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.
Identifieur interne : 000F83 ( Main/Corpus ); précédent : 000F82; suivant : 000F84Health 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.
Auteurs : Binh N. Do ; Tien V. Tran ; Dung T. Phan ; Hoang C. Nguyen ; Thao T P. Nguyen ; Huu C. Nguyen ; Tung H. Ha ; Hung K. Dao ; Manh V. Trinh ; Thinh V. Do ; Hung Q. Nguyen ; Tam T. Vo ; Nhan P T. Nguyen ; Cuong Q. Tran ; Khanh V. Tran ; Trang T. Duong ; Hai X. Pham ; Lam V. Nguyen ; Kien T. Nguyen ; Peter W S. Chang ; Tuyen Van DuongSource :
- Journal of medical Internet research [ 1438-8871 ] ; 2020.
English descriptors
- KwdEn :
- Adult (MeSH), COVID-19 (epidemiology), COVID-19 (prevention & control), Female (MeSH), Health Literacy (methods), Health Personnel (standards), Humans (MeSH), Life Style (MeSH), Male (MeSH), Middle Aged (MeSH), Psychometrics (methods), Reproducibility of Results (MeSH), SARS-CoV-2 (pathogenicity), Surveys and Questionnaires (MeSH), Telemedicine (methods), Young Adult (MeSH).
- MESH :
- epidemiology : COVID-19.
- methods : Health Literacy, Psychometrics, Telemedicine.
- pathogenicity : SARS-CoV-2.
- prevention & control : COVID-19.
- standards : Health Personnel.
- Adult, Female, Humans, Life Style, Male, Middle Aged, Reproducibility of Results, Surveys and Questionnaires, Young Adult.
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.
DOI: 10.2196/22894
PubMed: 33122164
PubMed Central: PMC7674138
Links to Exploration step
pubmed:33122164Le document en format XML
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Tran</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of Military Science, Military Hospital 103, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Director Office, Military Hospital 103, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Phan, Dung T" sort="Phan, Dung T" uniqKey="Phan D" first="Dung T" last="Phan">Dung T. Phan</name><affiliation><nlm:affiliation>Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Nursing Office, Viet Duc University Hospital, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Hoang C" sort="Nguyen, Hoang C" uniqKey="Nguyen H" first="Hoang C" last="Nguyen">Hoang C. 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Nguyen</name><affiliation><nlm:affiliation>Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Director Office, E Hospital, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Ha, Tung H" sort="Ha, Tung H" uniqKey="Ha T" first="Tung H" last="Ha">Tung H. Ha</name><affiliation><nlm:affiliation>Director Office, General Hospital of Agricultural, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Dao, Hung K" sort="Dao, Hung K" uniqKey="Dao H" first="Hung K" last="Dao">Hung K. Dao</name><affiliation><nlm:affiliation>Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Trinh, Manh V" sort="Trinh, Manh V" uniqKey="Trinh M" first="Manh V" last="Trinh">Manh V. Trinh</name><affiliation><nlm:affiliation>Director Office, Quang Ninh General Hospital, Quang Ninh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Do, Thinh V" sort="Do, Thinh V" uniqKey="Do T" first="Thinh V" last="Do">Thinh V. Do</name><affiliation><nlm:affiliation>Director Office, Bai Chay Hospital, Quang Ninh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Hung Q" sort="Nguyen, Hung Q" uniqKey="Nguyen H" first="Hung Q" last="Nguyen">Hung Q. Nguyen</name><affiliation><nlm:affiliation>Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Vo, Tam T" sort="Vo, Tam T" uniqKey="Vo T" first="Tam T" last="Vo">Tam T. Vo</name><affiliation><nlm:affiliation>Director Office, Trieu Phong District Health Center, Quang Tri, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Nhan P T" sort="Nguyen, Nhan P T" uniqKey="Nguyen N" first="Nhan P T" last="Nguyen">Nhan P T. Nguyen</name><affiliation><nlm:affiliation>General Planning Department, Da Nang Oncology Hospital, Da Nang, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Tran, Cuong Q" sort="Tran, Cuong Q" uniqKey="Tran C" first="Cuong Q" last="Tran">Cuong Q. Tran</name><affiliation><nlm:affiliation>Director Office, Thu Duc District Health Center, Ho Chi Minh, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculty of Health, Mekong University, Vinh Long, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Tran, Khanh V" sort="Tran, Khanh V" uniqKey="Tran K" first="Khanh V" last="Tran">Khanh V. Tran</name><affiliation><nlm:affiliation>Director