The mediating role of health literacy for COVID-19 between preventive behaviors and quality of life

Background: The coronavirus disease 2019 (COVID-19) pandemic rapidly developed around the world. Plenty of health information about the virus was available from multiple media platforms, but such information was not always accurate. Identifying misinformation depends on an individual's health literacy. Aims: The purposes of this study were to explore sociodemographic factors affecting health literacy in terms of COVID-19 and preventive behaviors, and relationships among health literacy, preventive behaviors, and quality of life by path modeling. Methods: A cross-sectional study design was conducted in July to November 2020. Participants were healthy adults aged over 20 years in the United States. Data collection used self-developed questionnaires designed by our research team and the World Health Organization-Quality of Life Scale. Descriptive analyses, independent t-tests, a one-way analysis of variance, and a partial least squares path model were performed for the statistical analyses. Results: In total, 467 people responded. Results showed significant differences in health literacy and preventive behavior scores in terms of age, gender, alcohol consumption, smoking status, being a health professional, and having been tested for COVID-19. A significant path model was developed with satisfactory to good composite reliability, good convergent validity and discriminant validity, and an acceptable model fit. Conclusions: Health literacy was a significant mediator between preventive behaviors and quality of life in the path model. Individuals can improve their health literacy to reinforce engaging in preventive behaviors and promoting quality of life during the pandemic.