Knowledge, attitude, and practices regarding COVID-19: A cross-sectional study among rural population in a northern Indian District

COVID-19 pandemic containment and management in city of Turaif: Understanding the experience

Saudi Arabia implemented precautionary measures earlier before the first COVID-19 case had been confirmed. In March 02, 2020, the first COVID-19 was confirmed in Saudi Arabia which resulted in tightening precautionary measures. Turaif's location and population structure present a challenge for pandemic management. Multidisciplinary approach is essential to ensure efficiency of coordinated effortsbetween local authority and health officials.

Knowledge, attitude and preventive practice toward Covid-19 and associated factors among outpatients in a rural hospital in Vietnam

Background

The COVID-19 pandemic has emphasized the critical role of public knowledge, attitudes, and practices (KAP) in disease containment. Understanding these aspects can guide health promotion initiatives and policy decisions.

Design and methods

This cross-sectional study examined the KAP concerning COVID-19 prevention in Vietnam. Participants' sociodemographic data, along with KAP toward COVID-19, were collected in a survey utilizing a standardized questionnaire. Uni- and multivariable logistic regression were used to identify factors associated with poor level of KAP.

Results

Of 335 participants, 97 (28.9%) had poor knowledge, 52 (15.5%) poor attitude, and 48 (14.3%) poor practices. Older age (OR = 2.23; p = 0.024), minority non-Kinh ethnicity (OR = 3.05; p = 0.03), education below high school (OR = 8.80; p < 0.001), limited social media access (OR = 2.86; p = 0.002), and limited mobile phone usage (OR = 3.08; p = 0.001) increased poor knowledge risks. Non-Kinh ethnicity (OR = 5.00; p = 0.005) and lower education (OR = 14.79; p < 0.001) were linked to poor attitude. Older age (OR = 2.26; p = 0.035), lower education (OR = 5.74; p = 0.003), and poor knowledge (OR = 3.33; p = 0.005) were associated with poor practices.

Conclusions

Elderly individuals, those with low education, and limited media access had elevated risks of poor KAP. Emphasizing public health media and targeted education, especially for underserved groups, is vital for effective epidemic management and future strategy planning.

Why elderly in rural China didn't wear masks during the COVID-19 pandemic? A qualitative narrative interview study

BACKGROUND

During the COVID-19 pandemic, ageism and stigmatization towards the elderly have been prominent issues. In addition, there have been debates on Chinese social media as to why elderly people in rural areas are not wearing masks. While some factors that affect the mask-wearing behaviour of the elderly have been analyzed, little attention has been given to the lived experiences and behavioral intentions of rural elderly people who choose not to wear masks, despite government mandates to do so.

METHOD

In this research, 50 semi-structured interviews with 30 elderly individuals in three Chinese villages were carried out using the qualitative method of semi-structured interviews. Following verbatim recording and transcription of the conversations, the subject was analyzed using the Theory of Reasoned Action.

RESULTS

We identified four factors that influence the non-masking behaviour of rural elderly, including past experiences, cultural concepts, cognitive attitudes, and health and safety anxiety, and identified nine sub-themes based on the four overarching themes. Past knowledge, experience, and history have led rural elderly people to distrust the government's mandatory "mask mandate," believing that they do not need to wear masks. Rural cultural concepts and habits make the elderly feel that masks not only fail to provide protection but also become obstacles, resulting in poor daily experiences. Cognitive attitudes and emotions determine the elderly's evaluation of masks, which in turn affects their use of masks. Finally, elderly individuals'chronic diseases directly affect the physical pain and life safety caused by their use of masks, which is a major objective factor for their non-masking.

CONCLUSIONS

Although numerous studies have concluded that Chinese people wore masks out of collectivism and conformity during the pandemic, marginalized groups' opposition to wearing masks also contains distinctive, individualized elements and underlying causes. By exposing these elements and reasons, we can better comprehend the peculiar behavior of particular groups while fighting the pandemic. The needs of marginalized populations should be prioritized by public health policy makers to provide more equitable services.

Staying in or out? COVID-19-induced healthcare utilization avoidance and associated socio-demographic factors in rural India

BACKGROUND

Although evidence on healthcare utilization avoidance during COVID-19 pandemic is emerging, such knowledge is limited in rural settings. An effective policy to the COVID-19 shocks and stresses in rural settings require empirical evidence to inform the design of health policies and programmes. To help overcome this evidence gap and also contribute to policy decisions, this study aimed at examining COVID-19-induced healthcare utilization avoidance and associated factors in rural India.

