2016;8:433\u0026ndash;40.\u003c/li\u003e\n \u003cli\u003eEthiopian Public Health Institute. Ethiopia : Food-Based Dietary Guidelines Booklet \u0026ndash; 2022. 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Available from: http://dx.doi.org/10.1016/S2214-109X(19)30370-5\u003c/li\u003e\n \u003cli\u003eespinel King Paola T and Lesley. A Framework for Monitoring Overweight and Obesity in NSW. NSW. Sydney: NSW Department of Health and the Physical Activity Nutrition Obesity Research Group; 2009. 13\u0026ndash;25 p.\u003c/li\u003e\n \u003cli\u003eLichtenstein AH, Appel LJ, Brands M. Diet and lifestyle recommendations revision 2006: A scientific statement from the American heart association nutrition committee. Circulation. 2006;114(1):82\u0026ndash;96.\u003c/li\u003e\n \u003cli\u003eRazon AH, Haque MI, Ahmed MF, Ahmad T. Assessment of dietary habits, nutritional status and common health complications of older people living in rural areas of Bangladesh. Heliyon [Internet]. 2022;8(2):e08947. Available from: https://doi.org/10.1016/j.heliyon.2022.e08947\u003c/li\u003e\n \u003cli\u003eNaeeni MM, Jafari S. Nutritional knowledge, practice, and dietary habits among school children and adolescents. Int J Prev Med. 2014;5(2):S171\u0026ndash;8.\u003c/li\u003e\n \u003cli\u003ePhillips JA. Dietary Guidelines for Americans, 2020\u0026ndash;2025. Vol. 69, Workplace Health and Safety. 2021. p. 395.\u003c/li\u003e\n \u003cli\u003eSch\u0026uuml;z J, Espina C, Wild CP. Primary prevention: a need for concerted action. Mol Oncol. 2019;13(3):567\u0026ndash;78.\u003c/li\u003e\n \u003cli\u003eIbrahim Elbur A. Level of Adherence To Lifestyle Changes and Medications Among Male Hypertensive Patients in Two Hospitals in Taif; Kingdom of Saudi Arabia. Int J Pharm Pharm Sci. 2015;7(4, 2015).\u003c/li\u003e\n \u003cli\u003eSalawu MM, Erakhaiwu JE, Bamgboye EA, Sani MU. Differentials in lifestyle practices and determinants among hypertensive adults from three geopolitical zones in Nigeria.\u003c/li\u003e\n \u003cli\u003eBuda ES, Hanfore LK, Fite RO, Buda AS. Lifestyle modification practice and associated factors among diagnosed hypertensive patients in selected hospitals, South Ethiopia. Clin Hypertens. 2017;23(1):1\u0026ndash;9.\u003c/li\u003e\n \u003cli\u003eKiberenge MW, Ndegwa ZM, Njenga EW, Muchemi EW. Knowledge, attitude and practices related to diabetes among community members in four provinces in Kenya: a cross-sectional study. Pan Afr Med J. 2010;7:2.\u003c/li\u003e\n \u003cli\u003eBadego B, Yoseph A, Astatkie A. Prevalence and risk factors of hypertension among civil servants in Sidama Zone, south Ethiopia. PLoS One [Internet]. 2020;15(6 June 2020):1\u0026ndash;17. Available from: http://dx.doi.org/10.1371/journal.pone.0234485\u003c/li\u003e\n \u003cli\u003eVanitha D, Anitha Rani M. Knowledge and practice on lifestyle modifications among males with hypertension. Indian J Community Heal. 2015;27(1):143\u0026ndash;9.\u003c/li\u003e\n \u003cli\u003eGrimason AM, Masangwi SJ, Morse TD, Jabu GC, Beattie TK, Taulo SE, et al. Knowledge, awareness and practice of the importance of hand-washing amongst children attending state run primary schools in rural Malawi. Int J Environ Health Res. 2014;24(1):31\u0026ndash;43.\u003c/li\u003e\n \u003cli\u003eGaremo M, Elamin A, Gardner A. Weight status and food habits of preschool children in Abu Dhabi, United Arab Emirates: NOPLAS project. Asia Pac J Clin Nutr. 2018;27(6):1302\u0026ndash;14.\u003c/li\u003e\n \u003cli\u003eBhawra J and, Kirkpatrick. Patterns and correlates of nutrition knowledge across five countries in the 2018 international food policy study. Nutr J [Internet]. 2023;22(1):1\u0026ndash;12. Available from: https://doi.org/10.1186/s12937-023-00844-x\u003c/li\u003e\n \u003cli\u003eNg N, Hakimi M, Van Minh H, Juvekar S, Razzaque A, Ashraf A, et al. Prevalence of physical inactivity in nine rural indepth health and demographic surveillance systems in five asian countries. Glob Health Action. 2009;2(1):44\u0026ndash;53.