Open Access

Journal of Medical Internet Research

, volume 22 , issue 11 , pages e22894

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

Binh N. Do ¹

Tien V Tran ¹

Dung T Phan ²

Hoang C Nguyen ³

Thao TP Nguyen ⁴

Huu C Nguyen ⁵

Tung H Ha ⁶

Hung K Dao ⁷

Manh V Trinh ⁸

Thinh V Do ⁹

Hung Q Nguyen ¹⁰

Tam T Vo ¹¹

Nhan P T Nguyen ¹²

Cuong Q Tran ¹³

Khanh V Tran ¹⁴

Trang T Duong ¹⁵

Hai X Pham ¹⁶

Lam V Nguyen ¹⁷

Kien T Nguyen ¹⁸

Peter W S Chang ^{19, 20}

Tuyen Van Duong ²¹

Hide authors affiliations Show authors affiliations: 21 affiliations

Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam. |

Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Vietnam. |

Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam. |

⁴

Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary. |

⁵

Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Vietnam. |

⁶

Director Office, General Hospital of Agricultural, Hanoi, Vietnam. |

⁷

Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, Vietnam. |

⁸

Director Office, Quang Ninh General Hospital, Quang Ninh, Vietnam. |

⁹

Director Office, Bai Chay Hospital, Quang Ninh, Vietnam. |

¹⁰

Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Vietnam. |

¹¹

Director Office, Trieu Phong District Health Center, Quang Tri, Vietnam. |

¹²

General Planning Department, Da Nang Oncology Hospital, Da Nang, Vietnam. |

¹³

Director Office, Thu Duc District Health Center, Ho Chi Minh, Vietnam. |

¹⁴

Director Office, Hospital District 2, Ho Chi Minh, Vietnam. |

¹⁵

Nursing Office, Tan Phu District Hospital, Ho Chi Minh, Vietnam. |

¹⁶

Director Office, District 9 Health Center, Ho Chi Minh, Vietnam. |

¹⁷

President Office, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam. |

¹⁸

Department of Health Education, Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam. |

¹⁹

Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States. |

²⁰

School of Medicine, Chung Shan Medical University, Taichung, Taiwan. |

²¹

School of Nutrition and Health Sciences Taipei Medical University Taipei Taiwan |

Publication type: Journal Article

Publication date: 2020-10-28

JMIR Publications

Journal of Medical Internet Research

scimago Q1

wos Q1

SJR: 1.992

CiteScore: 11.7

Impact factor: 6.0

ISSN: 14394456, 14388871

DOI: 10.2196/22894

Copy DOI

PubMed ID: 33122164

Health Informatics

Abstract

Background

The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic.

Objective

The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown.

Methods

We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations.

Results

The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance; satisfactory criterion validity as correlated with HL (ρ=0.42); satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84); and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, P<.001; B=0.72, 95% CI 0.43-1.00, P<.001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P<.001; B=0.60, 95% CI 0.34-0.86, P<.001), doctors (B=1.29, 95% CI 0.73-1.84, P<.001; B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P<.001; B=0.64, 95% CI 0.38-0.91, P<.001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P<.001; B=0.22, 95% CI 0.19-0.26, P<.001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, P=.001; OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P<.001; OR 1.04, 95% CI 1.03-1.05, P<.001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P<.001; OR 0.96, 95% CI 0.95-0.98, P<.001), respectively.

Conclusions

The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs’ HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.

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GOST |

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GOST Copy

Do B. N. et al. Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey // Journal of Medical Internet Research. 2020. Vol. 22. No. 11. p. e22894.

GOST all authors (up to 50) Copy

Do B. N., Tran T. V., Phan D. T., Nguyen H. C., Nguyen T. T., Nguyen H. C., Ha T. H., Dao H. K., Trinh M. V., Do T. V., Nguyen H. Q., Vo T. T., Nguyen N. P. T., Tran C. Q., Tran K. V., Duong T. T., Pham H. X., Nguyen L. V., Nguyen K. T., Chang P. W. S., Duong T. V. Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey // Journal of Medical Internet Research. 2020. Vol. 22. No. 11. p. e22894.

RIS |

Cite this

RIS Copy

TY - JOUR

DO - 10.2196/22894

UR - https://doi.org/10.2196/22894

TI - Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

T2 - Journal of Medical Internet Research

AU - Do, Binh N.

AU - Tran, Tien V

AU - Phan, Dung T

AU - Nguyen, Hoang C

AU - Nguyen, Thao TP

AU - Nguyen, Huu C

AU - Ha, Tung H

AU - Dao, Hung K

AU - Trinh, Manh V

AU - Do, Thinh V

AU - Nguyen, Hung Q

AU - Vo, Tam T

AU - Nguyen, Nhan P T

AU - Tran, Cuong Q

AU - Tran, Khanh V

AU - Duong, Trang T

AU - Pham, Hai X

AU - Nguyen, Lam V

AU - Nguyen, Kien T

AU - Chang, Peter W S

AU - Duong, Tuyen Van

PY - 2020

DA - 2020/10/28

PB - JMIR Publications

SP - e22894

IS - 11

VL - 22

PMID - 33122164

SN - 1439-4456

SN - 1438-8871

ER -

BibTex |

Cite this

BibTex (up to 50 authors) Copy

@article{2020_Do,

author = {Binh N. Do and Tien V Tran and Dung T Phan and Hoang C Nguyen and Thao TP Nguyen and Huu C Nguyen and Tung H Ha and Hung K Dao and Manh V Trinh and Thinh V Do and Hung Q Nguyen and Tam T Vo and Nhan P T Nguyen and Cuong Q Tran and Khanh V Tran and Trang T Duong and Hai X Pham and Lam V Nguyen and Kien T Nguyen and Peter W S Chang and Tuyen Van Duong},

title = {Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey},

journal = {Journal of Medical Internet Research},

year = {2020},

volume = {22},

publisher = {JMIR Publications},

month = {oct},

url = {https://doi.org/10.2196/22894},

number = {11},

pages = {e22894},

doi = {10.2196/22894}

}

MLA

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MLA Copy

Do, Binh N., et al. “Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey.” Journal of Medical Internet Research, vol. 22, no. 11, Oct. 2020, p. e22894. https://doi.org/10.2196/22894.

Publisher

JMIR Publications

Journal

Journal of Medical Internet Research

scimago Q1

wos Q1

SJR

1.992

CiteScore

11.7

Impact factor

6.0

ISSN

14394456 (Print)

14388871 (Electronic)