ABSTRACT
This paper investigates the economic impact of the three tiers risk framework implemented in Italy against the COVID-19 pandemic during the Autumn of 2020. Exploiting a large-scale dataset encompassing daily credit card transactions mediated by a large Italian bank, we estimate a set of panel event study models to disentangle the impact of restrictions with low, medium and high stringency levels in terms of consumption reduction. We show that space-time differentiated policies tend to produce stronger welfare losses for progressively more stringent restrictions in specific sectors targeted by these policies such as Retail and Restaurants. However, when we compare provinces implementing the same level of policy stringency, we show that territories with higher income per capita and larger concentration of manufacturing and service activities experience both significantly worse economic and epidemiological performances. Overall, our results suggest that policy makers should properly account for local socio-economic characteristics when designing tailored restrictions entailing an equal and homogeneous impact across territories. © The Author(s) 2023.
ABSTRACT
During the Covid-19 pandemic, individual and collective public health measures were undertaken to control the spread of the virus. Their effectiveness relies on people’s abilities to understand and adopt the correct behaviors. This study aims to evaluate the role of Health Literacy (HL) in influencing the adherence to Covid-19 preventive measures and risk perception of a sample of workers employed in various activities involving close contact with the population in the province of Prato (Tuscany, Italy) in the second pandemic wave (November-December 2020). A cross-sectional survey was conducted on a sample of public workers (e.g., teachers, educators, assistants/aides, other health personnel). Data on knowledge, attitudes and practices towards (KAP) Covid-19 preventive measures and risk perception were collected. HL was measured with the HLS-EU-Q6 tool. Spearman correlation analysis was used to assess the correlation between HL and KAP and Covid-19 risk perception. Multivariate linear regression analyses were performed to evaluate the role of HL in predicting KAP and Covid-19 risk perception, adjusted for sex, age, comorbidity, educational level, country of birth. A total of 402 people participated in this study;47.8% had a problematic HL level. The HL level was correlated with KAP and practices towards Covid-19 prevention measures;no significant associations were found with Covid-19 risk perception. In multivariate models, HL significantly and positively predicted a higher level of knowledge of Covid-19 preventive measures (B = 0.413 for problematic HL;B = 0.542 for sufficient HL). Confirming a previous study conducted in Prato in the first pandemic wave, HL did not predict adherence to Covid-19 infection control measures, probably due to fear of the disease and attention towards prevention behaviors being still higher in the second pandemic wave. Key messages • HL skills are linked to understanding of public health measures. • HL skills should be improved to favor the adherence to correct behaviors.
ABSTRACT
Background The COVID-19 pandemic caused an overabundance of valid and invalid information rapidly spread via traditional media, by internet and digital communication. Health Literacy (HL), as the ability to access, understand, appraise, apply health information, is fundamental for finding, interpreting, correctly using COVID-19 information. Methods In 2021, in the framework of the participation to the WHO M-POHL (Measuring Population and Organizational Health Literacy) network, a survey was conducted in a representative sample of the Italian general population aged 18+ years (N = 3,500). The validated HL questionnaire included coronavirus-related HL (HL-COVID, 16-items), general HL, sociodemographic characteristics, risk factors, lifestyles sections. For the HL-items, a 4-point Likert scale was applied: very easy, easy, difficult, very difficult. HL-COVID levels were defined as Good: very easy+easy>81.3% (more than 12 of 16 answers);Sufficient: 50.0%<very easy+easy < =81.3% (9-12 of 16 answers);Limited: very easy+easy < =50.0% (fewer than 9 of 16 answers). Elderly were responders aged 65+ years, the remaining ones were defined as adults. Ordinal Logistic Regression analysis was performed to assess the association of HL-COVID with sociodemographic characteristics (sex, age-group, educational level, financial deprivation). Results Good HL-COVID prevalence was lower in elderly than in adults (44.8% vs. 51.0%, p-value=0.001);the opposite for both sufficient (22.8% vs. 19.9%) and limited (32.5% vs. 29.1%) levels, but not statistically significant. The odds of a low HL-COVID (sufficient/limited) increased by 31% in the elderly and by 50%, 92%, and almost triple in persons with a low, considerable, and severe financial deprivation level, respectively. Conclusions The COVID-19 pandemic highlighted the need to improve HL and to prepare the general population for future emergency and non-emergency situations, confirming that HL can be considered a social vaccine. Key messages Low coronavirus-related HL level is mostly associated to elderly and to increasing deprivation level. The COVID-19 pandemic confirmed that Health Literacy can be considered a social vaccine.
