Health literacy and coronavirus guideline adherence among families in Mexico

Problem considered The COVID-19 pandemic severely impacted Mexico, where misinformation and limited health literacy (HL) may have influenced public adherence to preventive guidelines. Prior studies have suggested that HL plays a critical role in shaping health behaviors, yet little is known about how HL affects Coronavirus Guideline Adherence (CGA) within family units, particularly among parents and youth in Mexico. Methods We conducted a cross-sectional study with 373 parent–youth pairs across all Mexican states. Participants completed online surveys measuring general HL using a validated 12-item scale and CGA through self-reported adherence to public health guidelines. We applied actor-partner interdependence modeling to assess how parents' and youths' HL influenced their own and each other's CGA. Analyses accounted for key demographic factors, including age, sex, residence type, and socioeconomic status. Results Higher HL was associated with greater personal adherence to COVID-19 guidelines for both parents and youth. Parents' HL predicted their own adherence and significantly influenced youth adherence, while youths' HL predicted only their own adherence. Female participants reported higher adherence levels than males. No significant differences were observed by socioeconomic status or rural versus urban residence. Conclusion These findings suggest that improving HL can strengthen adherence to public health guidelines during health crises. Importantly, parental HL appears to influence not only parents' own behaviors but also those of their children, highlighting the potential value of family-centered health promotion strategies. Culturally sensitive interventions that enhance HL may help communities, particularly in Mexico, better navigate future public health emergencies by boosting compliance with preventive measures.