Hina Shan - Assistant Professor, Department of Public Health, National University of Medical Sciences
Uzma Hassan - Head of Department, Department of Public Health, National University of Medical Sciences (NUMS)
Rubab Zulfiqar - MPH Trainee, AFPGMI, National University of Medical Sciences (NUMS)
Tamkeen Jaffry - Associate Professor, Department of Public Health, National University of Medical Sciences (NUMS)
Maryam Shan - Associate Professor, Department of Anatomy, Quetta Institute of Medical Sciences (NUMS)
Saadia Maqbool - Assistant Professor, Department of Public Health, Akhtar Saeed Medical and Dental College

Background and Objectives: The concept of health literacy shaping attitudes and behaviours is critical in preventing and controlling person-to-person transmission in the spread of infectious diseases. Health literacy is a determinant of health; it impacts the effective use of health behaviour by empowering individuals and communities to prevent epidemics like Coronavirus and Monkeypox. The study aims to assess the association between health-protective behavior and health literacy for preventing the spread of the Coronavirus during the pandemic in adolescents of Rawalpindi, Pakistan.  Materials and Methods: A cross-sectional descriptive study was conducted in public and private schools of Rawalpindi, ۳۸۷ middle and high school students. Multiple linear regression was used to find the association between the main explanatory variable, health literacy and the outcome variables, health knowledge and health behaviour. The study was conducted in ten different sessions, each requiring one hour from ۱st August to ۳۱st October ۲۰۲۱, the self-administered questionnaire was used as a data collection tool, and a total of ۳۸۷ participants took part in the study. Data were entered and analysed using SPSS Version ۲۷.Results: Multiple linear regression analyses showed a significant association between health literacy and health knowledge ( β ̂ = ۰.۰۴, ۹۵% CI = ۰.۰۰۵–۰.۰۶۹, p=۰.۰۲۳), and between health literacy and health behaviour (β ̂= ۰.۰۷, ۹۵% CI = ۰.۰۴۸–۰.۰۹۹, p<۰.۰۰۱). Conclusion: Health literacy is significantly associated with increased hand hygiene knowledge and behaviour. Government should prioritise health literacy policy and practice and make it more sustainable, effective, and integral using the multi-level targeted approach for the national educational sector.

Adolescents, behaviour, COVID-۱۹, Education, Hand Hygiene, health promotion