Office, Hospital District 2, Ho Chi Minh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Duong, Trang T" sort="Duong, Trang T" uniqKey="Duong T" first="Trang T" last="Duong">Trang T. Duong</name><affiliation><nlm:affiliation>Nursing Office, Tan Phu District Hospital, Ho Chi Minh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Pham, Hai X" sort="Pham, Hai X" uniqKey="Pham H" first="Hai X" last="Pham">Hai X. Pham</name><affiliation><nlm:affiliation>Director Office, District 9 Health Center, Ho Chi Minh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Lam V" sort="Nguyen, Lam V" uniqKey="Nguyen L" first="Lam V" last="Nguyen">Lam V. Nguyen</name><affiliation><nlm:affiliation>President Office, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aesthetic Plastic Surgery & Skin Care Center, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Kien T" sort="Nguyen, Kien T" uniqKey="Nguyen K" first="Kien T" last="Nguyen">Kien T. Nguyen</name><affiliation><nlm:affiliation>Department of Health Education, Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Chang, Peter W S" sort="Chang, Peter W S" uniqKey="Chang P" first="Peter W S" last="Chang">Peter W S. Chang</name><affiliation><nlm:affiliation>School of Medicine, Chung Shan Medical University, Taichung, Taiwan.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Public Health and Community Medicine, Tufts University School Of Medicine, Boston, MA, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Duong, Tuyen Van" sort="Duong, Tuyen Van" uniqKey="Duong T" first="Tuyen Van" last="Duong">Tuyen Van Duong</name><affiliation><nlm:affiliation>School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33122164</idno><idno type="pmid">33122164</idno><idno type="doi">10.2196/22894</idno><idno type="pmc">PMC7674138</idno><idno type="wicri:Area/Main/Corpus">000F83</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000F83</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">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.</title><author><name sortKey="Do, Binh N" sort="Do, Binh N" uniqKey="Do B" first="Binh N" last="Do">Binh N. Do</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of Military Science, Military Hospital 103, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Director Office, Military Hospital 103, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Tran, Tien V" sort="Tran, Tien V" uniqKey="Tran T" first="Tien V" last="Tran">Tien V. Tran</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of Military Science, Military Hospital 103, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Director Office, Military Hospital 103, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Phan, Dung T" sort="Phan, Dung T" uniqKey="Phan D" first="Dung T" last="Phan">Dung T. Phan</name><affiliation><nlm:affiliation>Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Nursing Office, Viet Duc University Hospital, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Hoang C" sort="Nguyen, Hoang C" uniqKey="Nguyen H" first="Hoang C" last="Nguyen">Hoang C. Nguyen</name><affiliation><nlm:affiliation>Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Thao T P" sort="Nguyen, Thao T P" uniqKey="Nguyen T" first="Thao T P" last="Nguyen">Thao T P. Nguyen</name><affiliation><nlm:affiliation>Health Management Training Institute, Hue University of Medicine and Pharmacy, Thua Thien Hue, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Huu C" sort="Nguyen, Huu C" uniqKey="Nguyen H" first="Huu C" last="Nguyen">Huu C. Nguyen</name><affiliation><nlm:affiliation>Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Director Office, E Hospital, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Ha, Tung H" sort="Ha, Tung H" uniqKey="Ha T" first="Tung H" last="Ha">Tung H. Ha</name><affiliation><nlm:affiliation>Director Office, General Hospital of Agricultural, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Dao, Hung K" sort="Dao, Hung K" uniqKey="Dao H" first="Hung K" last="Dao">Hung K. Dao</name><affiliation><nlm:affiliation>Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Trinh, Manh V" sort="Trinh, Manh V" uniqKey="Trinh M" first="Manh V" last="Trinh">Manh V. Trinh</name><affiliation><nlm:affiliation>Director Office, Quang Ninh General Hospital, Quang Ninh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Do, Thinh V" sort="Do, Thinh V" uniqKey="Do T" first="Thinh