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What Did the COVID-19 Pandemic Teach Us About Health Literacy and Health Communication?

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 16006

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Special Issue Editors

Dr. Claudia F. Parvanta

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Guest Editor

College of Public Health, University of South Florida, Tampa, FL 33612, USA
Interests: public health communication; social marketing; anthropology; patient–provider communication; health literacy

Dr. Cheryl A. Vamos

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Guest Editor

1. Director, USF’s Center of Excellence in MCH Education, Science, & Practice, College of Public Health, University of South Florida, Tampa, FL 33612, USA
2. Fellow, Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
Interests: health literacy; women’s health; reproductive Health; MCH oral health; implementation science; quality improvement

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic has been a test of everything we know in public health and healthcare delivery. Countless public health scientists, healthcare providers, and health communicators can be credited with saving millions of lives. However, we also lost too many. How can we do a better job moving forward?

In the United States, the Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky has asked the agency to do a better job communicating directly with the public [1]. The summary document posted on the website does not reference longstanding guidance such as the HHS Office of Minority Health standards for “Culturally and Linguistically Appropriate Services” (CLAS) [2] nor the health literacy objectives in Healthy People 2020 [3] or HP 2030 [4]. However, we may assume, given the government’s charge, they are implicitly woven in.

Were you able to apply evidence-based/best practices in health literacy and/or culturally sensitive health communication during the COVID-19 pandemic? A good case study—what worked and what did not—is welcome. Manuscripts describing translational research, dissemination, implementation, and/or evaluation are especially encouraged.

The social media-fueled “infodemic” has lingering effects on how the public perceives or trusts health information. Studies of the problem, or interventions to create and promote shared meaning about how science works, are of interest.

What did you learn about gaps and opportunities to accelerate health education/training, research, policy, and/or practice with regard to health literacy and the pandemic? Studies at the programmatic or policy level are also welcome.

References

[1] CDC Moving Forward Summary Report | About | CDC Accessed September 3, 2022. Last updated September 1, 2022.

[2] https://thinkculturalhealth.hhs.gov/assets/pdfs/class-infographic-what-why-how.pdf

[3] Healthy People is the process and documentation of data-driven objectives to improve the health and well being of the nation. It is revised every decade.

[4] Health Communication and Health Information Technology Workgroup - Healthy People 2030 | health.gov Accessed September 3, 2022.

Dr. Claudia F. Parvanta
Dr. Cheryl A. Vamos
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

personal and organizational health literacy
health disciplines/professions
co-creation of health communication
culturally sensitive, transcreation
science literacy
misinformation, “Infodemic”
social media
CLAS (Culturally and Linguistically Appropriate Services)

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Published Papers (7 papers)

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18 pages, 296 KiB

Open AccessArticle

Health Support for At-Risk Older Adults during COVID-19

by Marian Ryan, Lisa M. Gibbs and Sonia R. Sehgal

Healthcare 2023, 11(13), 1856; https://doi.org/10.3390/healthcare11131856 - 26 Jun 2023

Cited by 1 | Viewed by 1543

Abstract

Older adults are highly susceptible to COVID-19 infection and at the highest risk for severe disease and death. Yet, older adults lacked access to accurate and easy-to-use COVID-19 information and support early in the pandemic. This prospective, experimental cohort study sought to examine whether older adults could be engaged during the pandemic through a community partner and if a low-touch intervention, designed with health literacy best practices, could positively impact COVID-19 knowledge, mitigation behaviors, telehealth/doctor visits, exercise, and loneliness. A senior resource kit was distributed to older adults sheltering at home through food assistance program agents from October 2020 to February 2021; the kit was developed using health literacy best practices. Simple random assignment was used to divide program participants into treatment and control groups. Both groups received senior kits, but the treatment group also received telephonic health coaching. The primary outcome was COVID-19 knowledge and mitigation behaviors as derived from self-reported surveys at baseline and after four months. Secondary outcomes included a telehealth or doctor visit, exercise frequency, and a loneliness score (3-Item Loneliness Scale). Health literacy was assessed using the BRIEF screening tool. Ninety-eight older adults consented to participate in the study and 87 completed the study (88.7% completion rate). Participants had moderate clinical risk, one-third preferred the Spanish language, and 52% were categorized as having inadequate or marginal health literacy. Significant changes were found for increasing COVID-19 mitigation behaviors and the frequency of exercise across the cohort, but not for COVID-19 knowledge, telehealth visits, or decreasing loneliness. Conclusions: Partnering with a trusted entity in the community is a feasible and important strategy to reach older adults during a lockdown and provide them with easy-to-read health information and resources. If the time horizon had been longer, improvements in other outcome variables may have been achieved. Full article