METHODS

This study used the third-round data from the COVID-19-Related Shocks in Rural India survey conducted between 20-24 September, 2020 across six states. The outcome variable considered in this study was COVID-19-induced healthcare utilization avoidance. Multivariable Binary Logistic Regression Model via Multiple Imputation was used to assess the factors influencing COVID-19-induced healthcare utilization avoidance.

RESULTS

Data on 4,682 respondents were used in the study. Of this, the prevalence of COVID-19-induced healthcare utilization avoidance was 15.5% in rural India across the six states. After adjusting for relevant covariates, participants from the Bihar State have significantly higher likelihood of COVID-19-induced healthcare utilization avoidance compared to those from the Andhra Pradesh. Also, participants whose educational level exceeds high school, those who use government hospital/clinic, engage in daily wage labour in agriculture have significantly higher odds of COVID-19-induced healthcare utilization avoidance compared to their counterparts.

CONCLUSION

Our study revealed that state of residence, type of health facility used, primary work activity and educational level were associated with COVID-19-induced healthcare utilization avoidance in rural India. The findings suggest that policy makers and public health authorities need to formulate policies and design interventions that acknowledge socioeconomic and demographic factors that influence healthcare use avoidance.

Hidden Problem of COVID-19: Behavioral Surveillance and Its Preventive Measures Among Rural Adult Population in Tamil Nadu, India

Background COVID-19-appropriate behavior has been recommended by the Government of India to reduce the spread of the disease. However, a lack of awareness, inadequate knowledge, or improper practices regarding personal protective measures have contributed to the ongoing cases in India. Therefore, this study aimed to assess the pattern of behavioral surveillance related to COVID-19 and its preventive measures and also to study the impact of knowledge of COVID-19 on their behavior among the rural population in Tamil Nadu, India. Methods A descriptive cross-sectional study was conducted among the rural adult population in Siruvachur Village, Perambalur district, Tamil Nadu, from June to December 2022. The study included adult participants aged 18 years and older who had no previous history of COVID-19 disease. The participants were selected using a systematic random sampling method. A pre-designed and semi-structured questionnaire was used to assess their awareness of COVID-19, knowledge of symptoms, preventive measures, and actual behavioral practices. The collected data were analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. The chi-square test and linear regression were employed to assess the association and strength between behavior and knowledge of COVID-19 preventive measures. A p-value of less than 0.05 was considered statistically significant. Results According to the results, 94.7% of the participants reported being aware of COVID-19, with fever being recognized as the most common symptom. Regarding specific preventive measures, 71.5% of participants demonstrated adequate knowledge of handwashing, while only 55.3% had sufficient knowledge of social distancing norms. In terms of mask usage, 62% reported having adequate knowledge of how to use masks to prevent COVID-19 transmission. However, despite having adequate knowledge, the study found that only 11.3% of participants consistently used masks in outdoor settings. This indicates a significant gap between knowledge and actual behavior in mask usage. Furthermore, a significant association was found between knowledge and behavioral practices related to COVID-19 preventive measures, such as mask usage and social distancing. In other words, participants who possessed greater knowledge of these measures were more likely to exhibit corresponding behaviors. On the other hand, the study did not find a significant impact of handwashing knowledge on actual handwashing behavior (p>0.05). Conclusion Despite a relatively high level of knowledge and awareness, there is a significant gap between knowledge and actual behavioral practices, particularly in terms of mask usage and hand hygiene. These findings highlight the need for targeted interventions to bridge the gap between knowledge and behavior in COVID-19 preventive measures, particularly in terms of consistent mask usage and adherence to social distancing norms. Efforts should focus not only on increasing knowledge but also on promoting behavior change through effective education, awareness campaigns, and practical demonstrations of proper preventive measures.

Gender differences in COVID-19 knowledge, risk perception, and public stigma among the general community: Findings from a nationwide cross-sectional study in India

Introduction

Individual and community characteristics predictive of knowledge, perception, and attitude on COVID-19, specifically on gender, have not been adequately explored.

Objective

To examine the gender differences in COVID-19 knowledge, self-risk perception and public stigma among the general community and to understand other socio-demographic factors which were predictive of them.

Method

A nationally representative cross-sectional multi-centric survey was conducted among adult individuals(≥18 yrs) from the community member (N = 1978) from six states and one union territory of India between August 2020 to February 2021. The participants were selected using systematic random sampling. The data were collected telephonically using pilot-tested structured questionnaires and were analyzed using STATA. Gender-segregated multivariable analysis was conducted to identify statistically significant predictors (p < 0.05) of COVID-19-related knowledge, risk perception, and public stigma in the community.

