Investigating health literacy and its Relationship with the Social Influences of COVID-19 in Police force employees

Document Type : Original Article


1 Department of Public Health, School of Public Health, Jiroft University of Medical Sciences, Jiroft, Iran

2 Assistant Professor, Department of Health, School of Health, Khoy University of Medical Sciences, Khoy, Iran

3 Department of Public Health, Faculty of Nursing and Midwifery, Iranshahr University of Medical Sciences, Iranshahr, Iran

4 Department of Midwifery, Islamic Azad University, Urmia Branch, Urmia, Iran

5 Department of Nursing, Islamic Azad University, Urmia Branch, Urmia, Iran


Background and Objective: COVID-19 quickly spread worldwide, causing anxiety and fear among individuals and negatively impacting society. One key component for improving control over social factors is health literacy. This study aimed to investigate health literacy and its relationship with the social Influences of COVID-19 on Police force employees.

Materials and methods: In this descriptive cross-sectional study, 300 employees of the Police force employees were included using the census sampling method. The data collection tool was a questionnaire consisting of demographic characteristics, a Health Literacy questionnaire (HELIA), and the social Influences of COVID-19(SIQ) in 2022. The collected data were analyzed using statistical tests including analysis of variance, Pearson correlation, and regression analysis. The data were analyzed with SPSS24 software at a significance level of 0.05.

Results: The results of this study showed that the average health literacy score of Police force employees was 21.91 ± 68.11. In the division of health literacy, 32% had insufficient health literacy, 20.3% had sufficient health literacy, and 22.6% had excellent health literacy. Also, in the classification of the social Influences of COVID-19, 38% were found to have high social Influences, 3/38% had moderate effects, and 7/23% had low effects. Regression results showed a significant relationship between health literacy and the social Influences of COVID-19 (p <0.001). Health literacy can explain 64.0% of the variance of social Influences in Police force employees.

Conclusion: Given the importance of health literacy in preventing COVID-19 and its impact on the social Influences of COVID-19, it appears that educational programs aimed at increasing health literacy can be effective in addressing the social Influences of COVID-19. 


Acknowledgements: The authors thank all participants.

Availability of data and materials: Data will be available upon request from the corresponding author.

Conflicts of interests: The authors declare that they have no conflict of interest.

Consent for publication: Not applicable.

Ethical approval and consent to participate: All methods were carried out in accordance with relevant guidelines and regulations as defined by the Declaration of Helsinki. The ethics committee of Islamic Azad University, Urmia Branch (IR.IAU.URMIA.REC.1400.098) approved the present research. In addition, the study team obtained Informed consent from participants

Funding: No financial support was received for this study.

Author contributions: All authors have their responsibilities in this review manuscript. All authors read the final draft of the manuscript and confirmed it.

