The coronavirus disease 2019 (COVID-19) pandemic causes fear, as its immediate consequences for the public have produced unprecedented challenges for the education and healthcare systems. We aimed to validate the fear of COVID-19 scale (FCoV-19S) and examine the association of its scores with health literacy and health-related behaviors among medical students. A cross-sectional study was conducted from 7 to 29 April 2020 on 5423 students at eight universities across Vietnam, including five universities in the North, one university in the Center, two universities in the South. An online survey questionnaire was used to collect data on participants’ characteristics, health literacy, fear of COVID-19 using the FCoV-19S, and health-related behaviors. The results showed that seven items of the FCoV-19S strongly loaded on one component, explained 62.15% of the variance, with good item–scale convergent validity and high internal consistency (Cronbach’s alpha = 0.90). Higher health literacy was associated with lower FCoV-19S scores (coefficient, B, −0.06; 95% confidence interval, 95%CI, −0.08, −0.04; p < 0.001). Older age or last academic years, being men, and being able to pay for medication were associated with lower FCoV-19S scores. Students with higher FCoV-19S scores more likely kept smoking (odds ratio, OR, 1.11; 95% CI, 1.08, 1.14; p < 0.001) or drinking alcohol (OR, 1.04; 95% CI, 1.02, 1.06; p < 0.001) at an unchanged or higher level during the pandemic, as compared to students with lower FCoV-19S scores. In conclusion, the FCoV-19S is valid and reliable in screening for fear of COVID-19. Health literacy was found to protect medical students from fear. Smoking and drinking appeared to have a negative impact on fear of COVID-19. Strategic public health approaches are required to reduce fear and promote healthy lifestyles during the pandemic.

Studies evaluating the influence of health literacy on patient behavior and outcomes suggest a positive relationship between health literacy and health knowledge, health behaviors, and health status. In Latin American countries, studies assessing health literacy are few, regional, and demonstrate considerable variation, with reported rates of adequate health literacy ranging from 5.0% to 73.3%. In this paper, we examine and explore the state of health literacy and efforts to promote it in Latin America. Key challenges to those efforts include socioeconomic inequality, social/geographic isolation, and cultural-, language-, and policy-related barriers, many of which disproportionately affect indigenous populations and others living in rural areas. Greater use of infographics, videos, and mobile apps may enhance health literacy and patient empowerment, especially when language barriers exist. This paper provides strategies and tools for tailored programming, examples of successful health literacy interventions, and policy recommendations to improve health literacy in Latin America, intending to spur additional discussion and action. Centrally organized collaboration across multiple sectors of society, with community involvement, will enhance health literacy and improve health and well-being across Latin America.

We set out to test a theory-based measure of health literacy. To do so, we included the newly developed Calgary Charter on Health Literacy scale in Pre- and Post-evaluation of the Life Enhancement Program at multiple sites. The program focusing on health literacy and the prevention of chronic disease is conducted with health-care provider organization partners across the United States. In testing the reliability and validity of the new measure of health literacy, Cronbach’s alpha is very acceptable level at 0.80. There are numerous statistically significant correlations between the change in health literacy and participants’ changes in knowledge, attitudes, beliefs, behaviors, and health status. Data and analysis indicate that the Calgary Charter on Health Literacy Scale is a valid and reliable measurement tool in the contexts and with the populations they were tested within. More testing is necessary and warranted in a wider variety of contexts and populations—ideally to include large representative random samples and comparison groups. We recommend that policymakers increase focus on advancing health literacy as an evidence-based approach to reach the goals of improved individual and public health at a lower cost.

In a steadily growing effort, the world has witnessed more than three decades of effort in research, practice, and policy to socially construct what has been identified as ‘health literacy. While much of the earlier work in health literacy was in the United States, the extent of scholars and practitioners is now truly global. To advance international health literacy, the chapter highlights the role of the World Health Organization (WHO) and a series of international conferences that began in 1980s. More specifically, the chapter outlines World Health Organization’s overarching health literacy efforts, notes the importance of health literacy within WHO’s new organization structure, briefly describes how the concept of health literacy emerged throughout a generation of the WHO’s international conferences, suggests an ethical foundation for the WHO’s health literacy work, and explains how the groundwork set by the WHO provides some challenges and foundations for future health literacy research and practice.