Results

Study identified significant differences between males and females in their self-risk perception (22.0% & 18.2% respectively) and stigmatizing attitude (55.3% & 47.1% respectively). Highly educated males and females had higher odds of having COVID-19 knowledge (aOR: 16.83: p < 0.05) than illiterates. Highly educated women had higher odds of having self-risk perception (aOR: 2.6; p < 0.05) but lower public stigma [aOR: 0.57; p < 0.05]. Male rural residents had lower odds of having self-risk perception and knowledge [aOR: 0.55; p < 0.05 & aOR: 0.72; p < 0.05] and female rural residents had higher odds of having public stigma [aOR: 1.36; p < 0.05].

Conclusion

Our study findings suggest the importance of considering thegender differentials and their background, education status and residential status in designing effective interventions to improve knowledge and reduce risk perception and stigma in the community about COVID-19.

A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana

Vulnerable populations such as camped refugees are often exposed to spread of infectious diseases because of their living conditions, limited resources available to them and exclusion from social services. This study examined the psychological state of camped refugees in Ghana during the COVID-19 pandemic and how their background characteristics predict the severity of the pandemic's psychological impact. It covered 763 refugees aged 15 years and above resident in two (Krisan = 316 and Ampain = 447) camps. Nine COVID-19 Anxiety Scale indicators were used to examine the psychological state of camped refugees. A composite indicator was derived to examine the overall psychological impact. Logistic regression was used to examine the factors that were associated with severe psychological impact. The multivariate analysis revealed that sex of the respondent, marital status and age of head of household were the only socio-demographic factors associated with having a severe psychological impact of the pandemic. There was very strong evidence that respondents who had moderate (OR = 1.74, 95% CI = 1.12, 2.7) and high (OR = 1.66, 95% CI = 1.05, 2.63) knowledge of the disease had increased odds of severe psychological impact. Also, those with moderate (OR = 2.97, 95% CI = 1.78, 4.97) and high (OR = 12.98, 95% CI = 7.86, 21.42) adherence had increased odds of severe psychological impact. None of the pre-existing health conditions and challenges were not significantly associated with severe psychological impact. The limited number of significant socio-demographic covariates suggests that severe psychological impact of the pandemic was a problem in the general population, and thus interventions should target the general population of camped refugees. Also, health education should not only focus on enhancing knowledge and promoting preventive measures but also on managing psychological distress.

Knowledge, Attitudes and Practices Towards COVID-19: A Cross-Sectional Survey

Aim

To assess the knowledge, attitudes and practices (KAP) regarding the corona virus disease 2019 (COVID-19) pandemic among patients and their attendants visiting the gynaecologic oncology outpatient department (OPD) and to assess the factors associated with a KAP score.

Methodology

A KAP cross-sectional survey was conducted over three months exploring KAP relevant to COVID-19. Mann–Whitney U test and Kruskal–Wallis test were used to compare the differences in knowledge, attitude and practice by demographic characteristics. Correlation between knowledge, attitude and practice was done using Spearman’s rank correlation test. Binary logistic regression analyses were applied to identify possible determinants of good knowledge, attitude and practice.

Results

A total of 521 completed questionnaires were included. The study revealed an overall good knowledge (16.09/20), attitude (8.34/10) and practice (12.73/14) scores. Education status, standard of living (rural/urban) and economic status determined an adequate overall knowledge, attitude and practice score, while an adequate practice score varied significantly by standard of living and education status. Significant positive linear correlations were found between knowledge–attitude (r = 0.513), knowledge–practice (r = 0.407) and attitude–practice (r = 0.407).

Conclusion

The study demonstrated good overall knowledge, attitude and practices towards COVID-19 pandemic among gynaecological oncology OPD patients and their attendants.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40944-022-00624-1.

Assessment of COVID-19-related awareness, knowledge, prevention practices and challenges faced by truck drivers in major transport cities of India: a cross-sectional survey

OBJECTIVES

To assess COVID-19-related awareness and knowledge among truck drivers across India and report prevention practices followed, and challenges faced, by them during the COVID-19 lockdown.

DESIGN

Cross-sectional study.

SETTING

Delhi, Kanpur, Kolkata and Bangalore from July to September 2020.

PARTICIPANTS

Data were collected in Hindi using a structured questionnaire via telephonic interviews. Minimum 200 drivers were included from each location.

OUTCOME MEASURES

Sociodemographic profile, awareness regarding COVID-19, knowledge regarding infection sources, disease spread and vulnerable populations, prevention practices followed and challenges faced. Information sources were also assessed.