1- Shiralinia K, Shirmardi S, Fathi K. Predicting Preventive Covid-19 Disease Behaviors Based on Health Literacy With the Mediating Role of Media and Social Responsibility in Adults Living in Ahvaz. Jundishapur Scientific Medical Journal. 2021;20(4):390-9.
2- Zareipour M, Jadgal M-S, Khazir Z, Moradi Z, Amirzehni J. Study of lifestyle and its relationship between health literacy in health ambassadors in Urmia. Journal of Health Literacy. 2021;6(2):33-40.  
3- Zareipour M, Sadaghianifar A, Moradi Z, Jafari N, Esmzadeh M. Health literacy and its relationship with self-efficacy in health ambassadors. Journal of Health Literacy. 2020;4(4):56-63.  
4- Mahmoudiani, Eddin S, Qaidi, Kiana, Rajabi, Maherkh. The effect of health literacy on health-oriented behaviors against the coronavirus in Shiraz City. Letter of Iranian Demographic Society. 2021;16(32):363-85.  
5- Rüegg R, Abel T. Challenging the association between health literacy and health: the role of conversion factors. Health promotion is international. 2022;37(1):daab054.
6- Omrani SA, Sheikhi S, Khaledi A, Safari S. The Relationship Between Health Literacy and Social Commitment with Health Self-Care during the Covid-19 disease pandemic. Social Welfare. 2021;21(82):161-88.  
7- Mahmoudiani S, ghaedi k. Investigating the Relationship between Health Literacy with the Odds of Infection with the COVID-19 Disease (The Case of Adult Population in Shiraz City in 2022). Hakim Research Journal. 2022;25(1):0-.  
8- sheivandi k, hasanvand f. Developing a Model for the Psychological Consequences of Corona Epidemic Anxiety and studying the Mediating Role of Spiritual Health %J Counseling Culture and Psycotherapy. 2020;11(42):1-36.  
9- Khalajinia Z, Abedini Z, Ahmari Tehran H, Khoramirad A. Explaining People's Experience of Life in the Context of Covid-19 Epidemic in Qom %J Qom Univ Med Sci J. 2021;15(7):464-73.  
10- Police force employees fi H. Damages of Corona in the field of pilgrimage and ways out of it. pilgrimage culture. 2022;42(11):93-118.  
11- Rahmani H, Arab M, Saeedpour J, Rajabi Vasokolaei G, Mirzaii H. Iran's Health Tourism Market during and after the Corona Pandemic: Letter to the editor %J Management Strategies in Health System. 2020;5(3):165-8.  
12- Parandeh A, Rahmati-Najarkolaei F, Isfeedvajani MS. Health literacy knowledge and experience survey: Cross-cultural adaptation and the psychometric properties of the Iranian nurse version. Journal of Education and Health Promotion. 2020;9.
PMid:33209936 PMCid:PMC7652083  
13- Rasouli H, Farajzadeh M, Tadayon AH. Evaluation of e-health literacy and its predictor factors among patients referred to a military hospital in Tehran, Iran, 2017. Journal of Military Medicine. 2018;20(1):83-92.  
14- Tavana M, Esmi, A...N, Good-hearted. Soldiers' awareness of health issues in one of the military training centers. military medicine 2022;10(4):293-7.  
15- Nouri R, Ashtiani A, Ahmadi K, Gholamalilavasani M. General status and mental health in basic combat training soldiers. J mil Psychol. 2014;5(18):5-14.  
16- Choi Y, Jeong GH. Army soldiers' knowledge of, attitude towards, and preventive behavior towards tuberculosis in Korea. Osong public health and research perspectives. 2018;9(5):269.
17- Zadeh A., Zadeh N., Kalrouzi, Peshgoui, Amirhossein S. Investigating the relationship between health literacy and preventive behaviors of soldiers. Journal of Military Care Sciences. 2021;8(2):109-16.  
18- Nowrozi, Varia, Talebi, Behnam, Sharif A, Frank, et al. Prediction of preventive behaviors against covid-19 based on health literacy in 30-50-year-old visitors to Ardabil health centers. Journal of Health Research in Society. 2023;8(4):1-12.  
19- Montazeri A, Tavousi M, Rakhshani F, Azin SA, Jahangiri K, Ebadi M. Health Literacy for Iranian Adults (HELIA): development and psychometric properties. Payesh. 2014;13(5):589-600.  
20- Adelinejad F, Faraji A, Alipour FJIJoE. Validation of the Societal Influences Survey Questionnaire for Effects of Covid-19 in Iranian Students. 2021;16:38-49.  
21- Shin KS, Lee EH. Relationships of health literacy to self‐care behaviors in people with diabetes aged 60 and above Empowerment as a mediator. Journal of advanced nursing. 2018;74(10):2363-72.  
22- Wong KK, Velasquez A, Powe NR, Tuot DS. Association between health literacy and self-care behaviors among patients with chronic kidney disease. BMC nephrology. 2018;19:1-8.
