Objective   To examine the status and influencing factors of health knowledge and behavior literacy among residents in Hubei province and to provide evidences for making health education and intervention plan.

  Methods   A self-administrated questionnaire survey was conducted among 630 adult residents ( ≥ 15 years old) selected with multistage stratified sampling in 3 urban and 3 rural regions in Hubei province between October 2014 and January 2015.

  Results   Of the participants, 28.36% and 31.97% demonstrated adequate literacy for health knowledge and health behavior. The top two health knowledge items answered correctly by 90.33% and 90.00% of the participants were whether a hypertension patient could have heavy alcohol drinking and whether maternal smoking during pregnancy may affect fetal development; while the two items answered correctly only by 26.39% and 35.74% of the participants were the recommended daily salt intake for an adult and whether a mosquito bite could transmit acquired immunodeficiency syndrome (AIDS). The health behavior most frequently reported by 78.03% of the participants was quitting smoking and restricting alcohol consumption and the behaviors less frequently reported by 35.08% and 29.51% of the participants were rational diet and physical exercise. The results of χ² test showed that health knowledge level differed by gender, age, education, occupation, and personal annual income (P < 0.05 for all); whereas the prevalence of health behaviors varied with gender, age, education, and occupation (all P < 0.05). Multivariate logistic regression analysis revealed that education level and personal annual income were main influencing factors of health knowledge literacy, and gender and occupation were main influencing factors of health behavior among the participants.

  Conclusion   The overall literacy level of health knowledge and behavior literacy is low and the inconsistence between health knowledge and health behavior exists among residents in Hubei province; the results suggest that specific health education programs should be implemented in populations with various characteristics.