Almost three out of 10 individuals in the Netherlands have limited health literacy (HL), meaning that they have difficulty finding, understanding, appraising and applying health information. During the COVID-19 pandemic, people have been confronted with a large amount of information about the virus and the governmental measures against its spreading. Especially for individuals with limited HL it may be a challenge to understand and process this information.

To find out how what specific challenges people with limited HL faced during the COVID-19 pandemic, a qualitative study was performed in the Netherlands. Between June and October 2020, 28 people with limited HL were interviewed by phone (age range 20-84). In the semi-structured interviews we asked the participants how they acquired information about COVID-19 and governmental measures against it, what difficulties they experienced in understanding and applying this information and what may be needed to overcome these difficulties. We also addressed worries and other problems people might face as a result of the pandemic.

The participants in our study generally found the COVID-19 information too difficult, since it is much and complicated and sometimes contradictory. Virtually all interviewed people watched official press releases by the government on television, but needed additional information and explanation to really understand it. None of the participants knew or used the specific materials on COVID-19 that have been developed for people with limited health literacy. Many participants, especially those with a  chronic disease, would value additional personalized information from their own health care provider. Whether people are able or willing to comply with the preventive measures partly relies on the level of trust they have in the government. Trust or rather distrust was a definite issue for some of the participants. A general problem that was frequently mentioned was that as a result of Covid-19 regular health care was sometimes postponed.