V" last="Do">Thinh V. Do</name><affiliation><nlm:affiliation>Director Office, Bai Chay Hospital, Quang Ninh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Hung Q" sort="Nguyen, Hung Q" uniqKey="Nguyen H" first="Hung Q" last="Nguyen">Hung Q. Nguyen</name><affiliation><nlm:affiliation>Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Vo, Tam T" sort="Vo, Tam T" uniqKey="Vo T" first="Tam T" last="Vo">Tam T. Vo</name><affiliation><nlm:affiliation>Director Office, Trieu Phong District Health Center, Quang Tri, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Nhan P T" sort="Nguyen, Nhan P T" uniqKey="Nguyen N" first="Nhan P T" last="Nguyen">Nhan P T. Nguyen</name><affiliation><nlm:affiliation>General Planning Department, Da Nang Oncology Hospital, Da Nang, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Tran, Cuong Q" sort="Tran, Cuong Q" uniqKey="Tran C" first="Cuong Q" last="Tran">Cuong Q. Tran</name><affiliation><nlm:affiliation>Director Office, Thu Duc District Health Center, Ho Chi Minh, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculty of Health, Mekong University, Vinh Long, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Tran, Khanh V" sort="Tran, Khanh V" uniqKey="Tran K" first="Khanh V" last="Tran">Khanh V. Tran</name><affiliation><nlm:affiliation>Director Office, Hospital District 2, Ho Chi Minh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Duong, Trang T" sort="Duong, Trang T" uniqKey="Duong T" first="Trang T" last="Duong">Trang T. Duong</name><affiliation><nlm:affiliation>Nursing Office, Tan Phu District Hospital, Ho Chi Minh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Pham, Hai X" sort="Pham, Hai X" uniqKey="Pham H" first="Hai X" last="Pham">Hai X. Pham</name><affiliation><nlm:affiliation>Director Office, District 9 Health Center, Ho Chi Minh, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Lam V" sort="Nguyen, Lam V" uniqKey="Nguyen L" first="Lam V" last="Nguyen">Lam V. Nguyen</name><affiliation><nlm:affiliation>President Office, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aesthetic Plastic Surgery & Skin Care Center, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Nguyen, Kien T" sort="Nguyen, Kien T" uniqKey="Nguyen K" first="Kien T" last="Nguyen">Kien T. Nguyen</name><affiliation><nlm:affiliation>Department of Health Education, Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Chang, Peter W S" sort="Chang, Peter W S" uniqKey="Chang P" first="Peter W S" last="Chang">Peter W S. Chang</name><affiliation><nlm:affiliation>School of Medicine, Chung Shan Medical University, Taichung, Taiwan.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Public Health and Community Medicine, Tufts University School Of Medicine, Boston, MA, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Duong, Tuyen Van" sort="Duong, Tuyen Van" uniqKey="Duong T" first="Tuyen Van" last="Duong">Tuyen Van Duong</name><affiliation><nlm:affiliation>School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of medical Internet research</title><idno type="eISSN">1438-8871</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>COVID-19 (epidemiology)</term><term>COVID-19 (prevention & control)</term><term>Female (MeSH)</term><term>Health Literacy (methods)</term><term>Health Personnel (standards)</term><term>Humans (MeSH)</term><term>Life Style (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Psychometrics (methods)</term><term>Reproducibility of Results (MeSH)</term><term>SARS-CoV-2 (pathogenicity)</term><term>Surveys and Questionnaires (MeSH)</term><term>Telemedicine (methods)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Health Literacy</term><term>Psychometrics</term><term>Telemedicine</term></keywords><keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Health Personnel</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Female</term><term>Humans</term><term>Life Style</term><term>Male</term><term>Middle Aged</term><term>Reproducibility of Results</term><term>Surveys and Questionnaires</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>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.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">33122164</PMID><DateCompleted><Year>2020</Year><Month>12</Month><Day>07</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>14</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1438-8871</ISSN><JournalIssue CitedMedium="Internet"><Volume>22</Volume><Issue>11</Issue><PubDate><Year>2020</Year><Month>11</Month><Day>12</Day></PubDate></JournalIssue><Title>Journal of medical Internet research</Title><ISOAbbreviation>J Med Internet Res</ISOAbbreviation></Journal><ArticleTitle>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.