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The collected data included socio-demographic information and measurements of health literacy, e-health literacy, men-tal well-being, and sleep hygiene behaviors. The study aimed to provide insights regarding health literacy status and re-lated factors in the general population residing in Qazvin province, Iran. The findings of the study will assist health au-thorities and policy makers in developing and implementing effective interventions, which in turn, improving health lit-eracy in the community. Additionally, the findings can also aid health sector workers, including non-communicable dis-ease researchers, public health experts, health education spe-cialists, epidemiologists, and sociologists, in their work to improve health literacy and overall health outcomes among general population. Therefore, the present study used paper-pencil method with multi-stage cluster sampling to collect data. Trained research associates (n = 25) collected data from9775 people living in Qazvin province between January and April 2022. All the participants completed the study ques-tionnaires using self-reported paper-pencil mode.

Background Health literacy and e-health literacy are important factors helping people shape awareness of health behaviours in different aspects, including sleep hygiene behaviours. Good sleep hygiene behaviours promote sleep quality and are beneficial to overall mental wellbeing. Objective We aimed to examine if sleep hygiene behaviours may mediate the association between health literacy/e-health literacy and mental wellbeing. Methods Adult Iranian subjects (n = 9775; mean [SD] age = 36.44 [11.97] years; 67.3% females) completed the Health Literacy Instrument for Adults, eHealth Literacy Scale, three items on sleep hygiene behaviour that have been used in prior research and the Short Warwick Edinburgh Mental Wellbeing Scale. Data were then subjected to structural equation modelling (SEM) including 500 bootstrapping resampling to examine whether sleep hygiene is a mediator in the relationship between health literacy/e-health literacy and mental wellbeing. Findings Both health literacy and e-health literacy were significantly associated with mental wellbeing (r = .63 for health literacy and .39 for e-health literacy; p < .001) and sleep hygiene behaviours (r = .58 for health literacy and .36 for e-health literacy; p < .001). Sleep hygiene behaviours were significantly associated with mental wellbeing (r = .42; p < .001). Moreover, SEM that incorporated bootstrapping approaches indicated that sleep hygiene behaviours were significant mediators in the association between health literacy/e-health literacy and mental wellbeing. Conclusions We conclude that health literacy and e-health literacy are associated with mental health wellbeing in the Iranian population. Additionally, the association could be mediated via sleep hygiene behaviours. Patient or Public Contribution The study was co-designed with healthcare providers from the vice-Chancellor's Office for Health Affairs of Qazvin University of Medical Sciences as equal partners. Moreover, the women's health vo