Coronavirus-Related Health Literacy in Germany: A Cross-Sectional Study in Adults During the COVID-19 Infodemic

Abstract

Background: The COVID-19 pandemic is surrounded by an infodemic – an overabundance of valid and invalid health information. Health literacy is the ability to access, understand, appraise and apply health information, making it crucial for navigating coronavirus and COVID-19 information environments. The aim of this cross-sectional study is to investigate health literacy in relation to coronavirus and the associated infodemic. Methods: A cross sectional representative study of participants ≥16 years in Germany was conducted using an online survey. A coronavirus-related health literacy measure was developed (HLS-COVID-Q22). Reliability and validity were evaluated by applying internal consistency and confirmatory factor analyses. Health literacy data was analysed using descriptive statistics and bivariate correlations. Findings: Internal consistency for the HLS-COVID-Q22 was very high (α = ·940; ρ = ·891). 50·1% of our sample had “problematic” (15·2%) or “inadequate” (34·9%) health literacy and 49·9% had sufficient health literacy. The participants felt well informed about coronavirus but 47·8% reported having difficulties judging whether they could trust media information on COVID-19. Confusion about coronavirus information was significantly higher among those who had lower health literacy. Interpretation: HLS-COVID-Q22 is a feasible tool for assessing coronavirus-related health literacy in population surveys. While the overall level of health literacy is high, a vast number of participants report difficulties dealing with coronavirus information. This calls for targeted public information campaigns and promotion of population-based health literacy for better navigation of the infodemic, identification of disinformation, and decision-making based on reliable and trustworthy information. Funding: German Federal Ministry of Education and Research (BMBF), Orkan Okan and Torsten Michael Bollweg received funding (01EL1824A; grant holder Ullrich Bauer) from the Federal Ministry of Education and Research: Health Literacy in Childhood and Adolescence (HLCA) for this work. Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: This study was approved by the Bielefeld University Ethics Board (Reference No 2020-060_S). All personal data obtained was anonymized by Allensbach, and Bielefeld University study group received a fully anonymized. Data protection procedures were covered in adherence with the European Union General Data Protection Regulation (EU) (GDPR).