**3. Discussion**

### *3.1. The "Understanding COVID" Strategy*

The government of Asturias launched a public health campaign to improve the population response to the COVID-19 crisis and to fight against pandemic fatigue and infodemia. The main novelty of the "Understanding COVID" strategy consisted of specifically targeting a population selected on the basis of vulnerability criteria and identifying the topics on which they should be trained in. In addition, the training actions were delivered through a wide variety of methodologies tailor-made for recipients. For example, online training for all interested vulnerable citizens, posters for the productive sectors with the highest risk of transmission, pedagogical contests and educational games for schools, presence in social networks, etc. Definitively, 100 training actions were carried out for 21 subgroups of the vulnerable population, reaching more than 1000 individuals, but also students from almost 1000 classrooms and countless users from the hostelry industry and church sector.

A large number of graphic and audiovisual materials were developed that supported a positive and preventive discourse in the face of the COVID-19 pandemic. In addition, some of the materials disseminated in the school environment were co-created by children and adolescents since including them in the design was considered to increase acceptability.

One of the main challenges of the strategy was to reach as many vulnerable people of different ages as possible, as has been done in similar studies and interventions [15–25], but at the same time minimizing the technological gap that could leave someone behind, which is a common problem when trying to reach a vulnerable population using information technologies [9,26,27]. To do this, everyday technology tools already existing in homes, such as tablets and smartphones, were used, with no need for additional installation of complex programs. The design of the communication and dissemination strategy through digital technologies was in line with similar studies [28]. The good reception of the strategy "Understanding COVID" reinforced the choice of the method of dissemination and implementation, bringing this information accessible also to the population with hearing disabilities (with the support of professional translators in sign language) and visual (adaptation of audiovisual media).

Of all the actions of the "Understanding COVID" strategy, the ones that generated the most participation were those carried out in schools and in the catering sector since educational activities were added to the online training sessions in the centers and schools, and the distribution of posters occurred in restaurants. Gray et al. described the need to develop protection strategies within the school community and responded to an important need to provide information and support both to the teaching community and to families and students [29]. In our strategy, creativity and horizontal and ascending training were encouraged: from some students to others and from students to their parents. The information strategy in the hospitality sector through the "First Quality Air" campaign allowed commercial establishments to display posters with recommendations for the population, as well as to have a certificate accrediting the training received, thus promoting confidence and security among customers. As the restaurant industry is particularly sensitive to disasters, specific campaigns were run in some countries to encourage people to go out for lunch or dinner. Campaigns such as "Go to Eat" in Japan or "Eat Out to Help Out" in the United Kingdom applied discounts for dining in restaurants and simultaneously achieved an increase in sales and a rebound in cases [30,31].

The "Understanding COVID" strategy focused more on security and less on the economy because it was understood that by pursuing the first goal, it would achieve the second one. Finally, although the results referring to visits to the website are difficult to measure, it was relevant that the highest volume of unique visitors occurred two weeks before Christmas 2021, a time when the restrictions had been modified, and the population was looking for information to safely carry out trips, family reunions and other recreational

activities. This increase in the number of hits to the page may reflect the confidence that the population has in seeking accurate, verified, accessible and adapted information, as was the objective of this strategy.

The "Understanding COVID" strategy contemplated some key elements that the scientific literature identifies for a campaign to be successful [32]. These include (1) messages that focus on the identity of the population, (2) the use of visual aids, and (3) the use of social networking features to encourage interaction. In addition, although it used online resources (web pages, webinars, social networks, etc.) to be consistent with the message of limiting physical and social contacts, other more appropriate resources were also used to reach the vulnerable population (posters, songs, etc.), which was somewhat less common in campaigns from other countries. In addition, it has been shown that the high penetration of mobile devices and technology in the younger population [33] opened a very interesting door to their inclusion in schools as a means to achieve early health literacy [34]. Additionally, parents of students can benefit from health literacy strategies from schools in collaboration with government health policies [17,35–37], as has been appreciated throughout this strategy.