</ArticleTitle><Pagination><MedlinePgn>e22894</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.2196/22894</ELocationID><Abstract><AbstractText Label="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.</AbstractText><AbstractText Label="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.</AbstractText><AbstractText Label="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.</AbstractText><AbstractText Label="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.</AbstractText><AbstractText Label="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.</AbstractText><CopyrightInformation>©Binh N Do, Tien V Tran, Dung T Phan, Hoang C Nguyen, Thao T P Nguyen, Huu C Nguyen, Tung H Ha, Hung K Dao, Manh V Trinh, Thinh V Do, Hung Q Nguyen, Tam T Vo, Nhan P T Nguyen, Cuong Q Tran, Khanh V Tran, Trang T Duong, Hai X Pham, Lam V Nguyen, Kien T Nguyen, Peter W S Chang, Tuyen Van Duong. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.11.2020.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y" EqualContrib="Y"><LastName>Do</LastName><ForeName>Binh N</ForeName><Initials>BN</Initials><Identifier Source="ORCID">0000-0002-1377-3921</Identifier><AffiliationInfo><Affiliation>Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Military Science, Military Hospital 103, Hanoi, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Director Office, Military Hospital 103, Hanoi, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Tran</LastName><ForeName>Tien V</ForeName><Initials>TV</Initials><Identifier Source="ORCID">0000-0002-3348-2566</Identifier><AffiliationInfo><Affiliation>Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Military Science, Military Hospital 103, Hanoi, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Director Office, Military Hospital 103, Hanoi, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Phan</LastName><ForeName>Dung T</ForeName><Initials>DT</Initials><Identifier Source="ORCID">0000-0002-9034-5752</Identifier><AffiliationInfo><Affiliation>Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Nursing Office, Viet Duc University Hospital, Hanoi, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Hoang C</ForeName><Initials>HC</Initials><Identifier Source="ORCID">0000-0003-0826-1785</Identifier><AffiliationInfo><Affiliation>Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Thao T P</ForeName><Initials>TTP</Initials><Identifier Source="ORCID">0000-0003-1320-964X</Identifier><AffiliationInfo><Affiliation>Health Management Training Institute, Hue University of Medicine and Pharmacy, Thua Thien Hue, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Huu C</ForeName><Initials>HC</Initials><Identifier Source="ORCID">0000-0002-6076-2491</Identifier><AffiliationInfo><Affiliation>Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Director Office, E Hospital, Hanoi, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ha</LastName><ForeName>Tung H</ForeName><Initials>TH</Initials><Identifier Source="ORCID">0000-0003-1856-5803</Identifier><AffiliationInfo><Affiliation>Director Office, General Hospital of Agricultural, Hanoi, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dao</LastName><ForeName>Hung K</ForeName><Initials>HK</Initials><Identifier Source="ORCID">0000-0002-1979-0925</Identifier><AffiliationInfo><Affiliation>Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Trinh</LastName><ForeName>Manh V</ForeName><Initials>MV</Initials><Identifier Source="ORCID">0000-0002-8823-4498</Identifier><AffiliationInfo><Affiliation>Director Office, Quang Ninh General Hospital, Quang Ninh, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Do</LastName><ForeName>Thinh V</ForeName><Initials>TV</Initials><Identifier Source="ORCID">0000-0003-0370-8330</Identifier><AffiliationInfo><Affiliation>Director Office, Bai Chay Hospital, Quang Ninh, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Hung Q</ForeName><Initials>HQ</Initials><Identifier Source="ORCID">0000-0001-6034-1657</Identifier><AffiliationInfo><Affiliation>Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vo</LastName><ForeName>Tam T</ForeName><Initials>TT</Initials><Identifier