gms | German Medical Science

23. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

24.09. - 27.09.2024, Potsdam

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Effects of health literacy on the risk of COVID-19 reinfection among healthy Austrian adults: a cross-sectional study

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  • Hans-Peter Wiesinger - Institute of General Practice, Family Medicine and Preventive Medicine; Institute of Nursing Science and Practice; Center for Public Health and Healthcare Research; PMU Salzburg, Österreich
  • Dagmar Schaffler-Schaden - Institute of General Practice, Family Medicine and Preventive Medicine; Center for Public Health and Healthcare Research; PMU Salzburg, Österreich
  • Maria Flamm - Institute of General Practice, Family Medicine and Preventive Medicine; Center for Public Health and Healthcare Research; PMU Salzburg, Österreich
  • Jürgen Osterbrink - Institute of Nursing Science and Practice; Center for Public Health and Healthcare Research; PMU Salzburg, Österreich
  • Alexandra-Domnica Höggerl - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU), Salzburg, Österreich
  • Verena Nunhofer - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU), Salzburg, Österreich
  • Lisa Weidner - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU);Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Salzburg, Österreich
  • Wanda Lauth - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU);Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Salzburg, Österreich
  • Georg Zimmermann - Team Biostatistics and Big Medical Data, IDA Lab Salzburg; Research Programme Biomedical Data Science; PMU Salzburg, Österreich
  • Nathalie Badstuber - Department of Psychological Assessment, Institute of Psychology; Paris-Lodron Universität Salzburg, Österreich
  • Christoph Grabmer - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU), Salzburg, Österreich
  • Orkan Kartal - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU), Salzburg, Österreich
  • Christof Jungbauer - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU);Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Salzburg, Österreich
  • Heidrun Neureiter - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU), Salzburg, Österreich
  • Nina Held - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU), Salzburg, Österreich
  • Will G Hopkins - Internet Society for Sport Science, Neuseeland
  • Tuulia Ortner - Department of Psychological Assessment, Institute of Psychology; Paris-Lodron Universität Salzburg, Österreich
  • Eva Rohde - GMP Laboratory; PMU, Salzburg, Österreich
  • Sandra Laner-Plamberger - Department for Transfusion Medicine; University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU), Salzburg, Österreich

23. Deutscher Kongress für Versorgungsforschung (DKVF). Potsdam, 25.-27.09.2024. Düsseldorf: German Medical Science GMS Publishing House; 2024. Doc24dkvf117

doi: 10.3205/24dkvf117, urn:nbn:de:0183-24dkvf1176

Published: September 10, 2024

© 2024 Wiesinger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background: Health literacy has a crucial role in self-prevention of infections (Sørensen et al., BMC Public Health 2012) and may therefore reduce the risk of reinfection with COVID-19.

Objective: We investigated the relationship between health literacy and risk of reinfection with COVID-19 in a study of Austrian blood donors. We hypothesised that individuals with higher utilisation of sources of information, greater estimation of their trustworthiness, and higher levels of perceived effectiveness are at lower risk of reinfection.

Methods: From December 2020, 180 blood donors (85 males, 95 females) aged 18 to 70 y who were positive for the anti-N (COVID) antibody participated in the study. No additional criteria were applied beyond blood-donation requirements. Donors returned to give a venous blood sample at 3, 6, 9, 18, and 24 months post-initial donation. Serological status was determined by assessing a more than 30% increase in anti-N antibodies in these samples,3 categorising individuals into primary infection, one reinfection, or more than one reinfection. At 18 and 24 months they completed a survey on health literacy to assess three constructs: source, trustworthiness, and effectiveness. Utilising a Poisson-regression model, we assessed the association between the number of reinfections and each of the three constructs of health literacy. The mean of Likert-scale variables was utilised for each construct. Risk of reinfection was expressed as the ratio of predicted mean count of reinfections for a difference of two standard deviations of the health-literacy variable. Uncertainty in the ratio relative to a smallest important reduction and increase of 0.90 and 1.11 provided evidence for a substantial effect. Ethical approval was obtained from the local ethics board (approval numbers: 1004/2021, SS22-0026-0026).

Results: Reinfection rates were similar for males and females (mean counts 1.08 and 1.16, respectively). Health-literacy constructs showed small-moderate correlations (0.24 to 0.48), so their effects on reinfection were analysed separately. With this initial small sample size, the effects of health literacy on reinfection with COVID-19 were generally inconclusive. However, there was some evidence that the perception of trustworthiness produced a reduction in reinfection for males (count ratio 0.85, 90%CI 0.67-1.08) and weak evidence that the perception of source produced a reduction for females (0.96, 0.87-1.06). There was weak evidence that the perception of effectiveness produced a reduction in reinfection for males (0.97, 0.86-1.08) and some evidence for an increase in females (1.16, 1.03-1.30).

Implication for research and/or (healthcare) practice: We need a bigger sample size to improve the precision of estimation before making a recommendation about improving health literacy. Based on these findings, we expect health literacy to be associated with at most a small reduction in the risk of reinfection with COVID-19.