The Role of Health Literacy in COVID-19 Preventive Behaviors and Infection Risk Perception: Evidence from a Population-Based Sample of Essential Frontline Workers during the Lockdown in the Province of Prato (Tuscany, Italy).

Vieri Lastrucci,Paolo Bonanni,Andrea Moscadelli,Angela Bechini,Sara Boccalini,Eleonora Gori,Fabrizio Chiesi,Francesco Puggelli,Marco Del Riccio,Renzo Berti,Guglielmo Bonaccorsi,Chiara Lorini,Beatrice Zanella

doi:10.3390/ijerph182413386

Abstract

Background: The effectiveness of pandemic control measures requires a broad understanding from the population. This study aimed to evaluate the role played by health literacy (HL) in influencing the adherence to COVID-19 preventive measures and risk perception of essential frontline workers during the lockdown period. Methods: A cross-sectional survey was conducted on a population-based sample of frontline workers from Prato Province (Italy). Data on knowledge, attitudes and practices towards COVID-19 preventive measures and risk perception were collected. HL was measured with the HLS-EU-Q6 tool. Multivariate linear regression analyses were performed. Results: A total of 751 people participated in this study, and 56% of the sample showed a sufficient level of HL. In the multivariate models, HL resulted in being positively correlated with both knowledge (beta 0.32 for sufficient HL, 0.11 for problematic HL) and attitudes (beta 0.33 for sufficient HL, 0.17 for problematic HL) towards the importance of COVID-19 preventive measures. The HL level was not associated with the adoption of preventive behaviors and COVID-19 risk perception. Conclusions: HL may play a key role in maintaining a high adherence to infection prevention behaviors and may be a factor to take into account in the implementation of public health interventions in pandemic times.

Highlights

COVID-19 disease is caused by a highly transmissible and pathogenic coronavirus—SARS-CoV-2—that emerged in 2019 and rapidly became a major public health issue
The results of multivariate linear regression analyses showed that the level of health literacy (HL) of participants positively predicted the level of knowledge on COVID-19 prevention measures and the attitude towards the importance of adopting those measures, whereas the level of HL did not significantly predict the implementation of COVID-19 prevention behaviors
The present study investigated the role of HL in influencing the knowledge, attitudes and practices towards COVID-19 prevention and risk perception in a representative sample of workers in essential public services during the first lockdown period

Summary

Introduction

COVID-19 disease is caused by a highly transmissible and pathogenic coronavirus—SARS-CoV-2—that emerged in 2019 and rapidly became a major public health issue. Until early 2021, there were no vaccines for COVID-19, and countries were reliant on the implementation of large-scale. The effectiveness of pandemic control measures requires a broad understanding from the population. This study aimed to evaluate the role played by health literacy (HL). In influencing the adherence to COVID-19 preventive measures and risk perception of essential frontline workers during the lockdown period. Methods: A cross-sectional survey was conducted on a population-based sample of frontline workers from Prato Province (Italy). Attitudes and practices towards COVID-19 preventive measures and risk perception were collected. HL resulted in being positively correlated with both knowledge (beta 0.32 for sufficient HL, 0.11 for problematic HL) and attitudes (beta 0.33 for sufficient HL, 0.17 for problematic HL) towards the importance of COVID-19 preventive measures

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