Coronavirus-related health literacy and knowledge among German fourth-graders

Abstract Background Little is known about how easy it is for children to deal with coronavirus-related information, or to what degree children have accurate knowledge about the virus. However, both might influence children’s preventive behaviors. Thus, this study explores children’s coronavirus-related health literacy (CHL) and related knowledge. Methods In a classroom survey among fourth graders’ in North-Rhine Westphalia, Germany (07/21 - 11/21), 4 items were used to assess CHL. 5 items were used to measure coronavirus knowledge, while also assessing the frequency of speaking about the coronavirus with parents. Sociodemographic characteristics were recorded, including family affluence (FAS). Bivariate correlations are reported. Results n = 364 students are included (49.5% female), the mean age is 9.5 years (SD=.69). 47.5% of the sample find it rather difficult or very difficult to find information about the coronavirus, while this share is 36.1% for understanding, and 39.1% for appraising coronavirus information. 22.4% say it’s difficult to not infect themselves or others (applying information). Dealing with coronavirus-related information is more difficult for children who less frequently talk to their parents about the virus (ρ = 0.166, p<.01) and have lower family affluence (r=.119, p<.05). While certain misbeliefs are rare (“the coronavirus doesn't exist”; 3.9% agreement; “Children can't get infected”; 3.0%), the belief that eating healthy prevents an infection (15.6%), that all infected people have coughs and fever (62.8%), and that a face mask doesn't help prevent an infection (44.3%) are more prevalent. Children who have a home language other than German state more inaccurate knowledge (p<.05). Conclusions This study suggests that children’s needs for accessible and understandable information on the coronavirus were met only party. Also, certain misbeliefs are prevalent which might undermine adherence to preventive measures. More research is needed to verify these findings. Key messages • In our sample, children’s needs for accessible and understandable information on the coronavirus were met only party. • Misbeliefs about the coronavirus are prevalent which might undermine preventive measures.

Grasping the complexity of public health interventions is of increasing interest. Program evaluation may involve previously known and unknown variables; the former are best explored with quantitative, the latter with qualitative methods. As part of the impact evaluation of the Balassagyarmat Health Education Program (BEP), a near-peer education intervention targeting adolescents from a disadvantaged region of Hungary, we aimed to understand the complex effects of being an educator on medical students' knowledge about the biopsychosocial model of health. Thus, we developed a unified method that enables us to conduct an exploratory study on the effects of our intervention, then quantify and model that qualitative data. We started the method design with literature review and consultations with methodological and public health experts. We then refined the research questions based on a focus-group discussion held with 6 peer educators. After a set of pilot-interviews, we chose simulation interviewing as our knowledge elicitation procedure, then finalized the protocol with the help of additional piloting. In this unified method, simulation interviews are administered to peer educators and aligned controls, and cognitive task analysis is performed with the help of visual stimuli. Codes are developed inductively and, along with segmentation procedures, applied deductively to the entire dataset via the Reproducible Open Coding Kit. Resulting quantified narratives are further processed with Epistemic Network Analysis. The relative frequency of code cooccurrence in each segment is modelled with networks enabling the qualitative and statistical comparison of data between subsamples. Building on the benefits of qualitative and quantitative approaches, this method offers a complex evaluation of the impact of health education interventions. By strengthening the methods of program evaluation we aim to facilitate the development of more effective interventions.

Key messages:
Qualitative and quantitative methods can be unified in program evaluation to promote a deeper understanding of the complexity in public health interventions.
Cognitive task analysis as a knowledge elicitation procedure can be used for the impact evaluation of health education programs.

Background:
Medical record is an essential tool both in patients' diagnostic and therapeutic pathways and communication between different care providers. It also has an economic-administrative, medical-legal and epidemiological function. From an economic-administrative point of view, a medical record allows an evaluation and review of services to better manage the corporate health budget. In addition, it allows traceability and complete transparency of the health activities carried out.
The study evaluates the formal quality of medical records compiled in an Italian private clinic before and after a training intervention.

Methods:
In June 2019, a retrospective study was carried out to assess a private clinic's quality of medical records. One month later, healthcare providers were trained on the appropriate compilation of medical records, whose pre-printed format was structurally improved. In March 2020, we verified the quality of medical records produced after that training intervention. Statistical analysis (Wilcoxon test) was carried out through Stata.