To date, we know little about COVID-19-related health literacy among school leaders, particularly in East Asia. The present study aimed to assess the level of COVID-19-related health literacy and associated factors (vaccine hesitancy, self-endangering behaviour, and work satisfaction) among school leaders in Hong Kong. A cross-sectional study of 259 school leaders was carried out during the COVID-19 pandemic between April 2021 and February 2022. COVID-19-related health literacy using HLS-COVID-Q22, three subscales of self-endangering work behaviour scales (i.e., “extensification of work”, “intensification of work” and “quality reduction”), and two dimensions of Burnout Assessment Tool (BAT) (i.e., psychosomatic complaints and exhaustion) were used. The study employed independent sample t-test, ANOVA, and multilinear regression models. The findings show that more than half (53.7%) of school leaders had insufficient health literacy. Participants with insufficient health literacy scored significantly higher in the following factors: exhaustion related to work situation (p = 0.029), psychosomatic complaints (p < 0.001), attitude about vaccination (i.e., less agree with vaccination) (p < 0.001), level of informing on COVID-19 related information (i.e., felt less informed) (p < 0.001), and level of confusion about COVID-19-related information (i.e., felt more confused) (p < 0.001). In a linear regression model predicting attitude about coronavirus vaccination, age (β, −0.188, 95% CI, −0.024, −0.005, p = 0.002) and health literacy (β, −0.395, 95% CI, −0.716, −0.361, p < 0.001) were the negative predictors, F(5, 214) = 11.859, p < 0.001. For the linear regression model adjusted for sex and age for predicting health literacy, the model was insignificant. Despite being a highly educated group, this study reveals that one in two Hong Kong school leaders have insufficient health literacy. Inadequate health literacy was strongly associated with a negative attitude about vaccination, low information, and confusion about COVID-19-related information. Additionally, insufficient health literacy was associated with the two secondary symptoms of burnouts. The study highlights an urgent need to develop intervention programmes to promote the COVID-19-specific as well as overall health literacy of the school leaders.

School teachers have faced many challenges due to the coronavirus disease-2019 (COVID-19) pandemic and public health-related containment measures. Recent studies have demonstrated high levels of stress and mental health issues among school teachers. To better understand teacher well-being and inform practices to support them in the face of the ongoing pandemic, we aimed to assess perceived stress, well-being and associated factors among school teachers in Hong Kong, China. For this cross-sectional study, we employed a self-reported questionnaire to assess teacher well-being as an indicator of mental health. Drawing on quantitative data obtained from 336 teachers in Hong Kong from April 2021 to February 2022, we assessed workloads, work-related sense of coherence, perceived stress, secondary burnout symptoms (i.e. intensification of work and exhaustion related to work situation), self-endangering work behaviours and satisfaction with work. Bivariate and multivariate analyses were performed to examine the associations between well-being, demographic and work characteristics. A high percentage (87.6%) of teachers had high levels of perceived stress, which was positively associated with extensification of work (r = 0.571, p < 0.01), intensification of work (r = 0.640, p < 0.01) and exhaustion related to work situation (r = 0.554, p < 0.01). A multilinear regression model adjusted for age and gender was computed to detect predictors of teachers’ well-being index values (F(12, 296) = 41.405, p < 0.001, R2 = 0.627). A higher WHO-5 score was associated with (1) higher teaching hours (B = 0.235, 95% CI = 0.093, 0.413, p = 0.002); (2) higher work-related sense of coherence (B = 2.490, 95% CI = 0.209, 4.770, p = 0.032); (3) higher work satisfaction (B = 5.410, 95% CI = 2.979, 7.841, p < 0.001); (4) lower level of exhaustion related to work situations (B = −9.677, 95% CI = −12.279, −7.075, p < 0.001); and (5) lower level of psychosomatic complaints (B = −4.167, 95% CI = −6.739, −7.075, p = 0.002). These findings highlight the critical need to allocate more attention and resources to improve the mental health of school teachers in Hong Kong. The findings can also inform the development of psychological and organisational interventions and support mechanisms for teachers during the prolonged COVID-19 pandemic and in preparation for future stressful scenarios. Safeguarding the well-being and mental health of teachers is important for improving the quality of teaching and learning environments and the mental health of school students.

