New study identifies link between parental health literacy with COVID-19 test results in children

A Swansea University-led study has highlighted the importance of parental health literacy and suggests those with higher understanding and access to medical information were more likely to take their child to be tested for COVID-19 and be identified as positive.

Supported by the National Centre for Population Health & Wellbeing Research (NCPHWR), academics from Population Data Sciencea at Swansea University, Leuphana University of Lüneburg and Technische Universität München explored the relationship between children’s health behaviours and COVID-19 infections via the national HAPPEN Primary School network.

HAPPEN delivers a health and wellbeing questionnaire, the HAPPEN Survey, that focuses on the physical and mental health of primary school children in Wales.

The study collected 7,000 responses submitted prior to March 2020 and the start of the pandemic.

The responses were then examined alongside routine PCR COVID-19 testing data, collected between March 2020 and August 2021, stored in the SAIL Databank at Swansea University.

From this, the research team identified a range of factors associated with an increased likelihood of being tested for COVID-19, such as:

• Eating breakfast compared to not eating breakfast 
• Consuming sugary throughout the week
• Participating in more out-of-school clubs 
• Able to ride a bike 
• Able to swim 25 meters
• Older children 

Factors associated with an increased likelihood of testing positive included:

• Eating breakfast compared to not eating breakfast
• Being physically active for 60 minutes on 1-7 days per week compared to 0 days
• Able to ride a bike
• Older children
• Girls

The study also found that children from deprived areas were more likely to have a positive COVID-19 test result.

Findings from the study indicate these associations of healthier behaviours may be related to parental health literacy; the ability to access, understand and apply medical information to make informed decisions regarding medical advice or guidelines.

They also emphasise the importance of positive parental monitoring behaviours and having the resources required to support these behaviours, such as participating in physical group activities, which may increase exposure to COVID-19, but is essential for child development.

Lead researcher Dr Emily Marchant, based at ADR Wales in Population Data Science at Swansea University and funded by the Economic and Social Research Council (ESRC), said: “COVID-19 has brought to the forefront what individuals can do, and the measures society puts in place, for promoting positive health behaviours.

“Our study suggests the importance of health literacy, associated parental monitoring behaviours, and having the time, knowledge and resources to access relevant health services.

“As we head into the start of the new school year, we have a real opportunity to establish and build collective ‘health literacy capital’ for current and future generations.”

Co-author Tom Crick, Professor of Digital & Policy and Deputy Pro-Vice-Chancellor for Civic Mission at Swansea University, said: “The findings from this study go wider than the pandemic, as we slowly emerge into a post-COVID new abnormal — socially, culturally and economically.

“As part of the new Curriculum for Wales, phasing in from this September, health and wellbeing will have clear prominence as one of the six new areas of learning and experience.

“Now more than ever, there is a significant opportunity for Wales to better align policy and practice across education, health and social care to further enhance wider public and population health outcomes.”