*1.3. The "Understanding COVID" Strategy*

For all these reasons, in most regions, it became necessary to implement information strategies tailor-made for the general population, especially for the most vulnerable people. "Understanding COVID" was a strategy that began to be developed in March 2020 at the General Directorate of Care, Humanization and Socio-Health Care of Asturias (Spain). Asturias is the most aged region in Spain and one of the most aged in Europe. In addition, although a large part of its population lives in diffuse urban environments [11,12], a

large number of small and dispersed rural centers that are difficult to access also exist. Therefore, the rural area of Asturias presents some particular problems leading to a risk of poverty or social exclusion: the demographic situation (shortage of population, exodus of inhabitants and aging of the population in rural areas); the difficulties for the mobility of the population (lack of infrastructures and basic services, lack of adequate transport connections); or problems related to the labor market (lower employment rates and longterm unemployment).

**Figure 1.** WHO: Pandemic fatigue: proposal of four key strategies for governments to maintain and reinvigorate public support for protective behaviors.

The general objective of the "Understanding COVID" strategy was to increase the offer of digital information on prevention and protection against COVID-19, individual care and emotional approach to both the largest number of citizens, prioritizing vulnerable groups and the rural environment of Asturias. The specific objectives were to:


The "Understanding COVID" strategy had various target population groups, which included citizens of rural areas, citizens of urban areas, municipal technical professionals, people of Roma ethnic origin, immigrants, and citizens with impaired vision and/or hearing. Another relevant focus to work with was the job sectors most exposed to COVID-19: local commercial activities carried out in indoor areas like hairdressers, beauty salons, and places of worship. In particular, tourism outlets and hotels developed training to protect

their own activity, increasing their own security measures and "how to use the facilities" materials for their customers. Finally, in the design of the "Understanding COVID" strategy, two groups were also taken into account in a differentiated way, schoolchildren and also their families, since children and adolescents were left out of the pedagogical approach used for the adult population, and other participation and information methodologies were incorporated.

Given that the "Understanding COVID" strategy was a population-based public health campaign, no sampling method was used, but it was disseminated throughout the target population in order to reach the largest possible number of vulnerable people and later study the scope and effectiveness of the strategy under real conditions, within the broad framework of the implementation science.