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Healthy lifestyles, Healthy behaviors and Public Servants","lastPublishedDoi":"10.21203/rs.3.rs-5552669/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5552669/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Maintaining a healthy lifestyle is essential to lowering the global burden of non-communicable diseases. Living a healthy lifestyle reduces the likelihood of developing a severe illness or passing away too soon. Public officials frequently lead unhealthy lifestyles because they are time-pressed and face many challenges that could negatively impact their health. However, there is limited evidence on the level of healthy lifestyle practice and factors associated with unhealthy lifestyle practice among public servants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003eThis study aimed to assess healthy lifestyle practice level and associated factors among public servants working in Fiche Town, Oromia, Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003cem\u003e:\u003c/em\u003e From April 1 to 30, 2022, 630 public servants participated in an institutional-based cross-sectional study. A self-administered, structured questionnaire was used to collect data from the participants. The data were entered into Epi-Data version 4.6 and then exported to SPSS version 26 for analysis. Descriptive statistics such as frequency, percentages, mean, and standard deviation were used to summarize the data. Variables that scored a p-value of less than 0.2 during the bivariate analysis were included in multilevel logistic regression. The odd ratio with a 95% confidence interval was estimated at the level of significance set at 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult: - \u003c/strong\u003eThe magnitude of poor health lifestyle practice among Fiche town public servants was 45.2% with a 95% confidence interval (CI) (41.4, 49.4). The study participants had poor attitude (23.7%), poor health lifestyle knowledge (55.4%), and poor physical activities (40.2%). The study participants who had a poor attitude, poor knowledge, poor physical activities, avoided extra salt from their diet, and knew about chronic non-communicable diseases were factors significantly associated with healthy lifestyle practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Generally, a healthy lifestyle practice among public servants was poor in Fiche Town. Therefore, public servants should be educated and counselled on the recommended healthy lifestyle practices that may help them avoid chronic non-communicable diseases and premature death.\u003c/p\u003e","manuscriptTitle":"Healthy LifeStyle Practice and Its Associated Factors among Public Servants in Fiche Town, Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-06 09:21:16","doi":"10.21203/rs.3.rs-5552669/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-13T06:52:45+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-13T06:52:02+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-01T09:36:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"249066648286044882915305630623554913291","date":"2025-05-01T05:40:23+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-30T02:43:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-30T02:41:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-04-29T04:39:18+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"08190c30-ffd7-4a56-aaf6-e19118ed4ae5","owner":[],"postedDate":"May 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-01T16:02:54+00:00","versionOfRecord":{"articleIdentity":"rs-5552669","link":"https://doi.org/10.1186/s12889-025-24402-8","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2025-08-27 15:58:06","publishedOnDateReadable":"August 27th, 2025"},"versionCreatedAt":"2025-05-06 09:21:16","video":"","vorDoi":"10.1186/s12889-025-24402-8","vorDoiUrl":"https://doi.org/10.1186/s12889-025-24402-8","workflowStages":[]},"version":"v1","identity":"rs-5552669","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5552669","identity":"rs-5552669","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}