Coronavirus-Related Health Literacy: A Cross-Sectional Study in Adults during the COVID-19 Infodemic in Germany

TLDR

The COVID‑19 pandemic has created an infodemic of abundant valid and invalid information, making health literacy—accessing, understanding, appraising, and applying health information—critical for navigating coronavirus‑related content. The study aimed to develop a coronavirus‑related health literacy instrument (HLS‑COVID‑Q22). Researchers conducted a cross‑sectional, representative online survey of German adults aged 16 and older to develop and validate the HLS‑COVID‑Q22 health literacy measure. The HLS‑COVID‑Q22 showed excellent reliability (α = 0.94) and adequate construct validity, yet only 49.9 % of participants had sufficient coronavirus‑related health literacy, with 50.1 % reporting problematic or inadequate levels, and many expressed difficulty judging the trustworthiness of media information, indicating a need for targeted public information campaigns.

Abstract

There is an “infodemic” associated with the COVID-19 pandemic—an overabundance of valid and invalid information. Health literacy is the ability to access, understand, appraise, and apply health information, making it crucial for navigating coronavirus and COVID-19 information environments. A cross-sectional representative study of participants ≥ 16 years in Germany was conducted using an online survey. A coronavirus-related health literacy measure was developed (HLS-COVID-Q22). Internal consistency was very high (α = 0.940; ρ = 0.891) and construct validity suggests a sufficient model fit, making HLS-COVID-Q22 a feasible tool for assessing coronavirus-related health literacy in population surveys. While 49.9% of our sample had sufficient levels of coronavirus-related health literacy, 50.1% had “problematic” (15.2%) or “inadequate” (34.9%) levels. Although the overall level of health literacy is high, a vast number of participants report difficulties dealing with coronavirus and COVID-19 information. The participants felt well informed about coronavirus, but 47.8% reported having difficulties judging whether they could trust media information on COVID-19. Confusion about coronavirus information was significantly higher among those who had lower health literacy. This calls for targeted public information campaigns and promotion of population-based health literacy for better navigation of information environments during the infodemic, identification of disinformation, and decision-making based on reliable and trustworthy information.