Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 25, 2022
Date Accepted: Mar 30, 2023
Date Submitted to PubMed: Apr 3, 2023
The relationship between health literacy, knowledge, fear, and COVID-19 prevention behavior in different age groups: A Cross-sectional online study in Japan
ABSTRACT
Background:
Coronavirus (COVID-19) caused not only a pandemic but also an infodemic. Misinformation can increase fear and influence COVID-19 infection prevention behaviors. Health literacy is considered important in infodemics for coping with misinformation. It has been reported that infection prevention behavior, health literacy, and COVID-19 fear differ by age, and it is important to clarify the relationship by age. In addition, an association between health literacy and COVID-19 knowledge has been reported, but no paper has examined this association in Japan.
Objective:
The aim of this study was (1) to examine factors associated with COVID-19 infection prevention behaviors by age group and (2) to clarify relationship between health literacy and COVID-19 knowledge.
Methods:
A cross-sectional study was conducted with 512 participants aged 20–69 years, recruited from an online sample from November 1 to 5, 2021. An online self-administered questionnaire was used to obtain participants’ characteristics, COVID-19 infection prevention behaviors, health literacy, COVID-19 knowledge, and fear of COVID-19. The Kruskal-Wallis rank-sum test was used to compare the scores of each item for each age group. The relationship between COVID-19 infection prevention behaviors, health literacy, COVID-19 knowledge, and fear of COVID-19 was reported by Spearman-rank correlation analysis. Additionally, multiple regression analysis was conducted with COVID-19 infection prevention behaviors as the dependent variable; health literacy, COVID-19 knowledge, and fear of COVID-19 as independent variables; and sex as adjustment variable.
Results:
The results of the correlation analysis showed a significant positive correlation between infection prevention behavior and health literacy (p<.001), COVID-19 knowledge (p<.001), and fear of COVID-19 (p<.001). In addition, a multiple regression analysis was conducted to examine the factors associated with infection prevention behaviors. Health literacy, COVID-19 knowledge, and fear of COVID-19 were significantly associated with infection-prevention behaviors (p<.001). Furthermore, analysis by age revealed that the factors associated with infection-prevention behavior differed by age group. In the age group of 20-29, 30-39, and 40-49 years, multiple factors, including health literacy, influenced COVID-19 infection prevention behaviors, whereas in the age group of 50-59 and 60-69 years, only fear of COVID-19 was shown to have an impact.
Conclusions:
The results suggest that it is important to improve health literacy and correctly inform people of the risks specific to diseases to promote infection prevention behaviors.
Citation
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