Exploratory study to characterise the individual types of health literacy and beliefs and their associations with infection prevention behaviours amid the COVID-19 pandemic in Japan: a longitudinal study

Mao Yagihashi; Michio Murakami; Mai Kato; Asayo Yamamura; Asako Miura; Kei Hirai

doi:10.7717/peerj.16905

Exploratory study to characterise the individual types of health literacy and beliefs and their associations with infection prevention behaviours amid the COVID-19 pandemic in Japan: a longitudinal study

PeerJ. 2024 Feb 22:12:e16905. doi: 10.7717/peerj.16905. eCollection 2024.

Authors

Mao Yagihashi¹, Michio Murakami¹, Mai Kato², Asayo Yamamura², Asako Miura^{1

2}, Kei Hirai^{1

2}

Affiliations

¹ Division of Scientific Information and Public Policy, Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan.
² Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan.

Abstract

Background: During a global infectious disease pandemic such as the coronavirus disease 2019 (COVID-19), individuals' infection prevention/risk-taking behaviours are likely to differ depending on their health literacy and beliefs regarding the disease. To effectively promote infection prevention behaviours, it is necessary to enable information dissemination and risk communication that consider individuals' health literacy and beliefs. In this study, we exploratorily characterised segments based on individual health literacy and beliefs regarding COVID-19 among the Japanese during the early stage of the COVID-19 pandemic, and investigated whether infection prevention/risk-taking behaviours and fear of COVID-19 differed among these segments.

Methods: In this study, we conducted two web-based longitudinal surveys in Japan (PHASE 1, 1-30 November 2020, 6,000 participants; PHASE 2, 1-31 December 2020, 3,800 participants). We characterised segments of the target population using cluster analysis on health literacy and beliefs regarding COVID-19 obtained in PHASE 1. We further investigated the associations between the clusters and infection prevention/risk-taking behaviours and fear of COVID-19, obtained from PHASE 2.

Results: Five clusters were identified: 'Calm/hoax denial', 'Hoax affinity/threat denial', 'Minority/indifference', 'Over vigilance', and 'Optimism'. There were significant differences in infection prevention/risk-taking behaviours and fear of COVID-19 among the five clusters. The belief in susceptibility to infection, rather than affinity for hoaxes and conspiracy theories, was coherently associated with infection prevention/risk-taking behaviours and fear of infection across clusters. This study provides foundational knowledge for creating segment-specific public messages and developing interactive risk communication to encourage infection prevention behaviours.

Keywords: Cluster; Health literacy; Individual type; Infection prevention behaviour; Risk communication.

MeSH terms

COVID-19* / prevention & control
Health Literacy*
Humans
Japan / epidemiology
Longitudinal Studies
Pandemics / prevention & control
SARS-CoV-2

Grants and funding

This work was supported by Japan Agency for Medical Research and Development (AMED) COVID-19-related research (Initiatives regarding ethical, legal and social issues (ELSI)). Project name: Exploration for appropriate risk communication based on the detection of inappropriate ones: SNS case analysis and questionnaire survey (PI: Asako Miura). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.