Disparity between knowledge and practice regarding COVID-19 in Thailand: A cross-sectional study of older adults

Post-pandemic health literacy: COVID-19 knowledge among future teachers in the Czech Republic

OBJECTIVES

The global situation concerning the incidence of infectious diseases emphasises the need for increased health literacy, particularly after the COVID-19 pandemic. A large part of this need relates to the area of education. The aim of this study was to analyse health literacy in relation to the cognitive dimension in the field of knowledge about the COVID-19 disease in the post-pandemic period among future teachers.

METHODS

The research sample comprised 286 female students in the first year of Bachelor's teacher training courses at the Faculty of Education in the Czech Republic. The research study was conducted during the academic year 2022/2023. To explore the level of health literacy, the present research used the standardized HLS-EU-Q86 questionnaire designed by the World Health Organization. For the purposes of this study, the original 'structured interview' method was changed to an online questionnaire. An additional online questionnaire was attached to explore participants' knowledge related to the COVID-19 disease.

RESULTS

The average score for general health literacy was 34.1, placing it within the 'sufficient' category. A total of 14.0% of the students showed an excellent level and 38.1% a sufficient level of general health literacy. Relatively the most favourable results were observed in the dimension of health promotion literacy. The threshold for successful completion of each knowledge test related to the COVID-19 was set at 80% of correct answers. Only 14.0% of the future teachers met the criteria for inclusion in the overall excellent level of the knowledge test.

CONCLUSIONS

The level of knowledge of future teachers associated with COVID-19 is inadequate. Therefore, it is desirable to strengthen education in the field of prevention of infectious diseases. The results indicate the need for some action, e.g., expanding the portfolio of compulsory courses in all branches of teacher training in order to increase the level of health literacy among future teachers.

Factors associated with knowledge and practices of COVID-19 prevention among mothers of under-2 children in Bangladesh

The COVID-19 pandemic extensively impacted maternal, neonatal, and child health (MNCH) in Bangladesh. Misconceptions arising from a lack of knowledge related to the virus contributed to reduced uptake of MNCH services, which eventually helped increase maternal and neonatal mortality rates during the pandemic. In this study, we assessed the knowledge and practices related to COVID-19 prevention among the mothers of under-2 children in Bangladesh. The study was conducted in May 2021 as part of a broader research project related to COVID-19 response on MNCH service utilization. We collected data from 2207 mothers in six districts of Bangladesh using a multi-stage cluster sampling technique. We constructed weighted and unweighted composite knowledge and practice scores and identified different socio-demographic characteristics associated with the scores using multilevel generalized mixed-effect linear regression models. In general, the mothers revealed poor knowledge and practices related to COVID-19. On a weighted scale of 100, the mean composite knowledge and practice scores were 32.6 (SD = 16.4) and 53.1 (SD = 13.9), respectively. The mothers presented inadequate knowledge about COVID-19 transmission, symptoms, and the recommended preventive measures. At the same time, maintaining a safe physical distance was the least practiced preventative measure (10.3%). Level of education, access to television, and the internet were significantly positively associated with their knowledge and practices related to COVID-19. Knowledge score was also positively associated with the practice score (OR = 1.26; p-value <0.001). Mothers living in islands or wetlands scored poorly compared to those living in inland. The results indicate significant gaps in knowledge and practices related to COVID-19 prevention among mothers of under-2 children. Addressing these gaps, particularly by targeting mothers with lower levels of education and residing in hard-to-reach geographic locations, could consequently help enhance MNCH service uptake during pandemics like COVID-19.

Measuring the frequency and determinants of COVID-19 prevention behaviours: a cross-sectional assessment of large-scale programmes in seven countries, late 2020

OBJECTIVES

This multicountry analysis aimed to assess the prevalence of key hygiene prevention behaviours and their determinants, associated with international non-governmental organisation (WaterAid) hygiene behaviour change programmes for COVID-19 prevention. The goal of this analysis is to inform future outbreak preparedness and pandemic response in low and middle-income countries.

DESIGN

Cross-sectional study.

SETTING

Households in seven countries where WaterAid implemented a first-phase COVID-19 response programme in 2020 (Ethiopia, Ghana, Nepal, Nigeria, Rwanda, Tanzania and Zambia).

PARTICIPANTS

3033 adults (1469 men and 1564 women, alternately sampled from one household to the next to maintain gender balance) in specific programme areas (211 villages) surveyed between October and November 2020.