(This article belongs to the Special Issue What Did the COVID-19 Pandemic Teach Us About Health Literacy and Health Communication?)

15 pages, 934 KiB

Open AccessArticle

A Tale of Two Audiences: Formative Research and Campaign Development for Two Different Latino Audiences, to Improve COVID-19 Prevention Behavior

by Dianna Bonilla Altera, Imani Cabassa and Genevieve Martinez-Garcia

Healthcare 2023, 11(13), 1819; https://doi.org/10.3390/healthcare11131819 - 21 Jun 2023

Cited by 2 | Viewed by 1339

Abstract

The COVID-19 pandemic disproportionately affected the Latino population in the United States, further exacerbating the existing racial and ethnic health disparities that this group faces. While government health entities rushed to develop COVID-19 prevention educational materials in Spanish, these failed to recognize the unique motivators and barriers that move different Latino audience segments to act. We conducted five online focus groups with two different Latino audience segments, general Latino people, and Latino migrant workers, to assess their experience navigating the pandemic, their engagement in preventive behavior, and their consumption of health news. While the general Latino audience had higher levels of social capital and established preventive healthcare, they were more skeptical about getting the COVID-19 vaccine. Migrant workers needed to be vaccinated to retain their jobs, and saw the vaccine as the only way to keep their families healthy. We used the focus group results to develop two different creative concepts that aligned with each audience’s unique experience. Our study highlights the importance of developing hyper-focused messages, responsive to the experience of distinct audience segments, for maximum impact. Full article

(This article belongs to the Special Issue What Did the COVID-19 Pandemic Teach Us About Health Literacy and Health Communication?)

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12 pages, 843 KiB

Open AccessArticle

Building Evidence for Principles to Guide the Development of Products for Adults with Intellectual and Developmental Disabilities and Extreme Low Literacy—A Product Development Tool

by Linda Squiers, Molly M. Lynch, Sidney L. Holt, Aileen Rivell, Kathleen Walker, Stacy Robison, Elizabeth W. Mitchell and Alina L. Flores

Healthcare 2023, 11(12), 1742; https://doi.org/10.3390/healthcare11121742 - 14 Jun 2023

Viewed by 1456

Abstract

This article presented a new product development tool for adults with intellectual and developmental disabilities (IDD) developed by the Centers for Disease Control and Prevention (CDC). People with IDD who also have extreme low literacy (ELL) have unique communication needs; public health communicators often face challenges developing effective communication materials for this audience. To support CDC communication specialists with the development of communication products for adults with IDD/ELL, CDC, with its partners RTI International and CommunicateHealth, created a product development tool for this audience through literature review, expert input, and interviews with adults with IDD/ELL and caregivers of adults with IDD/ELL. To build evidence around the principles described in the tool, RTI conducted interviewer-administered surveys with 100 caregivers who support people with IDD/ELL. During the interviews, we presented caregivers with stimuli (portions of a communication product) that either did or did not apply a single principle and asked which would be easier for the person they support to understand. Across all 14 principles tested, the caregiver respondents indicated that the principle-based version would be easier for the person they support to understand compared with the non-principle-based version(s). These findings provide additional evidence to support the principles included in CDC’s Tool for Developing Products for People with IDD/ELL. Full article

(This article belongs to the Special Issue What Did the COVID-19 Pandemic Teach Us About Health Literacy and Health Communication?)

