The Impact of Health Literacy on Knowledge and Attitudes towards Preventive Strategies against COVID-19: A Cross-Sectional Study

Abstract

The coronavirus disease 2019 (COVID-19) pandemic introduced a set of mitigation measures based on personal behavior and attitudes. In the absence of vaccination or specific treatment, it became essential to comply with these measures to reduce infection transmission. Health literacy is the basis for changing behaviors. AIM: To characterize the impact of literacy on knowledge and attitudes towards preventive strategies against COVID-19. METHODS: This cross-sectional study involved an online questionnaire applied to students of the University of Porto, Portugal, containing questions about knowledge and attitudes towards COVID-19 based on European guidelines. Health literacy was assessed through the Newest Vital Sign questionnaire. Logistic regression estimated the relationship between health literacy and both knowledge and attitudes. RESULTS: We included 871 participants (76.3% female), with a median age of 22 years old. We found adequate literacy in 92% of our sample, irrespective of gender and age. In the global analysis, 78.6% of the participants had adequate knowledge, and 90.4% had adequate attitudes. We found that better literacy was significantly associated with attitudes towards COVID-19, but not with better knowledge. In a model adjusted for gender, age, and previous education in the health field, female gender and previous education in the health field were associated with better knowledge and attitudes. CONCLUSION: Better health literacy is associated with better attitudes towards preventive strategies against COVID-19. We should invest in ways to improve health literacy, so we can improve people’s attitudes and consequently reduce coronavirus’ transmission.

Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population

“…The European HL survey showed that 47% of the individuals had inadequate HL [14]. A recent study in Portuguese reported adequate HL in 92% of the sample [47]. The population characteristics of these studies were different (literate or specific age groups vs. representative population) and they measured different domains of HL (functional HL in the current study vs. critical/interactive HL).…”

“…The authors explained this phenomenon based on 'patient inertia', which is a state that involves lack of motivation to indulge in healthy behaviours, which further delays protective behaviours despite being cognisant of the benefits and consequences of such actions. A recent study that assessed the association of HL with disease knowledge reported no significant association of HL with disease knowledge of the ongoing pandemic, whereas a significant association was noted with attitudes towards prevention strategies [47]. The authors explained that while knowledge is important, it is not sufficient to bring about a positive change in behaviour.…”

Measuring COVID-19 Related Health Literacy in Healthcare Professionals—Psychometric Evaluation of the HL-COV-HP Instrument

“…A higher level of health literacy, especially e-health literacy, is associated with COVID-19 awareness [8], positive attitudes towards preventive strategies against COVID-19 [9][10][11][12][13][14], and a higher adherence to prevention guidelines [8,15]. Health literacy is positively associated with COVID-19 vaccination acceptance [16] and can mitigate the negative effects of healthcare system distrust on vaccination willingness [17,18].…”

“…While there is a growing body of research on aspects of COVID-19 related health literacy of the general population [4,15,16,22] or specific populations, e.g., migrants, children, students, or patients [8][9][10][11]13,[19][20][21]23], little is known about the COVID-19 related health literacy of healthcare professionals, such as physicians, nurses, or psychologists. Since 2020, many studies have investigated the knowledge, attitude, and behavior of healthcare professionals worldwide [24][25][26][27][28][29][30][31][32][33][34].…”

The Effects of Health Promotion Literacy Program on Knowledge and Health Behaviors of National Health Recommendations among Middle School Students

“…It makes level individual ability to access, understand, and use information excellently. Health Literacy is promoted and maintain always good health (Health Education Division, Department of Health Service Support, 2019; Kaeodumkoeng, 2018;Silva & Santos, 2021). The Ministry of Health has the 12th National Health Development plan (2017)(2018)(2019)(2020)(2021).…”