PRIMARY OUTCOME MEASURES

Self-reported primary outcomes were: a composite measure of HWWS for prevention of respiratory infection/COVID-19 (total of 5 key moments); respondent increased HWWS behaviour after the COVID-19 pandemic; respondent always wears a mask in public spaces; respondent always practices physical distancing in public spaces.

RESULTS

Most respondents (80%) reported increasing their handwashing behaviour after the pandemic, but practice of HWWS at COVID-19-specific prevention moments was low. Mask wearing (58%) and physical distancing (29%) varied substantially between countries. Determinants of key behaviours were identified, including age and socioeconomic status, perceived norms, self-regulation and the motive of protecting others. Incidence rate ratios or odds ratios and 95% CIs for a range of psychosocial determinants for each of the four primary outcomes are reported.

CONCLUSIONS

These findings highlight that leveraging behaviour-specific emotional drivers and norms, reducing common barriers and promoting targeted messages about specific behaviours and actions individuals can take to reduce risk are necessary to support large-scale behaviour change. Learning from the COVID-19 response to more effectively integrate novel behaviours into existing health promotion will be vital for disease prevention and outbreak resilience.

Evaluating the Knowledge of and Behavior Toward COVID-19 and the Possibility of Isolating at a City Level: Survey Study

BACKGROUND

Mass testing campaigns were proposed in France during the first wave of the COVID-19 pandemic to detect and isolate asymptomatic individuals infected by SARS-CoV-2. During mass testing in Saint-Étienne (February 2021), we performed a survey of the general population.

OBJECTIVE

We evaluated, on the scale of a city's population, the literacy level about SARS-CoV-2 transmission, barrier gesture respect, and isolation acceptability or possibility in case of SARS-CoV-2 infection.

METHODS

We used the validated CovQuest-CC questionnaire. Data were analyzed and correlated with volunteer characteristics and their SARS-CoV-2 screening results using multivariate analysis.

RESULTS

In total, 4707 participants completed the CovQuest-CC questionnaire. Multivariate analysis revealed that female sex was a determinant of a higher score of knowledge about SARS-CoV-2 transmission (adjusted β coefficient=0.14, 95% CI 0.04-0.23; corrected P=.02). Older ages of 50-59 years (adjusted β coefficient=0.25, 95% CI 0.19-0.31; corrected P<.001) and ≥60 years (adjusted β coefficient=0.25, 95% CI 0.15-0.34; corrected P<.001) were determinants of a higher score on barrier gesture respect compared to ages 20-49 years considered as reference. Female sex was also a determinant of a higher score on barrier gesture respect (adjusted β coefficient=0.10, 95% CI 0.02-4.63; corrected P<.001). The knowledge score was correlated with the score on barrier gesture respect measures (adjusted β coefficient=0.03, 95% CI 0.001-0.004; corrected P=.001). Older ages of 50-59 years (adjusted β coefficient=0.21, 95% CI 0.13-0.29; corrected P<.001) and ≥60 years (adjusted β coefficient=0.25, 95% CI 0.1-0.38; corrected P<.001) were determinants of a higher score on isolation acceptability or possibility compared to the age of 20-49 years considered as reference. Finally, the knowledge score regarding SARS-CoV-2 transmission was significantly associated with a lower risk of RT-PCR (reverse transcriptase-polymerase chain reaction) positivity (adjusted odds ratio 0.80, 95% CI 0.69-0.94; corrected P<.03), implying that a 1-point increase in the knowledge score lowers the risk of positivity by 20% on average.

CONCLUSIONS

This study identified factors associated with health literacy regarding SARS-CoV-2 infection in asymptomatic individuals in a large French city's population. We can confirm that in the context of the COVID-19 pandemic, the determinants of better health literacy are not the same as those in other contexts. It seems critical to obtain a more detailed understanding of the determinants of individual citizens' behavior, as part of a strategy to combat the large-scale spread of the virus. The harsh experience of this pandemic should teach us how to nurture research to structure customized interventions to encourage the adoption of ad hoc behaviors to engage citizens in adapting behaviors more favorable to their health.

