Letramento em saúde, ameaça de adoecer pela Covid-19 e intenção de vacinar de adolescentes brasileiros

Abstract

Objective: To analyze the relationship of health literacy with perceived health threat by COVID-19, intention to vaccinate, and with sociodemographic and clinical factors of Brazilian adolescents. Method: Cross-sectional study with 526 Brazilian adolescents aged 14 to 20 incomplete years. Data were collected using the instruments: Questionnaire for sociodemographic characterization and health-disease profile; COVID-19 threat assessment questionnaire and intention to be vaccinated and Health Literacy Assessment Tool - Portuguese version, organized via online form. Data collection took place from July 13 to September 30, 2021 using the Google Forms tool. Associations were assessed by bivariate analysis, multiple linear regression with Poisson response (article 1) and multiple linear regression with normal response (article 2). Results: The mean health literacy score was 25.3 points ±5.4. Better health literacy (p=0.010), having heart disease (p=0.006), lower income (p=0.000) and living in the northern region (p=0.007) were factors that contributed to feeling more threatened by COVID- 19. Regarding vaccination intent, 65.2% (n=343) of participants had not yet received any dose against COVID-19, 24.9% (n=131) had already received the first dose, and 9.9% (n=52) had received both doses of the vaccine or the single dose vaccine. Among those who had not started or completed the vaccination schedule, 86.9% (n=457) intended to receive the vaccine. The prevalence of intention not to be vaccinated was lower among adolescents from the Southeast compared to the North (p=0.010), among those in higher education compared to those in elementary school (p=0.049), and among those with higher income (p=0.000). Intention not to be vaccinated was not influenced by health literacy, although a trend was observed in which the higher the health literacy score, the lower the prevalence of intention not to be vaccinated. Considering health literacy as an outcome, factors such as female gender (p=0.014), higher education (p=0.002), and medication use (p=0.020) were related to higher levels of health literacy. Adolescents with chronic diseases had higher total health literacy scores, on average 1.51 points, when compared to those without chronic diseases. Conclusion: Health literacy influenced perceived disease threat, but not the intention not to be vaccinated. Health threat assessment by COVID-19 and the prevalence of intention not to be vaccinated were influenced by region of residence, income, and education. The level of health literacy was influenced by gender, education, and medication use. These factors reinforce the importance of professional interventions focused on the social determinants of health and the implementation of intersectoral actions aimed at adolescent health.