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24 pages, 3729 KiB

Open AccessArticle

Locating Medical Information during an Infodemic: Information Seeking Behavior and Strategies of Health-Care Workers in Germany

by Christopher Holzmann-Littig, David Stadler, Maria Popp, Peter Kranke, Falk Fichtner, Christoph Schmaderer, Lutz Renders, Matthias Christoph Braunisch, Tarek Assali, Louise Platen, Marjo Wijnen-Meijer, Julia Lühnen, Anke Steckelberg, Lisa Pfadenhauer, Bernhard Haller, Cornelia Fuetterer, Christian Seeber, Christian Schaaf and on behalf of the CEOsys Consortium

Healthcare 2023, 11(11), 1602; https://doi.org/10.3390/healthcare11111602 - 30 May 2023

Cited by 2 | Viewed by 1740

Abstract

Background: The COVID-19 pandemic has led to a flood of—often contradictory—evidence. HCWs had to develop strategies to locate information that supported their work. We investigated the information-seeking of different HCW groups in Germany. Methods: In December 2020, we conducted online surveys on COVID-19 information sources, strategies, assigned trustworthiness, and barriers—and in February 2021, on COVID-19 vaccination information sources. Results were analyzed descriptively; group comparisons were performed using

χ

²-tests. Results: For general COVID-19-related medical information (413 participants), non-physicians most often selected official websites (57%), TV (57%), and e-mail/newsletters (46%) as preferred information sources—physicians chose official websites (63%), e-mail/newsletters (56%), and professional journals (55%). Non-physician HCWs used Facebook/YouTube more frequently. The main barriers were insufficient time and access issues. Non-physicians chose abstracts (66%), videos (45%), and webinars (40%) as preferred information strategy; physicians: overviews with algorithms (66%), abstracts (62%), webinars (48%). Information seeking on COVID-19 vaccination (2700 participants) was quite similar, however, with newspapers being more often used by non-physicians (63%) vs. physician HCWs (70%). Conclusion: Non-physician HCWs more often consulted public information sources. Employers/institutions should ensure the supply of professional, targeted COVID-19 information for different HCW groups. Full article

(This article belongs to the Special Issue What Did the COVID-19 Pandemic Teach Us About Health Literacy and Health Communication?)

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12 pages, 291 KiB

Open AccessArticle

Trust in and Use of COVID-19 Information Sources Differs by Health Literacy among College Students

by Xuewei Chen, Darcy Jones McMaughan, Ming Li, Gary L. Kreps, Jati Ariati, Ho Han, Kelley E. Rhoads, Carlos C. Mahaffey and Bridget M. Miller

Healthcare 2023, 11(6), 831; https://doi.org/10.3390/healthcare11060831 - 11 Mar 2023

Cited by 7 | Viewed by 2538

Abstract

People’s health information-seeking behaviors differ by their health literacy levels. This study assessed the relationship between health literacy and college students’ levels of trust in and use of a range of health information sources of COVID-19. We collected data from August to December 2020 among college students (n = 763) through an online survey. We used a health literacy measure containing three self-reported survey questions, developed by the CDC. We assessed the extent to which participants trusted and used any of the sixteen different sources of information about COVID-19. Respondents reported high levels of trusting and using COVID-19 information from the CDC, health care providers, the WHO, state/county/city health departments, and official government websites when compared to other sources. After controlling for demographic characteristics (i.e., gender, age, race, ethnicity, and income), those who reported having lower health literacy were significantly less likely to trust and use COVID-19 information from these health authorities when compared to participants who reported having higher health literacy. Students with lower self-reported health literacy indicated not trusting or using official health authority sources for COVID-19 information. Relying on low-quality information sources could create and reinforce people’s misperceptions regarding the virus, leading to low compliance with COVID-19-related public health measures and poor health outcomes. Full article

(This article belongs to the Special Issue What Did the COVID-19 Pandemic Teach Us About Health Literacy and Health Communication?)

