The association between behaviors of wearing masks and health literacy among residents in Shandong Province
Objective To explore the association between behaviors changing of wearing masks and health literacy before and during the pandemic of COVID-19.Methods A cross-sectional survey was conducted in Shandong Province.By using stratified multi-stage cluster random sampling method,a total of 3247 residents aged 15-69 years were included in this study.Complex samples logistic regression model was conducted to explore the association between behaviors of wearing masks and health literacy.Results During the epidemic of COVID-19,96.69%of residents worn masks when they going out,only 33.94%of them knew how to wear masks correctly.Complex samples Logistic regression analysis showed that com-pared to the residents with low health literacy,residents with intermediate health literacy[OR(95%CI):4.50(3.11-6.50),P<0.001]and residents with adequate health literacy[OR(95%CI):9.05(4.82-17.02),P<0.001]had significant influence on wearing masks correctly.During the epidemic of COVID-19,54.56%of the residents had good behaviors of wearing masks,42.13%of the residents'behaviors of wearing masks changed better,and 3.31%of the resi-dents had poorly behaviors of wearing masks.Complex samples logistic regression analysis showed that compared to the resi-dents with low health literacy,residents with intermediate health literacy[OR(95%CI):12.55(3.60-43.72),P=0.001]and residents with adequate health literacy[OR(95%CI):26.23(2.77-248.03),P=0.008]were more likely to have good behaviors of wearing masks.Residents with intermediate health literacy[OR(95%CI):13.83(3.68-52.04),P=0.001]and residents with adequate health literacy[OR(95%CI):29.60(3.28-267.14),P=0.006]had significant influence on the changing better of mask wearing behaviors.Conclusion The behaviors changing of wearing masks among residents were related to their health literacy.Residents with adequate health literacy had better behav-iors of wearing masks than those who with low health literacy.The behaviors changing of wearing masks of residents with ade-quate health literacy were better than that of residents with low health literacy.