JMIR Publications

ABSTRACT

Background:

Coronavirus disease (COVID-19) pandemic creates a heavy burden on healthcare systems and governments. Health literacy (HL) and eHealth literacy (eHEAL) are recognized as strategic public health elements but underestimated during the pandemic. HL, eHEAL, practices, lifestyles, and health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic.

Objective:

To evaluate psychometric properties of the eHEAL scale, and examine associations of HL and eHEAL with adherence to infection prevention and control procedures (AIPC), lifestyle changes, and suspected COVID symptoms (S-COVID-19-S) among HCWs during the lockdown.

Methods:

We conducted an online survey on 5209 HCWs from 15 hospitals and health centers across Vietnam from 6th to 19th April 2020. HCWs were asked about their socio-demographics; HL; eHEAL; AIPC; changes in dietary intake, smoking, drinking, physical activity; and S-COVID-19-S. Principal component analysis, correlation analysis, bivariate, and multivariate linear and logistic regression models were utilized to validate eHEAL scale and examine the associations.

Results:

The eHEAL was found with a good construct validity with eight items highly loaded on one component with factor loadings rank from .78 to .92, explained 76.34% of variance; satisfactory criterion validity as correlated with HL (rho=.42); good convergent validity with high item-scale correlations (rho=.80-.84); high internal consistency (Cronbach α=.95). HL and eHEAL were significantly higher in men (unstandardized coefficient, B 1.01, 95% confidence interval, 95% CI 0.57 to 1.45, P<.001; B 0.72, 95% CI 0.43 to 1.00, P<.001), better ability to pay for medication (B 1.65, 95%CI 1.25 to 2.05, P<.001; B 0.60, 95%CI 0.34 to 0.86, P<.001), being doctors (B 1.29, 95%CI 0.73 to 1.84, P < .001; B 0.56, 95%CI 0.20 to 0.93, P=.003), having epidemic containment experiences (B 1.96, 95%CI 1.56 to 2.37, P<.001; B 0.64, 95%CI 0.38 to 0.91, P<.001), as compared to their counterpart, respectively. HCWs with higher HL score, or higher eHEAL score had better AIPC (B 0.13, 95%CI 0.10 to 0.15, P<.001; or B 0.22, 95%CI 0.19 to 0.26, P<.001), higher likelihood of healthy eating (odds ratio, OR 1.04, 95%CI 1.01-1.06, P=.001; or OR 1.04, 95%CI 1.02-1.07, P=.002), and doing more physical activity (OR 1.03, 95%CI 1.02-1.03, P<.001; or OR 1.04, 95%CI 1.03-1.05, P<.001), and lower likelihood of having S-COVID-19-S (OR 0.97, 95%CI 0.96-0.98, P<.001, or OR 0.96, 95%CI 0.95-0.98, P<.001), respectively.

Conclusions:

The eHEAL is a valid and reliable survey tool. Gender, ability to pay for medication, type of healthcare personnel, and epidemic containment experience are independent predictors of HL and eHEAL. HCWs with higher HL score or eHEAL score had better AIPC, healthier lifestyles, and lower S-COVID-19-S likelihood. Efforts to improve HCWs’ HL and eHEAL can help to contain the COVID-19 pandemic and its consequences.