15 pages, 2161 KiB

Open AccessArticle

Health Literacy among Japanese College Students: Association with Healthy Lifestyle and Subjective Health Status

by Hisayo Yokoyama, Daiki Imai, Yuta Suzuki, Akira Ogita, Hitoshi Watanabe, Haruka Kawabata, Takaaki Miyake, Izumi Yoshii, Shinji Tsubouchi, Yoshimasa Matsuura and Kazunobu Okazaki

Healthcare 2023, 11(5), 704; https://doi.org/10.3390/healthcare11050704 - 27 Feb 2023

Cited by 6 | Viewed by 3304

Abstract

The improvement of health literacy (HL) is a critical issue for college students who are in the transitional period to adulthood and are establishing their subsequent lifestyles. The present study aimed to evaluate the current state of HL among college students and to explore the factors that influence HL. Moreover, it investigated the relationship between HL and health conditions. For this study, the researchers conducted an online survey of college students. The questionnaire consisted of the Japanese version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47), which is a self-assessment tool for HL that covers the major health issues of college students and health-related quality of life. The study analyzed 1049 valid responses. Based on the HLS-EU-Q47 total score, 85% of the participants exhibited problematic or unsatisfactory HL levels. Participants who reported high levels of healthy lifestyles obtained high HL scores. High levels of HL were associated with high levels of subjective health. Results from quantitative text analysis suggested that specific mindsets were correlated with high levels of competency in appraising health information among male students. In the future, educational intervention programs for college students need to be established to improve HL levels. Full article

(This article belongs to the Special Issue What Did the COVID-19 Pandemic Teach Us About Health Literacy and Health Communication?)

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16 pages, 282 KiB

Open AccessProject Report

“I See a lot of Crazy Things and I Don’t Know What to Believe”: Lessons Learned about Health Literacy and Strategies for Communicating with Vaccine-Hesitant College Students

by Corinne N. Berry, Kathleen Walker, Nikole Baker and Claudia Trevor-Wright

Healthcare 2023, 11(15), 2212; https://doi.org/10.3390/healthcare11152212 - 6 Aug 2023

Cited by 5 | Viewed by 2230

Abstract

Throughout the COVID-19 pandemic, the American College Health Association (ACHA) has partnered with CommunicateHealth (CH) to develop COVID-19 mitigation resources for colleges and universities. In 2021, the CH team conducted a series of applied research activities to gain a nuanced understanding of factors that shape perceptions of risk and drive vaccine hesitancy among campus audiences—especially college students who are emerging adults (approximately ages 18 to 22). Based on our findings, CH and ACHA identified key traits of vaccine-hesitant college students and implications for future vaccine communication campaigns. First, vaccine-hesitant students are more likely to ask “why” and “how” questions such as “Why do I need to get vaccinated?” and “How was the vaccine developed and tested?”. Secondly, these students want to have open, authentic dialogue rather than simply accepting health recommendations from a trusted source. Finally, the CH team noted that vaccine-hesitant students were not highly motivated by their own personal risk of getting sick from COVID-19; concern about spreading COVID-19 to others was a much stronger motivating factor. Leveraging these insights, CH and ACHA developed strategies to apply health literacy principles to reach vaccine-hesitant college students with the right information at the right time—and to leverage relevant motivators and overcome barriers to vaccination. By implementing these strategies, CH and ACHA developed clear and empowering educational materials about COVID-19 vaccination tailored to the unique information needs of vaccine-hesitant students. Full article

(This article belongs to the Special Issue What Did the COVID-19 Pandemic Teach Us About Health Literacy and Health Communication?)

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