Optimism bias regarding COVID-19: a cross-sectional study of lower-income older adults in Thailand

Objective: Understanding the discernment of individuals about their health is crucial during public health situations such as the COVID-19 pandemic. Within this theme of study is how older adults perceive their vulnerabilities because it can relate to subsequent disease preventing behaviour.Materials and methods: The analysis explored optimism bias, or the perception of infection avoidance, regarding COVID-19 among lower-income Thais aged 60 and over. The study utilized an analytic sample of 2,139 individuals from the 2021 Survey on Housing and Support Services for Poor Older Adults. Logit regression model analysis was conducted, using optimistic bias as the outcome variable.Results: Increasing age and residing in urban areas were associated with a higher likelihood of bias. On the other hand, higher educational attainment was found to decrease the association with optimistic bias, indicating higher perception of risks. Adherence of older individuals to the residence-in-place policy might have contributed to perception of lower infection risks. Urban residents had better access to welfare benefits and medical facilities, which led to reduced worry and greater optimistic bias.Conclusion: Greater understanding of the disease and preventive strategies offer insights on how higher education levels lead to perceiving possible risks surrounding COVID-19.

What Sustains Mask-Wearing Behavior among Elders in a Rural Community in the Post-COVID-19 Era: An Exploratory Mixed-Methods Study

The current study investigates the factors influencing face-mask-wearing practices among elderly individuals in rural Thailand. A mixed-methods approach was employed, involving qualitative interviews with 15 elderly participants and a subsequent survey of 201 elders. Seven subthemes were identified, including the perceived benefits of mask-wearing, the perceived threat of COVID-19, mask-wearing enhancing attractiveness and self-confidence, social norms, misconceptions about COVID-19 prevention tools, perceived barriers to mask-wearing, and resources to afford face masks. The developed themes, codes, and quotes were utilized for creating a questionnaire. The survey revealed the adherence of 81.1% of the participants to mask-wearing. Structural equation modeling (SEM) analysis demonstrated that motivation, comprising (1) the perceived threat of COVID-19, (2) alternative threats aside from COVID-19, and (3) the perceived benefits of a face mask strongly affected mask-wearing practices (β = 0.68, p < 0.001) and the willingness to wear a face mask (β = 0.61, p < 0.001). Social norms had a negative direct effect on the perceived barrier (β = -0.48, p < 0.001) and a positive direct effect on mask-wearing practices (β = 0.25, p = 0.001). This study highlights that motivation and social norms play pivotal roles in sustaining mask-wearing behavior among rural elderly populations. Encouraging local cooperative actions through community rules could initiate behavioral changes within the community. These findings contribute to the understanding of factors influencing mask-wearing and provide insights into designing effective interventions to promote mask-wearing among elderly individuals in rural areas.

Communication inequalities and health disparities among vulnerable groups during the COVID-19 pandemic - a scoping review of qualitative and quantitative evidence

BACKGROUND

The COVID-19 pandemic has exacerbated health disparities in vulnerable groups (e.g., increased infection, hospitalization, and mortality rates in people with lower income, lower education, or ethnic minorities). Communication inequalities can act as mediating factors in this relationship. Understanding this link is vital to prevent communication inequalities and health disparities in public health crises. This study aims to map and summarize the current literature on communication inequalities linked with health disparities (CIHD) in vulnerable groups during the COVID-19 pandemic and to identify research gaps.

METHODS

A scoping review of quantitative and qualitative evidence was conducted. The literature search followed the guidelines of PRISMA extension for scoping reviews and was performed on PubMed and PsycInfo. Findings were summarized using a conceptual framework based on the Structural Influence Model by Viswanath et al. RESULTS: The search yielded 92 studies, mainly assessing low education as a social determinant and knowledge as an indicator for communication inequalities. CIHD in vulnerable groups were identified in 45 studies. The association of low education with insufficient knowledge and inadequate preventive behavior was the most frequently observed. Other studies only found part of the link: communication inequalities (n = 25) or health disparities (n = 5). In 17 studies, neither inequalities nor disparities were found.

CONCLUSIONS

This review supports the findings of studies on past public health crises. Public health institutions should specifically target their communication to people with low education to reduce communication inequalities. More research about CIHD is needed on groups with migrant status, financial hardship, not speaking the language in the country of residence, sexual minorities, and living in deprived neighborhoods. Future research should also assess communication input factors to derive specific communication strategies for public health institutions to overcome CIHD in public health crises.

Knowledge, attitudes, practices, and its associated factors toward COVID-19 pandemic among Bangladeshi older adults

BACKGROUND

The newly emerged COVID-19 has an unprecedented impact on all classes of people, particularly the elderly. The knowledge, attitudes, and practices (KAP) of older adults toward COVID-19 are currently unknown. This study aimed to investigate the KAP and its associated factors toward COVID-19 among older adults in Bangladesh.

