What are the demographic predictors and barriers to self-care engagement in the UK? a cross-sectional survey study.

BACKGROUND: Understanding how people manage everyday health challenges is vital for developing self-care policies that are inclusive, equitable and effective. Little is known about how demographic characteristics shape self-care confidence, symptom management strategies and health-seeking behaviours across the UK adult population. While the companion paper from the same survey examined healthcare professionals' attitudes toward self-care and the professional-public interface, the demographic predictors and personal barriers shaping self-care engagement among the general UK public remain poorly understood. OBJECTIVE: To examine the demographic predictors of self-care engagement among UK adults, focusing on self-care confidence, health information-seeking behaviour, symptom management strategies and perceived barriers to self-care. DESIGN: Cross-sectional online survey conducted from June to September 2024. SETTING: Community-dwelling adults across the UK, recruited via online platforms and professional networks. PARTICIPANTS: 3,255 UK adults, including a subset of health and care professionals (HCPs). INTERVENTIONS: None (observational study). PRIMARY AND SECONDARY OUTCOME MEASURES: Self-reported self-care confidence, health information-seeking behaviours, symptom management strategies and barriers to self-care. RESULTS: Regression analyses highlighted marked demographic disparities in self-care engagement. Older adults (65+) were significantly more confident in their self-care knowledge (aOR=3.22, 95% CI 2.06 to 5.03, p<0.001) and healthy lifestyle behaviours (aOR=2.96) and were also more likely to seek health information. Males reported lower self-care confidence than females (aOR=0.79, 95% CI 0.68 to 0.91, p=0.002). Black British participants were more confident in self-care knowledge (aOR=1.99, 95% CI 1.39 to 2.84, p<0.001), but along with Asian British individuals, were significantly less likely to seek health information (aORs=0.56 and 0.70, respectively). People living with disabilities (aOR=0.69) and long-term conditions (aOR=0.76) reported lower confidence across self-care domains. HCPs consistently reported higher self-care confidence (aOR=1.51, p=0.006) and health behaviour engagement (aOR=1.66). Financial constraints (53%), lack of time (47%) and low self-efficacy (22%) emerged as key barriers to self-care, alongside low use of pharmacists (1.3%) and digital resources (9.7%). CONCLUSION: This study highlights demographic disparities in self-care confidence, information-seeking behaviours and barriers to engagement, urging the need for tailored self-care interventions. Future research should focus on targeted interventions to improve health literacy, enhance pharmacist-led self-care support and promote equitable access to digital health resources, particularly for underserved and demographically diverse population groups.