JMIR Publications

ABSTRACT

Background:

Mass testing campaigns were proposed in France during the first wave of the pandemic to detect and isolate asymptomatic individuals infected by SARS-Cov-2. During the mass testing of Saint-Etienne in February 2021 we performed a questionnaire survey to evaluate knowledge, behavior and isolation possibility about SARS-CoV-2 infection.

Objective:

Our study aimed at evaluating, on the scale of a city population, literacy level about SARS-CoV-2 transmission, barrier gesture respect and isolation acceptability/possibility in case of SARS-CoV-2 infection. Results of these measurements and their potential link with PCR positivity are reported herein.

Methods:

We used the validated Cov-Quest-CC to assess knowledge, behavior, and isolation scores. These scores were analyzed and correlated with volunteer characteristics and their SARS-CoV-2 screening results using multivariate analysis.

Results:

4707/7020 participants completed the Cov-Quest-CC. Multivariate analysis showed that female sex was shown as determinant of a higher score of knowledge about transmission of SARS-CoV-2, (adjusted beta coefficient 0.14, 95% CI [0.04: 0.23], corrected P=.015). Older age (50–59-year-old) and senior age (>60-year-old) were shown as determinant of a higher score on barrier gesture respect by comparison to 20–49-year-old taken as reference (adjusted beta coefficient: 0.25, 95% CI [0.19: 0.31], corrected P<.001 for older age, and adjusted beta coefficient 0.25, 95% CI [0.15-0.34], corrected P<.001 for senior age). Female sex also appeared as a determinant of a higher score on barrier gesture respect (adjusted beta coefficient: 0.10, 95% CI [0.02: 4.63] corrected P<.001). The level of the knowledge score, was also correlated to that of the score on barrier measures (adjusted beta coefficient: 0.03, 95% CI [0.001: 0.004], corrected P=.001). Older age (50–59-year-old) and senior age (>60-year-old) were shown as determinant of a higher score on isolation acceptability/possibility by comparison to 20–49-year-old taken as reference (adjusted beta coefficient: 0.21, 95% CI [0.13: 0.29], corrected P<.001 for older age, and adjusted beta coefficient: 0.25, 95% CI [0.1: 0.38], corrected P-value < 0.001 for senior age). Finally, the knowledge score on SARS-CoV-2 transmission was significantly associated with a lower risk of PCR positivity (adjusted OR of 0.80 with a 95% CI of 0.69-0.94 and a corrected P<.033), meaning that one-point increase in knowledge score lowers the risk of positivity by 20% on average.

Conclusions:

This large-scale population inquiry regarding SARS-CoV-2 infection gave interesting sociological trends on the level of health literacy during the pandemic. With the growing impact of viral outbreaks on the health and behavior of people, it seems necessary to improve health literacy notably in some strata of the French population. Clinical Trial: Ethics Committee of IRB ILE DE FRANCE 1 (No. IRB: I ORG0009918), (Protocole No. EudraCT: 2021-A00390-41).