RESULTS

Fisher's exact test and Analysis of variance (ANOVA) test were used to check for significant differences across proportions. P value less than 0.05 was considered significant. Overall, 1246 drivers were included, with 72% response rate. Of 1246 drivers, 65% were 30-50 years of age. A majority correctly answered knowledge questions regarding communicability (95%) and fatality (66%). Fifty per cent drivers were aware of treatability of the disease, while only 43% and 24% correctly reported all signs and symptoms and routes of transmission, respectively. No driver was aware of all high-risk populations. Overall Knowledge Score is significantly associated with region. Mobile phones were the primary source of information across all regions. Over two-third drivers follow all prevention practices regularly, which differed significantly across regions. Following standard prevention practices was positively correlated with higher knowledge scores and was significantly correlated with mask use. Worry about the disease was common. Less than 40% drivers received full payment for work during this period, while 25% drivers were unable to return home due to the pandemic. Seven per cent and 26% drivers had either limited or no access to food and health services, respectively.

CONCLUSIONS

Awareness activities and employer provisioned social security/health insurance might safeguard this vulnerable population till the pandemic fully abates as well as in similar situations in the future.

Analysis of change in knowledge, attitude, and practices about COVID-19 following and awareness session in rural population of Western India

BACKGROUND

Beginning of the pandemic showed our limitations in our understanding of the spread of the dreaded coronavirus-19 that had sprung from China and spread through thick and thin across the world. The measures to contain the spread of virus in the absence of specific treatment protocol had everyone grope for the solutions in a very short time frame. One such is the knowledge, attitude, and practice in the rural setup.

AIM

The aim of the study is to measure the change in knowledge, attitude, and practices (KAP) regarding COVID-19 following an awareness session in rural population.

MATERIALS AND METHODS

A cross-section interventional study was carried out in January 2021. An interactive awareness session was conducted with the help of audiovisual aids following MOHFW guidelines for COVID-19, and the change in KAP about COVID-19 was measured by pre- and posttest standardized questionnaire.

RESULTS

Of all the participants, statistically significant change in knowledge was seen from 43% to 52%. The villagers were educated about preventive steps and a positive change was measured in the practice of changing masks regularly (84%-100%), maintaining social distancing (44%-64%), frequent handwashing (52%-64%). No change was seen in wearing of masks (92%) and negative change was seen in avoiding handshakes (32%-28%). The preventive practices regarding COVID-19 pandemic changed significantly from 50% to 58%. Our study measured positive attitude change toward getting vaccinated from 64% to 72%.

CONCLUSION

A single, short awareness session led to significant change in KAP about COVID-19 in rural population.

Awareness, perception, and mitigating measures on COVID-19: Do we still need to educate our masses on COVID-19?

BACKGROUND

COVID-19 was declared an emergency of international concern by the World Health Organization in 2020. This study assesses patients' awareness, perception, and mitigating measures taken during the COVID-19 outbreak visiting an apex tertiary health-care center in North India.

MATERIALS AND METHODS

A cross-sectional study was conducted between September 15, 2020, and November 15, 2020, in a tertiary care public hospital, North India, using a structured self-administered questionnaire. The survey included 809 patients using a consecutive sampling strategy. The self-structured and prevalidated questionnaire was used to collect information on study variables. Chi-square test and independent samples t-test, followed by binary and multivariate logistic regression, was used to determine the factors associated with awareness toward COVID-19.

RESULTS

The mean age of participants was 32.41 (±11.24) years. Multivariate logistic regression shows that married participants (OR: 0.660, 95 % CI: 0.440-0.989, P= 0.044), reading books/magazine or attended institutional lectures (OR: 2.241, 95% CI: 1.545-3.249, P = 0.001), and watching television and radio (OR: 1.824, 95% CI: 1.283-2.592, P = 0.001) are significantly more aware than their counterparts. Participants with higher income group (>20,000 Indian rupee) significantly had higher awareness than participants having salary <10,000 rupees (OR: 0.280, 95% CI: 0.178-0.440, P = 0.001) or 10,001-20,000 rupees (OR: 0.481, 95% CI: 0.297-0.777, P = 0.003). Patients avoiding traveling across or abroad had significantly much reasonably good awareness than their counterparts (OR: 0.357, 95% CI: 0.139-0.918, P = 0.033).

CONCLUSIONS

Participants demonstrated good awareness, encouraging perception, and complied with appropriate mitigating measures during the outbreak. Considering frequent waves and the pandemic's long duration, consistent reinforcement of government measures, including masks, maintaining social distance, and frequent handwashing, is much needed.