Relationship of health literacy with COVID-19 prevention and control knowledge, attitude and practice in general population of Baoji city

ABSTRACT

Objective: To explore the relationship of health literacy with COVID-19 prevention and control knowledge, attitude and practice (KAP) in general population so as to contribute scientific evidence for strengthening health education and promoting health literacy to resist the threat of major infectious disease outbreaks. Methods: In September 2020, a questionnaire survey was conducted in residents selected by a multi-stage random sampling across all the twelve counties/districts of Baoji city. The questionnaire, which was issued by the Chinese Health Education Center, consisted of a health literacy questionnaire and a COVID-19 prevention and control KAP questionnaire. According to the national unified scoring method, the participants were divided into two groups those who met and those who failed to meet the overall standard of health literacy. The results of the answer to each KAP question were compared between the two groups by Chi-square test or rank sum test. Multivariate binary Logistic regression was used to control confounding effects of socio-demographic characteristics to draw relatively reliable conclusions. Results: A total of 4 544 valid questionnaires were collected, in which 664(14.60%)met the overall standard of health literacy, but 3 880(85. 40%)failed to do so. Compared with the unmet group, the met group had a higher correct answer rate in 10 of the 11 knowledge-related questions(all P<0.001);showed more positive answer to each attitude-related question in the three aspects, namely, responsibility for the prevention and control of infectious disease transmission, evaluation for COVID-19-related information release and reporting, and evaluation for the government's COVID-19 prevention and control results (all P<0.001);and acted more actively in 6 of the 7 practice concerning appropriate self-prevention and control behaviors during the COVID-19 outbreak(all P<0.001). Logistic regression analyses confirmed that achieving the overall standard of health literacy played a positive role in each of the contents of COVID-19 prevention and control KAP in study(ORs were between 1.44 and 4.09, all P<0.001). Moreover, the absolute value of regression coefficient of the overall standard of health literacy was the largest compared with all the socio-demographic factors. Logistic regression was used to further analyze relationships between each of the six health dimensions of health literacy and COVID -19 prevention and control KAP, which revealed that the association with safety and first aid, infectious diseases prevention, and health information was the closest. Conclusion: Health literacy is closely related to COVID-19 prevention and control KAP in the general population of Baoji city. Promoting residents' health literacy by targeted health education can play an important and positive role in dealing with the threat of major infectious diseases outbreaks.