Health Literacy, Covid-19 and risk perception: a cross-sectional survey in Prato in the 2nd wave

Abstract   During the Covid-19 pandemic, individual and collective public health measures were undertaken to control the spread of the virus. Their effectiveness relies on people’s abilities to understand and adopt the correct behaviors. This study aims to evaluate the role of Health Literacy (HL) in influencing the adherence to Covid-19 preventive measures and risk perception of a sample of workers employed in various activities involving close contact with the population in the province of Prato (Tuscany, Italy) in the second pandemic wave (November-December 2020). A cross-sectional survey was conducted on a sample of public workers (e.g., teachers, educators, assistants/aides, other health personnel). Data on knowledge, attitudes and practices towards (KAP) Covid-19 preventive measures and risk perception were collected. HL was measured with the HLS-EU-Q6 tool. Spearman correlation analysis was used to assess the correlation between HL and KAP and Covid-19 risk perception. Multivariate linear regression analyses were performed to evaluate the role of HL in predicting KAP and Covid-19 risk perception, adjusted for sex, age, comorbidity, educational level, country of birth. A total of 402 people participated in this study; 47.8% had a problematic HL level. The HL level was correlated with KAP and practices towards Covid-19 prevention measures; no significant associations were found with Covid-19 risk perception. In multivariate models, HL significantly and positively predicted a higher level of knowledge of Covid-19 preventive measures (B = 0.413 for problematic HL; B = 0.542 for sufficient HL). Confirming a previous study conducted in Prato in the first pandemic wave, HL did not predict adherence to Covid-19 infection control measures, probably due to fear of the disease and attention towards prevention behaviors being still higher in the second pandemic wave. Key messages • HL skills are linked to understanding of public health measures. • HL skills should be improved to favor the adherence to correct behaviors.


Background:
The development of melanoma in adulthood is strongly associated with sunburns during childhood. Parental knowledge and behaviours play a key role in sun protection behaviour from which children can acquire general and integrated learning patterns. With this being known, numerous positive preventive health behaviours can be initially shaped in the family, with children having parents as a model.

Methods:
A cross-sectional approach (web-based questionnaire) was conducted to gather information regarding parents' knowledge and behaviours of children's sun protection, alongside the predictors that might influence the adoption of these behaviours, between April and May 2021. The survey was disseminated to 53 primary school teachers from 9 schools in Cluj-Napoca Romania, and the data set included 355 valid surveys (parents with at least one child aged between 0 to 12 years old) out of 476 total surveys. Descriptive statistics, Chi-square tests of association and logistic regressions were computed.

Results:
The study showed differences in children's sun exposure patterns, their sunburn and parental sun protection behaviour. Overall, parents reported fair sun protection behaviours and children's sunburn frequency was overall moderate among all children in the previous summer season. However, an increase in children's age generates an increase in parents' sunscreen application for their children in both planned and incidental situations. There were statistically significant associations between parents' sex and their knowledge about the fatal consequences of skin cancer or their level of education and the damage produced by tanning bed usage or sunscreen efficiency measures.

Conclusions:
These results are a starting point for various program interventions that can be done for parents in order to increase their knowledge on sun protection practices for their children.

Key messages:
Skin cancer is substantially preventable if unprotected exposure to ultraviolet radiation is reduced during the first years of a child's life. Parental knowledge and behaviors play a key role in sun protection behavior from whom children can acquire general and integrated learning patterns. During the Covid-19 pandemic, individual and collective public health measures were undertaken to control the spread of the virus. Their effectiveness relies on people's abilities to understand and adopt the correct behaviors. This study aims to evaluate the role of Health Literacy (HL) in influencing the adherence to Covid-19 preventive measures and risk perception of a sample of workers employed in various activities involving close contact with the population in the province of Prato (Tuscany, Italy) in the second pandemic wave (November-December 2020). A cross-sectional survey was conducted on a sample of public workers (e.g., teachers, educators, assistants/aides, other health personnel). Data on knowledge, attitudes and practices towards (KAP) Covid-19 preventive measures and risk perception were collected. HL was measured with the HLS-EU-Q6 tool. Spearman correlation analysis was used to assess the correlation between HL and KAP and Covid-19 risk perception. Multivariate linear regression analyses were performed to evaluate the role of HL in predicting KAP and Covid-19 risk perception, adjusted for sex, age, comorbidity, educational level, country of birth. A total of 402 people participated in this study; 47.8% had a problematic HL level. The HL level was correlated with KAP and practices towards Covid-19 prevention measures; no significant associations were found with Covid-19 risk perception. In multivariate models, HL significantly and positively predicted a higher level of knowledge of Covid-19 preventive measures (B = 0.413 for problematic HL; B = 0.542 for sufficient HL). Confirming a previous study conducted in Prato in the first pandemic wave, HL did not predict adherence to Covid-19 infection control measures, probably due to fear of the disease and attention towards prevention behaviors being still higher in the second pandemic wave.

Background:
Caries is one among the most prevalent dental disease and its prevention and treatment are crucial from both dental care and public health perspectives. Yet, caries' management greatly varies across contexts according to the availability of specific Clinical Practice Guidelines (CPGs). Here, we present the results of a systematic review aimed at the appraisal of the current available CPGs on caries prevention and treatment.

Methods:
A literature search was performed in PubMed, EMBASE, SCOPUS, and seven relevant guidelines databases up to March 2022, exploring CPGs published from 2012. The literature review was conducted in accordance with PRISMA guidelines. The Appraisal of Guidelines, Research and Evaluation (AGREE) II checklist was used to measure the methodological rigour and quality of the retrieved CPGs.

Results:
The systematic search resulted in a total of 1403 records, and 21 CPGs met the inclusion criteria. Overall, these considered different aspects of caries prevention and treatment. Regarding the appraisal through the AGREE II tool, the overall median score was 60.2% and 11 out of 21 CPGs were classified as ''Recommended'', while the others as ''Recommended with modification''. The domain analysis showed that the highest median scores were reached for Scope and Purpose (88.9%), Clarity of Presentation (86.9%), and Rigor of Development (67.8%), while the lowest were seen for Stakeholder Involvement (63.3%), Applicability (17.5%), and Editorial Independence (50%).

Conclusions:
This systematic review showed that the rigor of CPGs for caries prevention and treatment remained suboptimal according to AGREE II evaluation, and highlighted that more efforts are needed to improve their quality. The AGREE II checklist is a comprehensive and easy-to-use tool for the development of CPGs, and its use ensures that evidence-based approaches are incorporated into consistent recommendations for the translation of evidence into practice. Key messages: The rigor of CPGs for caries prevention and treatment is suboptimal according to AGREE II evaluation, however, more efforts are needed to improve their quality. The AGREE II checklist is a comprehensive and easy-to-use tool for the development of CPGs.
Abstract citation ID: ckac131.365 Exploring behavior change motivation in an outpatient sample with more than one health risk behavior

Background:
Evidence from western countries shows that the majority of adults have two or more health risk behaviors. The motivation to engage in a health behavior change (HBC) is the most proximal determinant of behavior change in the future. The aim of this study was to investigate the intention to increase physical activity and to quit smoking in an outpatient sample that show both health risk behaviors.

Methods:
We used baseline data (n = 109) of an intervention study (Germany, 2016-2019) on physical activity and smoking cessation. Eligibility criteria were: aged 40 to 65 years, systolic blood pressure 130 mmHg, no history of cardiovascular event or vascular intervention. We collected information on HBC motivation, sex, age, and self-rated health (SRH) and