Association between echinococcosis-specific health literacy and behavioural intention to prevent echinococcosis among herdsmen on the Tibet Plateau in China: a cross-sectional study.

BACKGROUND Echinococcosis is considered a neglected zoonotic disease and has been a major worldwide public health problem. Although it is known that health literacy is closely related to health behaviours and health outcomes, few studies have paid attention to echinococcosis related health literacy. This study aims to examine the association between echinococcosis-specific health literacy (ES-HL) and behavioural intention to prevent echinococcosis (BIPE) among herdsmen on the Tibet Plateauin in China. METHODS A cross-sectional study of 401 Tibetan herdsmen was conducted in Gande county of Qinghai Province, China. Participants were recruited from August to September 2018 and from February to March 2019. A self-developed questionnaire was used to measure demographic information, ES-HL and BIPE. Hierarchical regression analysis was done to identify the factors associated with BIPE. RESULTS In the hierarchical regression analysis, we entered age, sex, education level, marital state and family monthly income per capita into model 1 which explained a significant amount of variance in BIPE (Adjusted R2 change = 0.029, P = 0.006). Sex (β = - 0.125, P = 0.013) and family monthly income per capita (β = - 0.133, P = 0.009) were found to be associated with BIPE. Subsequently, the three factors of ES-HL were added to Model 1 to create Model 2. In Model 2, the two factors of ES-HL, perceived echinococcosis information support (β = 0.229, P < 0.001) and echinococcosis-specific self-management ability (β = 0.252, P < 0.001), were significantly associated with BIPE, while the information acquisition and evaluation ability factor (β =0.093, P = 0.089) was not found to be associated with BIPE. The model improved significantly when ES-HL was included (Model 2) explaining the 25.8% of variance of BIPE (Adjust R2 change =0.229, P < 0.001). CONCLUSIONS ES-HL is an important predictor of whether individuals take preventive actions against echinococcosis. An ES-HL promotion action project should be developed targeting specific populations to enhance the prevention of echinococcosis.