Health literacy in the general population in the context of epidemic or pandemic coronavirus outbreak situations: rapid scoping review

ABSTRACT

BACKGROUNDAuthorities responded with contact restrictions and other measures to the global spread of SARS-CoV-2. Health literacy (HL) has been linked to health outcomes and refers to the ability to access, understand, appraise and apply health information in order to make good health decisions. When restrictions are gradually lifted, individual HL becomes essential to control the pandemic and to prevent the resumption of these restriction, should infection numbers surge again. The aim of this rapid scoping review, for which only studies from the general population were considered, was to describe the extent of existing research on HL in the context of previous coronavirus outbreaks (SARS-CoV-1, MERS-CoV and SARS-CoV-2). Facets of HL that were of particular interest were type of assessment of HL (theory-based versus proxy assessment; validated instrument versus ad hoc assessment), domains of HL, interventions aiming to improve HL during outbreak situations, and HL surveillance during outbreak. METHODSWe searched two major databases and included publications of quantitative and qualitative studies in English and German on any type of research on the functional, critical and communicative domains of HL conducted in the context of the three outbreaks in the general population. We extracted and tabulated relevant data and narratively reported where and when the study was conducted, the design and method used, and how HL was measured. FINDINGS72 studies were included. Three investigated HL or explicitly referred to the concept of HL, 14 were guided by health behaviour theory. We did not find any study designed to develop or psychometrically evaluate pandemic HL instruments, or relate pandemic or general HL to a pandemic outcome, or any controlled intervention study. Type of assessment of the domains of HL varied widely. INTERPRETATIONTheory-driven observational studies as well as interventions, examining whether pandemic-related HL can be improved are needed. In addition, the development and validation of instruments that measure pandemic-related HL is desirable.