A Psychometric and Relative Importance Evaluation of Health Literacy and Health Consciousness on COVID-19 Preventive Behaviors Among Hispanic Adults

Abstract

Given the COVID-19 pandemic's disproportionate impact on Hispanic individuals in the United States, research examining modifiable psychosocial correlates of COVID-19 preventive behaviors in this population is warranted. Prior research highlights health literacy and health consciousness as integral for the establishment of health-promoting behaviors. Notwithstanding, very little research has validated theory-based measures for health literacy and health consciousness and no research has investigated their relative importance in explaining behaviors that prevent COVID-19 illness among Hispanic individuals. This information is necessary for informing behavioral interventions seeking to promote the well-being of Hispanic people during the current pandemic and in future ones. This study provides a psychometric evaluation of the General Health Literacy Scale (GHLS) and the Health Consciousness Scale (HCS) and further examines their association with conventional COVID-19 preventive behaviors. Confirmatory factor analyses evaluated the psychometric properties of GHLS and HCS. Four separate hierarchical linear regressions, followed by dominance analyses, estimated the relative importance of health literacy and health consciousness on COVID-19 preventive behaviors, adjusting for sociodemographic characteristics. Both GHLS and HCS achieved adequate psychometric criteria, and holding constant sociodemographic characteristics, positively related to COVID-19 preventive behaviors. Although both health literacy and health consciousness were more important than sociodemographic characteristics in explaining COVID-19 preventive behaviors, health consciousness was most important, exceeding the explanatory power of health literacy in all regressions. COVID-19 public health campaigns that seek to raise health awareness among Hispanic people might prove more effective than campaigns that only seek to improve their health literacy.

Keywords: COVID-19 preventive behaviors; dominance analysis; health consciousness; health literacy.