Study Design and Sampling
This descriptive and cross-sectional study was carried out between March-June 2022. The target population of the study consisted of teachers working in schools affiliated to the XXX Provincial Directorate of National Education at the time the study was conducted. The sample size of the study was calculated according to the formula for the sample size whose target population is known (Sümbüloğlu & Sümbüloğlu 2009). The formula used for the calculation is given below. The size of the target population was 1050 teachers in 34 schools and the sample size was found as 282 teachers.
In addition, using the OpenEpi sample size calculation program, it was calculated that 407 teachers should be included in the study sample at 50% incidence rate, 1% standard deviation, and 99.99% power. The teachers who worked at the schools affiliated to the XXX Provincial Directorate of National Education at the time of the research, who voluntarily agreed to participate in the research, and who filled out the consent form and data collection forms completely, were included in the study.
Data Collection Tools
The Personal Information Form developed by the researchers, the Health Literacy Instrument-Short Form, and the Vaccine Hesitancy Scale were used as data collection tools.
Personal Information Form
The form was developed by the researchers in line with the literature and consists of 18 questions pertaining to participants' age, gender, marital status, years of experience at work, school where the participant works, socio-demographic characteristics, the status of catching COVID-19, general health perception, presence of a chronic disease, and vaccination status.
Health Literacy Instrument-Short Form
The Turkish validity and reliability study of the instrument was conducted by Yılmaz and Eskici (2021). The Cronbach’s alpha of the original instrument is 0.856. The scale includes 12 items rated on a four-point Likert-type scale ranging from 1 (very difficult) to 4 (very easy). The formula of Index = (Mean-1) x 50/3 is used in the evaluation of the instrument. Mean is calculated by dividing the total score obtained from the instrument by the number of items in the instrument. The index value calculated by the formula varies between 0-50. Higher scores indicate better health literacy levels. In this study, the Cronbach’s alpha was found to be 0.844.
Vaccine Hesitancy Scale-Short Form
The scale was developed by Kılınçarslan et al. (2020). It consists of 12 items on a 5-point Likert scale (1-I strongly disagree, 5-I strongly agree). The items are grouped under three factors. Items 1, 2, 3, 4, and 5 are reverse-coded. The score range in the scale varies between 5 and 60, and high scores indicate that the individual's vaccine hesitancy level is high. The Cronbach's alpha of the original scale was 0.855, while the Cronbach’s alpha was found to be 0.882 in this study.
Data Collection
The data were collected via the online link (Google form) created for the research. The school administration sent the online link to the school groups and the teachers were invited to the research. In the link, information about the study was given and the teachers were requested to give consent for voluntary participation. The teachers who gave consent were able to see the data collection forms.
Data Analysis
Analysis was carried out using the SPSS 24 program. While evaluating the data, descriptive statistical methods (number, percentage, min-max, median values, mean and standard deviation) were used. The data analysis process started by testing whether the data showed normal distribution. For this purpose, skewness and kurtosis values were calculated. It was seen that the data did not show normal distribution. Thus, the Mann Whitney U test and the Kruskal Wallis analysis were performed. The Bonferroni analysis was conducted to determine the difference in multiple comparisons. Spearman correlation analysis was performed to determine the relationship between the scales. The analysis was carried out at 95% confidence interval and p<0.05 was considered significant.
Ethical Considerations
Ethical approval for the study was obtained from XXX Non-Interventional Human Research Ethics Committee (Decision No 2022/03-08), and institutional permission was obtained from XXX Provincial Directorate of National Education. All steps of the study were carried out in accordance with the Declaration of Helsinki. The teachers invited to the study were included in the study after their informed consent was obtained. On the first page of the online link, the participants were informed about the research team and the aim of the study. They were explained that the data obtained from the study will be used only for scientific purposes, they can withdraw from the study at any time, their participation in the research will not have any impact on their lives, and the data collected will be kept confidential. Those who chose the option "I agree" were considered to give consent to participate in the study.