Source="ORCID">0000-0001-6683-2158</Identifier><AffiliationInfo><Affiliation>Director Office, Trieu Phong District Health Center, Quang Tri, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Nhan P T</ForeName><Initials>NPT</Initials><Identifier Source="ORCID">0000-0003-1428-836X</Identifier><AffiliationInfo><Affiliation>General Planning Department, Da Nang Oncology Hospital, Da Nang, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tran</LastName><ForeName>Cuong Q</ForeName><Initials>CQ</Initials><Identifier Source="ORCID">0000-0001-5447-404X</Identifier><AffiliationInfo><Affiliation>Director Office, Thu Duc District Health Center, Ho Chi Minh, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculty of Health, Mekong University, Vinh Long, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tran</LastName><ForeName>Khanh V</ForeName><Initials>KV</Initials><Identifier Source="ORCID">0000-0002-0121-6212</Identifier><AffiliationInfo><Affiliation>Director Office, Hospital District 2, Ho Chi Minh, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Duong</LastName><ForeName>Trang T</ForeName><Initials>TT</Initials><Identifier Source="ORCID">0000-0003-3596-0741</Identifier><AffiliationInfo><Affiliation>Nursing Office, Tan Phu District Hospital, Ho Chi Minh, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pham</LastName><ForeName>Hai X</ForeName><Initials>HX</Initials><Identifier Source="ORCID">0000-0001-6960-6770</Identifier><AffiliationInfo><Affiliation>Director Office, District 9 Health Center, Ho Chi Minh, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Lam V</ForeName><Initials>LV</Initials><Identifier Source="ORCID">0000-0001-5970-0528</Identifier><AffiliationInfo><Affiliation>President Office, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aesthetic Plastic Surgery & Skin Care Center, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Kien T</ForeName><Initials>KT</Initials><Identifier Source="ORCID">0000-0002-7176-8055</Identifier><AffiliationInfo><Affiliation>Department of Health Education, Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chang</LastName><ForeName>Peter W S</ForeName><Initials>PWS</Initials><Identifier Source="ORCID">0000-0001-6651-3624</Identifier><AffiliationInfo><Affiliation>School of Medicine, Chung Shan Medical University, Taichung, Taiwan.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Public Health and Community Medicine, Tufts University School Of Medicine, Boston, MA, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Duong</LastName><ForeName>Tuyen Van</ForeName><Initials>TV</Initials><Identifier Source="ORCID">0000-0002-2287-0723</Identifier><AffiliationInfo><Affiliation>School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>Canada</Country><MedlineTA>J Med Internet Res</MedlineTA><NlmUniqueID>100959882</NlmUniqueID><ISSNLinking>1438-8871</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D057220" MajorTopicYN="N">Health Literacy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008019" MajorTopicYN="N">Life Style</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011594" MajorTopicYN="N">Psychometrics</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015203" MajorTopicYN="N">Reproducibility of Results</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName><QualifierName UI="Q000472" MajorTopicYN="Y">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017216" MajorTopicYN="N">Telemedicine</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">COVID-19</Keyword><Keyword MajorTopicYN="Y">Vietnam</Keyword><Keyword MajorTopicYN="Y">adherence</Keyword><Keyword MajorTopicYN="Y">control</Keyword><Keyword MajorTopicYN="Y">disposing</Keyword><Keyword MajorTopicYN="Y">eHealth</Keyword><Keyword MajorTopicYN="Y">eHealth literacy</Keyword><Keyword MajorTopicYN="Y">handwashing</Keyword><Keyword MajorTopicYN="Y">health care workers</Keyword><Keyword MajorTopicYN="Y">health literacy</Keyword><Keyword MajorTopicYN="Y">infection prevention</Keyword><Keyword MajorTopicYN="Y">lifestyle</Keyword><Keyword MajorTopicYN="Y">masks</Keyword><Keyword MajorTopicYN="Y">personal protective equipment</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>07</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>10</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>09</Month><Day>25</Day></PubMedPubDate><PubMedPubDate 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