ABSTRACT
Introduction In Italy, COVID-19 vaccination campaign for school personnel started in February 2021 and began mandatory from 15th December 2021 to all the people who work within schools. Here we described Italian school principals’ beliefs about vaccines and its association with feelings about information regarding coronavirus, COVID-19 and the pandemic. Methods Data collection started in October 2021 and is ongoing. Beliefs about vaccines were investigated both for COVID-19 vaccination and for vaccination in general. Results A total of 726 questionnaires were analyzed so far. The majority feels to be well informed about the coronavirus or the pandemic (75%) and not at all nor a little confused about COVID-19 information (89%). Only 2% disagree/strongly disagree with the statement “vaccination is compatible with my attitudes or religious beliefs”. Beliefs regarding vaccines in general are correlated with those regarding COVID-19 vaccines. When different beliefs are described, we observed a trend towards considering COVID-19 vaccines less safe and effective, but more important to protect themselves and their family than other vaccines. Moreover, beliefs about vaccination in general and regarding COVID-19 are associated with how well they feel informed about the coronavirus or the pandemic, and whether they feel confused about COVID-19 information. In particular: the better they feel informed about the coronavirus and the related pandemic, the higher the perception of vaccines in general and COVID-19 vaccine as important, safe, and effective;the less they feel confused about COVID-19 information. Conclusions School principals showed a high level of confidence on vaccines. The association between beliefs in vaccinations and the characteristics of information about COVID-19 supported the effectiveness of Italian vaccination policy and information campaigns.
ABSTRACT
Gender appears to be a strong predictor of online health information-seeking behaviour (OHISB). Gender differences in OHISB have been studied in different countries with different results, but no studies investigated gender-specific behaviour among University students during the COVID-19 pandemic, which has brought with it a consequential infodemic. We sought to investigate any gender differences in OHISB in the period between the first and the second wave of the COVID-19 pandemic. A questionnaire promoted by the COVID-HL network was administered to 2996 students of all the courses at the University of Florence. It included existing validated scales adapted to the COVID-19 pandemic and newly developed scales. Gender differences were tested using the χ2 test or the Mann-Whitney U test, where appropriate. Male students reported a higher score in DHL than females (p < 0.001). However, female students reported using more often different sources for online information seeking (p < 0.05, except for YouTube), searching more corona-related topics (p < 0.05, except for economic and social consequences) and considering ‘‘very important'’ each item in the ‘‘Importance of internet information search'’ section (p < 0.05). Furthermore, female students are more likely to be ‘‘often dissatisfied'’ or ‘‘partly satisfied'’ with information about COVID-19 (p < 0.001) and to search more often for information for themselves and other people. Our study confirmed that gender could affect the way students search for health information on the Internet. Since students, in particular females, have been affected by stress and anxiety during the pandemic, these findings could help institutions to promote gender-specific education programmes to improve students’ DHL and their mental health outcomes, as well as to provide health information that fit specific gender needs. Key messages • Gender influences how university students search on the Internet for health information. • This should guide institutions to better address educational programmes to improve their Digital Health Literacy.
ABSTRACT
Background In order to support primary care during the first pandemic wave (March 2020), the Italian Government instituted multiprofessional health teams called “USCA” (Special Continuity Care Units), which ensured continuity of care for COVID-19 patients who do not need hospitalization. The aim of our study was to compare the volumes of USCA service utilization in Florence (Tuscany, Italy) during the peak of home visits of three pandemic waves. Methods This single-center study followed a retrospective cross-sectional design. The USCA of the Heath District of Florence served a population of 366,190 people. The following data were collected: home medical visits, nursing home (NH) visits, visits in health-care hotels. The peak periods of three epidemic waves were considered in the analyses: the second wave (23 October - 20 November 2020), the third wave (25 March - 22 April 2021), and the Omicron period (27 December 2021 - 6 February 2022). The maximum 7-day moving averages of the daily number of visits during the three periods were calculated. Relative percent differences for visits comparing the considered periods were computed. Results Home visits during the third pandemic wave increased by 14% compared to the second wave (second wave: N = 1370, third wave: N = 1562), while a decrease was observed during the Omicron period (Omicron vs third wave: -21%;peak value: 41 vs 60). Visits in health-care hotels during the third wave doubled compared to the second wave. After the start of the COVID-19 vaccination campaign, NH visits steeply declined (third wave vs second wave: -95%;N = 323 vs 15;peak value= 14 vs 2 visits per day). During the Omicron period, NH visits increased by almost four times compared to the third wave period. Conclusions The USCA service utilization was significant in all the analyzed periods. In a pandemic context, it is necessary to strengthen primary care services such as USCA, which have proved to respond to rapidly changing health needs. Key messages • The USCA service is an innovative model of integrated home care that has proved to respond to rapidly changing health needs during all phases of the COVID-19 pandemic. • The USCA service utilization was significant during all phases of the pandemic. The USCA service has introduced new ways of working and new relationships between services in primary care.