METHODS

A cross-sectional survey was conducted from April to May 2021 among Bangladeshi older adults. Face-to-face interviews were used to collect data from five selected divisions in Bangladesh using simple random sampling. The questionnaire consisted of socio-demographic characteristics, disease conditions, and KAP toward COVID-19. Descriptive statistics, t-tests, one-way analysis of variance (ANOVA), and logistic regression analyses were performed.

RESULTS

Out of 900 respondents, the majority of older adults (82.9%) indicated that COVID-19 is a viral disease and the major clinical symptom of COVID-19 (86.5%). Only 22.1% of participants always washed their hands with soap or hand sanitizer, and 27.6% wore a mask to protect against the virus when going outside the home. Overall, 55.2% had adequate knowledge, 50.2% had positive attitudes toward COVID-19 and only 22.7% had good practices. Out of 30 scores, mean score values were 20.8±6.7 in the knowledge section, 21.2±4.3 in the attitude section, and 11.3±6.7 in the practice section out of 30. In binary logistic regression analysis, factors associated with poor knowledge, and practices were being male, aged >70 years, having a primary education, less income <5000BDT, and multimorbidity (p < 0.05). Participants having poor knowledge of COVID-19 had higher likelihood of negative attitudes (OR: 6.79, 95% CI = 4.87-9.47, p < 0.001) and poor practices (OR: 9.15, 95% CI = 6.94-13.16, p < 0.001).

CONCLUSION

The findings highlight the need for immediate implementation of health education programs and adequate intervention programs for COVID-19 which integrates consideration of associated factors to improve the level of older adults' knowledge, attitudes, and practices.

Knowledge, Attitudes, and Practices Toward the Coronavirus Disease 2019 (COVID-19) Pandemic in a Population Under Community-Wide Containment Measures in Southern Thailand

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak has had a significant impact on public health and the socioeconomic system. While governments established community-wide containment measures to prevent further transmission, the number of patients continued to increase. For a better COVID-19 outbreak response, there is a need to better understand communities' knowledge, attitudes and practices toward COVID-19.

OBJECTIVE

Our main objective is to describe knowledge, attitudes, and practices toward COVID-19 in a population under community-wide containment measures.

PARTICIPANTS AND SETTING

Eligible participants affected by community-wide containment measures living in southern Thailand were included. A convenience sampling strategy was used to include the participants.

METHODS

A descriptive cross-sectional survey was used in this study. We developed an online self-administered Thai-language questionnaire that included the respondents' demographic profiles and questions regarding their knowledge, attitudes, and practices toward COVID-19. Piloting the questionnaire was performed in a small sample at Walailak University, Nakhon Si Thammarat.

RESULTS

In total, 717 subjects were included in this study. Regarding the knowledge and practice assessments, most respondents knew about COVID-19 by browsing websites. The respondents were confident in their knowledge, understood the situation causing the COVID-19 outbreak and knew how to prevent it. However, there were still misunderstandings. Regarding the attitude assessment, only 56.4% (405/717) of the subjects scored greater than or equal to 80%.

CONCLUSION

COVID-19 misunderstandings render disease outbreaks more difficult to control. These misunderstandings may result from outdated or inaccurate online information. It is essential to gain knowledge from a reliable source for proper understanding.

The Mental Health of Older Adults in the Densely Populated Areas of Tacna Region-Peru, 2021: Implications of the COVID-19 Information

The purpose of this research was to analyze the implications of exposure to various news channels that broadcast information on COVID-19 and their impact on the mental health of older adults in the sparsely populated area of the Tacna Region during the year 2021. The present study used a descriptive correlational type of quantitative approach on a sample of 389 older adults aged 60 years and over, who were recruited by non-probabilistic convenience sampling. For the application of the survey technique, the instrument used was a questionnaire modified by the authors. In terms of research ethics for the development of the study, the respondents provided informed consent, and other ethical considerations were addressed. In relation to sociodemographic variables of mental health, it was found that women had a greater incidence of anxiety (p < 0.01) and that people with fewer years of study had a greater incidence of depression (p < 0.01) and anxiety in sparsely populated areas. Exposure to news through television was associated with depression, and news obtained from other people was associated with depression (p < 0.001). An association was also found between the number of hours of television news and stress (p < 0.05), and radio news was associated with anxiety (p < 0.05). In terms of psychological consequences, the highest mean for television exposure was fear, while the greatest psychological consequence of radio news was fear, followed by stress and awareness. Finally, negative, inverse, and significant relationships were found that indicate protective factors, such as depression with awareness and indignation, and anxiety was inversely related to awareness.