ABSTRACT
Background: The coronavirus disease-19 (COVID-19) pandemic has led to unprecedented morbidity and mortality across the world. Chronic disease patients of urban poor neighbourhoods are one of the most vulnerable population subgroups as the number of cases and deaths increase exponentially in India. The study aims to explore the factors associated with desirable health behaviours among chronic disease patients availing care from a primary health facility and examine their association with the COVID-19 preventive behaviour. Material and Methods: A cross-sectional study was conducted among chronic disease patients attending a health centre in an urban area of Jodhpur, Rajasthan. A interviewer administered semi-structured questionnaire was pilot tested and validated prior to initiation of data collection. A total of 520 patients were enrolled for the study. Results: Poor adherence to health behaviour was observed among a majority of the respondents (infrequent physical activity: 72.0%, one or less fruit serving per day: 96.5%, one or less vegetable serving per day: 88.8%). A factor analysis revealed three domains of COVID-19 preventive behaviour: sanitisation, preventive hygiene and social distancing. Multiple regression revealed respondents opting for COVID-19 screening and those with lower salt intake followed the overall and individual COVID-19 preventive behaviour. Conclusion: The health behaviour assessment and inter-personal counselling by the health care providers at the primary health facilities may contribute to the increasing adherence for the COVID-19 preventive behaviour among chronic disease patients.
ABSTRACT
BACKGROUND AND AIMS: Potential role of health literacy in determining adherence to COVID-19 preventive behavior, pharmacological, and lifestyle management among diagnosed patients of chronic diseases during nationwide lockdown is inadequately investigated. METHODS: A cross-sectional study was conducted from May-August 2020 among diagnosed patients of chronic diseases residing in a COVID-19 hotspot of urban Jodhpur, Rajasthan, and availing health services from primary care facility. Telephonic interviews of participants were conducted to determine their health literacy using HLS-EU-Q47 questionnaire, adherence to COVID-19 preventive behaviour as per World Health Organization recommendations, and compliance to prescribed pharmacological and physical activity recommendations for chronic disease. RESULTS: All the 605 diagnosed patients of chronic diseases availing services from primary care facility were contacted for the study, yielding response rate of 68% with 412 agreeing to participate. Insufficient health literacy was observed for 65.8% participants. Only about half of participants had scored above median for COVID-19 awareness (55.1%) and preventive behavior (45.1%). Health literacy was observed to be significant predictor of COVID-19 awareness [aOR: 3.53 (95% CI: 1.81-6.88)]; COVID-19 preventive behavior [aOR: 2.06, 95%CI; 1.14-3.69] and compliance to pharmacological management [aOR: 3.05; 95% CI: 1.47-6.35] but not for physical activity. CONCLUSION: COVID-19 awareness, preventive behavior, and compliance to pharmacological management is associated with health literacy among patients of chronic disease availing services from primary health facility. Focusing on health literacy could thus be an essential strategic intervention yielding long term benefits.