How did individual differences in neurocognition and health literacy influence the initial uptake and use of health-related information about COVID-19?

Abstract

Objective: The rapid development of coronavirus disease 2019 (COVID-19) into a pandemic required people to quickly acquire, evaluate, and apply novel complex health-related information about the virus and transmission risks. This study examined the possible interplay between neurocognition and health literacy in the early uptake and use of COVID-19 public health information. Method: Data were collected between April 23 and May 21, 2020, a period during which 42 out of 50 states were under a stay-at-home order. Participants were 217 healthy adults who completed a telephone-based battery that included standard tests of neurocognition, health literacy, verbal IQ, personality, and anxiety. Participants also completed measures of COVID-19 information-seeking skills, knowledge, prevention intentions, and prevention behaviors. Results: A series of hierarchical multiple regressions with data-driven covariates showed that neurocognition (viz, episodic verbal memory and executive functions) was independently related to COVID-19 knowledge (e.g., symptoms, risks) at a medium effect size, but not to informationseeking skills, prevention intentions, or prevention behaviors. Health literacy was independently related to all measured aspects of COVID-19 health information and did not interact with neurocognition in any COVID-19 health domain. Conclusions: Individual differences in neurocognition and health literacy played independent and meaningful roles in the initial acquisition of knowledge related to COVID-19, which is a novel human health condition. Future studies might examine whether neurocognitive supports (e.g., spaced retrieval practice, elaboration) can improve COVID-19-related knowledge and health behaviors in vulnerable populations.

Knowledge About COVID-19 Symptoms, Transmission, and Prevention: The Relationship With Cognitive Status in Older Adults

“…These findings correspond with prior studies that show disease related knowledge of medical conditions such as diabetes, hypertension, and heart disease is associated with cognitive functioning (Levinthal et al, 2008;Morrow et al, 2006;Wykes et al, 2017). With respect to COVID-19 knowledge, our findings are consistent with Babicz et al (2021) who found that greater accuracy was predicted by better memory and executive function. As noted by these investigators, an association with memory is intuitive since it is critical for encoding and retention of information.…”

“…However, the possible impact of cognitive status was not investigated in their study. In contrast, Babicz et al. (2021) found that lower cognitive functioning is associated with poorer knowledge of COVID-19 symptoms.…”

“…However, the possible impact of cognitive status was not investigated in their study. In contrast, Babicz et al (2021) found that lower cognitive functioning is associated with poorer knowledge of COVID-19 symptoms. These investigators conducted a telephonebased survey of COVID-19 symptom and preventive knowledge in individuals with a mean age of 35 years (range = 18-77).…”

“…Likewise, it makes sense that being oriented is a necessary component of acquisition and retention. Intact executive functioning guides the initial organization of to-be-learned information and retrieval strategies ( Babicz et al, 2021 ). More detailed cognitive testing may have revealed additional associations that were not appreciated in the current study.…”

“…A challenge is to promote public health messages that are tailored to provide older adults, including those with cognitive impairment, with effective education about disease risks. Compensatory strategies such as spaced retrieval and elaboration have been proposed as having possible value ( Babicz et al, 2021 ) but have not yet been applied to acquisition and retention of COVID-19 knowledge. Another challenge is that health knowledge is necessary but not sufficient for translation into adherence behaviors.…”