The health and well-being of school leaders during the COVID-19 pandemic have been largely neglected compared to the health and well-being of students and teachers. This study assessed the magnitude of perceived stress and well-being and the associated factors, including number of working hours, work-related sense of coherence (work-SoC), perceived stress, self-endangering work behaviour, secondary burnout symptoms, and satisfaction with work, among school leaders in Hong Kong, China during the COVID-19 pandemic. This cross-sectional, survey-based study collected demographic data and mental health measurements from 259 eligible school leaders in Hong Kong from April 2021 to February 2022. Pearson’s correlation analyses, multilinear regression models, and independent-samples Student’s t-tests were performed. The findings revealed that school leaders’ perceived stress was negatively correlated with their well-being (r = −0.544, p < 0.01) and work-related SoC (r = −0.327, p < 0.01) but positively correlated with their extensification of work (r = 0.473, p < 0.01), exhaustion related to work situations (r = 0.559, p < 0.01), and psychosomatic complaints (r = 0.439, p < 0.01). In a model that adjusted for gender and age, student leaders with higher subjective well-being scores had a lower level of perceived stress (B = −0.031; 95% confidence interval [CI], −0.59, −0.02; p = 0.034), whereas leaders in schools with a larger student population had a higher level of perceived stress (B = 0.002; 95% CI, 0.000, 0.003; p = 0.030). School leaders with a higher likelihood of performing the self-endangering work behaviour of ‘intensification of work’ had higher perceived stress levels (B = 1.497; 95% CI, 0.717, 2.278; p < 0.001). School leaders with a higher work-related SoC (B = 4.20; 95% CI, 1.290, 7.106; p = 0.005) had a higher level of well-being. School leaders with higher levels of perceived stress (B = −0.734; 95% CI, −1.423, −0.044; p = 0.037), a higher likelihood of performing the self-endangering work behaviour of ‘extensification of work’ (B = −4.846; 95% CI, −8.543, −1.149; p = 0.010), and a higher score for exhaustion related to work (B = −10.449; 95% CI, −13.864, −7.033; p = 0.000) showed lower levels of well-being. The finding of a high incidence of stress among school leadership justifies the need for more societal attention to the well-being of school leaders in Hong Kong. It is important that policies and initiatives are designed to enhance the well-being of school leaders and that they are supported in leading the management of schools and coping with stress in school settings.

ObjectivesThe coronavirus disease 2019 (COVID-19) pandemic developed rapidly, with changing guidelines, misinformation, inaccurate health information and rumors. This situation has highlighted the importance of health literacy, especially among educators. The aims of this study were (i) to assess COVID-19-specific health literacy among school teachers in Hong Kong and (ii) to examine its association with demographic factors, self-endangering work behaviors (i.e., work intensification, work extensification and work quality reduction), secondary burnout symptoms (i.e., exhaustion related to work and psychosomatic complaints), the level of knowledge of COVID-19- or pandemic-related information and the level of confusion about COVID-19-related information.MethodsA self-report survey was administered to 366 Hong Kong school teachers from April 2021 to February 2022. COVID-19-specific health literacy was measured using the HLS-COVID-Q22 instrument. Other instruments, including self-endangering work behavior scales (i.e., extensification of work, intensification of work and work quality reduction) and two dimensions of the Burnout Assessment Tool (i.e., psychosomatic complaints and exhaustion) were also used for assessment. Data were analyzed using an independent samples Student's t-test, analysis of variance, correlation analysis and adjusted multilinear regression models.ResultsThe results showed that 50.8% of school teachers had sufficient health literacy, 38.3% had problematic health literacy and 10.9% had inadequate health literacy. The HLS-COVID score did not vary by sex, but varied according to the type of school, the number of working hours per week and the number of students attending the school. Teachers with sufficient health literacy scored significantly lower for two types of self-endangering work behavior–intensification of work (p = 0.003) and work quality reduction (p = 0.007)—than those with insufficient health literacy. After excluding those who had already been vaccinated, respondents with sufficient health literacy felt more positive about COVID-19 vaccination than those with insufficient health literacy (t[180] = 4.168, p &lt; 0.001). In addition, teachers with sufficient health literacy felt more informed (p &lt; 0.001) and less confused (p &lt; 0.001) about COVID-19-related information than those with insufficient health literacy. Multiple linear regression analysis revealed that age (β = 0.14, p = 0.011) and the number of teaching hours per week (β = −0.206, p &lt; 0.001) were significant predictors of the HLS-COVID score.ConclusionsThe findings of this study may serve as a guide for addressing health literacy gaps among school teachers.