ABSTRACT
Covid-19 is a pandemic and an infodemic, with contrasting information regarding risk and preventive measures, including vaccination. This study aims to assess Vaccine Literacy (VL) of a sample of workers in the province of Prato (Tuscany, Italy) in the second wave of the Covid-19 pandemic (November-December 2020) and to analyze the relationship between VL and attitudes about Covid-19 and flu vaccination. A cross-sectional design was adopted. Sociodemographic characteristics, health information, vaccination behaviour for past and current flu season and intention to get vaccinated against Covid-19 were collected. A multivariate logistic regression was performed to identify predictors of getting a Covid-19/flu vaccination. The Italian Health Literacy tool on Vaccination (HLVa-IT) tool was used to measure VL. A total of 117 questionnaires were analyzed. Among them, 64.9% intended to get Covid-19 vaccine. The mean VL was 3.18 ± 0.43 (functional 2.87 ± 0.72;interactive-critical 3.36 ± 0.45) out of 4. Having more than one comorbidity was a negative predictor of intention to get Covid-19 vaccine (OR: 0.21 95%CI: 0.04 - 0.91). Regarding the flu vaccine, being vaccinated in the previous season was the only positive predictor of being vaccinated in the current season (OR = 24.25 95%CI 7.96 - 87.73). The study was conducted before the authorization of Covid-19 vaccines: little information about them may have contributed to VL not being related to the intention to get vaccination. The negative role of comorbidities could be due to fear of adverse effects on fragile health status. For flu vaccination, VL may have exerted a lower impact because of the positive experience with the flu vaccine in terms of safety and effectiveness in the previous seasons. Key messages • The introduction of new vaccines should be supported by effective communication. • Better knowledge of current vaccines and not just routine administration is desirable for greater personal empowerment.
ABSTRACT
In the first COVID-19 pandemic period, when no vaccines were available, individual behaviours were essential for controlling the spread of the virus. In this context of rapidly changing guidance, emerging new evidence, fake news and misinformation, there have been new challenges for health literacy (HL). This study explored whether guidance-compliant healthy behaviours were associated with HL in individuals who have performed essential activities (public employees and volunteers of the Civil Protection) during the lock-down period in the Province of Prato, Italy. Items on knowledge, attitudes and practices (KAP) towards COVID-19 preventive measures and COVID-19 risk perception, along with the Italian version of the 6-items European Health Literacy Survey Questionnaire (HLS-EU-Q6), were collected using a self-administered structured questionnaire. In May 2020, 751 responses were collected;respondents were mostly males (59%), younger than 65 years old (83.5%), with sufficient HL (56%), and never smokers (54.2%). Most of the items related to the KAP towards COVID-19 preventive measures were significantly correlated with the HLS-EU-Q6 score in the total sample. In the multiple linear model, HL results to be a predictor of both a better self-reported knowledge of COVID-19 preventive measures (beta 0.32 for sufficient HL, 0.11 for problematic HL, 1.00 for inadequate HL) and a higher score of attitude towards the importance of COVID-19 preventive measures (beta 0.33 for sufficient HL, 0.17 for problematic HL, 1.00 for inadequate HL), while it has no role in predicting a higher risk perception. These findings can be useful to understand the importance of HL in promoting guidance-compliant healthy behaviours and in helping people to understand the rapidly changing public health messages and then act accordingly. Key messages Lower levels of Health Literacy predict poor COVID-19 related knowledge and a worse attitudes towards the importance of COVID-19 preventive measures. Health Literacy may be an important factor in promoting guidance-compliant healthy behaviours and in helping people to understand the rapidly changing public health messages and then act accordingly.