23- Turhan Z, Dilcen HY, Dolu İ. The mediating role of health literacy on the relationship between healthcare system distrust and vaccine hesitancy during the COVID-19 pandemic. Current psychology. 2022;41(11):8147-56.
PMid:34312580 PMCid:PMC8295547  
24- Naveed MA, Shaukat R. Health literacy predicts Covid‐19 awareness and protective behaviors of university students. Health Information & Libraries Journal. 2022;39(1):46-58.
PMid:34595814 PMCid:PMC8646606  
25- Yang BX, Xia L, Huang R, Chen P, Luo D, Liu Q, et al. Relationship between eHealth literacy and psychological status during COVID‐19 pandemic: A survey of Chinese residents. Journal of nursing management. 2021;29(4):805-12.
PMid:33269492 PMCid:PMC7753302  
26- Nawrozi W, Talebi B, Asadi Sharif F, Mansoori K, Abasiraki F. Prediction of Preventive Behaviors against Covid-19 among Patients Aged 30 to 50 Admitted to Ardabil Health Centers Based on Health Literacy. Journal of health research in the community. 2023;8(4):1-12.  
27- Borji M, Tarjoman A, Otaghi M, Salimi E, Naseri A. Health literacy level and its related factors among the elderlies in Ilam in 2015. Iran Journal of Nursing. 2017;30(108):33-43.  
28- Mehralian G, Yusefi AR, Davarani ER, Ahmadidarrehsima S, Nikmanesh P. Examining the relationship between health literacy and quality of life: evidence from older people admitted to the hospital. BMC geriatrics. 2023;23(1):1-9.
PMid:36932343 PMCid:PMC10024369  
29- Sørensen K, Pelikan JM, Röthlin F, Ganahl K, Slonska Z, Doyle G, et al. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). European Journal of public health. 2015;25(6):1053-8.
PMid:25843827 PMCid:PMC4668324  
30- Saatchi M, Panahi M, Mozafari AA, Sahebkar M, Azarpakan A, Baigi V, et al. Health literacy and its associated factors: a population-based study, Hormuz Island. Iranian Journal of Epidemiology. 2017;13(2).  
31- Isazadeh M, Asadi ZS, Tahmasebi Gharajehmalek M, Soleimanifar M. Evaluation of Electronic Health Literacy Level of Patients Referring to a Selected Military Hospital in Tehran. Payavard Salamat. 2020;14(1):79-85.  
32- Rajabi E, Dastani M, Hadi Tavallaee N, Taghizadeh N, Jalali Z, Ameri F. Effect of E-Health Literacy on Mental Health of People During the COVID-19 Pandemic: A Systematic Review. Journal of Modern Medical Information Sciences. 2023;8(4):396-407.  
33- Kugbey N, Meyer-Weitz A, Asante KO. Access to health information, health literacy and health-related quality of life among women living with breast cancer: Depression and anxiety as mediators. Patient education and counseling. 2019;102(7):1357-63.
34- Nguyen HC, Nguyen MH, Do BN, Tran CQ, Nguyen TT, Pham KM, et al. People with suspected COVID-19 symptoms were more likely depressed and had lower health-related quality of life: the potential benefit of health literacy. Journal of clinical medicine. 2020;9(4):965.
PMid:32244415 PMCid:PMC7231234  
35- Mokhtari N, Nezafati A, Sheikholeslami F, Kazemnejad Leili E. Survey of the Relationship between Health Literacy Level and Health status among Elderly People Referring to Retirement Centers in Rasht City. 2019.  
36- Duplaga M, Grysztar M. The Association between Future Anxiety, Health Literacy and the Perception of the COVID-19 Pandemic: A Cross-Sectional Study. Healthcare. 2021;9(1):43.
PMid:33466487 PMCid:PMC7824811  
37- McCaffery K, Dodd RH, Cvejic E, Ayre J, Batcup C, Isautier JM, et al. Disparities in COVID-19-related knowledge, attitudes, beliefs, and behaviors by health literacy. medRxiv. 2020:2020.06. 03.20121814.  
38- Wolf MS, Serper M, Opsasnick L, O'Conor RM, Curtis L, Benavente JY, et al. Awareness, attitudes, and actions related to COVID-19 among adults with chronic conditions at the onset of the US outbreak: a cross-sectional survey. Annals of internal medicine. 2020;173(2):100-9.
38- Nguyen HT, Do BN, Pham KM, Kim GB, Dam HT, Nguyen TT, et al. Fear of COVID-19 scale associations of its scores with health literacy and health-related behaviors among medical students. International Journal of environmental research and public health. 2020;17(11):4164.
PMid:32545240 PMCid:PMC7311979  
40- Duplaga M, Grysztar M, editors. The association between future anxiety, health literacy and the perception of the COVID-19 pandemic: A cross-sectional study. Healthcare; 2021: MDPI.
PMid:33466487 PMCid:PMC7824811