Knowledge, Attitude, and Practice Toward COVID-19 Among Sherubtse College Students in Bhutan: A Web-Based Cross-Sectional Study

Factors affecting knowledge, attitude, and practice of COVID-19: A study among undergraduate university students in Bangladesh

The global expansion of the COVID-19 outbreak is one of the worst disasters the world has faced in recent decades. This study explored various factors of knowledge, attitude, and practice regarding COVID-19 among Bangladeshi undergraduate university students. In addition, we also look at how COVID-19 based knowledge, attitude, and practice influence each other. Using a random sampling technique and a self-administered structured questionnaire survey, this study collected data from 167 private university students in Bangladesh from 1st October to 30th October 2020. Data were analyzed using descriptive statistics (including frequencies, percentages, and means), binary logistic regression, bivariate regression analysis, and factor analysis. The findings suggest that most of the students learned about COVID-19 from various sources, including news media (TV, radio, newspapers, etc.), international organizations (WHO, UN, etc.), various government programs, or from their friends, family members, or neighbors. Most of the students were concerned about becoming sick, keeping social distance, and family members' job insecurity, followed by the university shutdown and the subsequent quarantine. Many students believe Bangladesh's media, government, medical sector, and religious organizations played a significant role during COVID-19. Binary logistic regression demonstrates that students' gender, department, and residency significantly explained their COVID-19 knowledge. In addition, students' attitudes significantly vary with their religion and place of residence. Students' departments and semesters found significant in explaining their practice regarding COVID-19. Moreover, factor analysis results also identified several crucial factors in explaining students' overall knowledge, attitude, and practice of COVID-19. Finally, we found a statistically significant relationship between knowledge, attitude, and practice.

Knowledge, attitudes, and practices regarding COVID-19 and mental health status among college students in China: a cross-sectional study

Background

During the prevalence of coronavirus disease 2019 (COVID-19), little was known about the knowledge, attitudes, practices (KAP) about COVID-19 and psychological status of college students in minority areas. This study aimed to evaluate the KAP of college students in minority areas of China toward COVID-19 and to provide a scientific basis for health education and policy formulation.

Methods

From October 28th to November 6th, 2021, a cross-sectional study was conducted with 5,272 college students to examine KAP and its effects on mental health.

Results

Regarding COVID-19 knowledge, the overall awareness rate was 24.11% (1,271). Regarding health attitudes, most students had positive attitudes about COVID-19 prevention and control (94.95%), and females had higher positive attitudes than males (OR: 1.920; CI: 1.494-2.469). Regarding preventive behaviors, more than half of the students took preventive measures (53.48%), and freshmen had the highest health behavior scores. In terms of psychological status, there were fewer females with depression and stress than males.

Conclusion

College students in minority areas have positive health attitudes; however, their knowledge of COVID-19 prevention and control is low. Moreover, their precautionary behaviors are insufficient, and they have many negative emotions.

Impact of COVID-19 on mental health in Bhutan: a way forward for action

The coronavirus disease 2019 (COVID-19) pandemic continues to impact mental health and wellbeing globally. There is a lack of scientific documentation highlighting the mental health impact of COVID-19 in Bhutan. We present the mental health burdens and control measures taken, and suggest ways to further strengthen mental health services in Bhutan. During the pandemic, a rise in depression and anxiety had been reported in Bhutan. Depression rose from an average prevalence of 9 per 10,000 between 2011 and 2019 to 16 per 10,000 in 2020 and 32 per 10,000 in 2021. Similarly, anxiety rose from an average prevalence of 18 per 10,000, to 29 per 10,000 in 2020, and 55 per 10,000 in 2021. Psychological impacts related to isolation due to lockdowns, economic losses, and poor coping abilities were associated with negative outcomes. Stigma and discrimination towards mental health disorders discouraged mentally distressed people from seeking care. In response to increased demand, Bhutan's government initiated a range of interventions including home delivery of medicines and tele-counselling to people in need of urgent mental health care. Mental health care in Bhutan can be further improved through investment in services and human resources, and decentralization of services to the community.

Knowledge, Attitude, and Practice towards COVID-19 among Patients Attending Phuentsholing Hospital, Bhutan: A Cross-Sectional Study

Bhutan is one of the few countries in the world to take unprecedented steps to control the spread of COVID-19 in the country. This study aimed to investigate knowledge, attitude, and practice (KAP) and their associated covariates among patients attending Phuentsholing Hospital, Bhutan. Therefore, a cross-sectional study was conducted among patients attending Phuentsholing Hospital in Bhutan between March 17 and April 9, 2021, using an interview-administered questionnaire. The multivariable logistic regression was used to identify statistically significant covariates of good KAP. Further, the association between levels of KAP scores was assessed using Pearson's correlation coefficient. Of the 441 participants, 54.6% (241) were female. Knowledge, attitude, and practice score were reported by 55.3%, 51.8%, and 83.7% of participants, respectively. Higher education, secondary education, monastic education, and non-formal education were 9 [adjusted odds ratio (AOR) = 9.23; 95% confidence interval (CI) 3.438, 24.797], 3.5 (AOR = 3.5; 95% CI 1.425, 8.619), and 4 (AOR = 3.8; 95% CI 1.199, 12.141) times more likely to report good knowledge than illiterates. A positive attitude was associated with higher (AOR = 2.97; 95% CI 1.154, 7.66) and secondary (AOR = 3.53; 95% CI 1.454, 8.55) education compared to illiteracy. The good practice was associated with higher (AOR = 12.31; 95% CI 2.952, 51.318) and secondary (AOR = 11.5; 95% CI 3.439, 38.476) education compared to illiteracy. Participants in the age groups 26-35 years (AOR = 0.11; 95% CI 0.026, 0.484) and >45 years (AOR = 0.12; 95% CI 0.026, 0.588) were less likely to exhibit good practice compared to those aged 18-25 years. Those working in the private or business sectors were 9 (AOR = 8.81; 95% CI 1.165, 41.455) times more likely to have good practice compared to civil servants. There was a weak but positive correlation between knowledge-attitude (r = 0.228), knowledge-practice (r = 0.220), and attitude-practice scores (r = 0.338). The need for health education on COVID-19 to increase knowledge and attitude is highly recommended, and should be focused on the less educated and other vulnerable groups such as farmers and students, as well as those older than 25 years.

Hand Hygiene, Face Mask Use, and Associated Factors during the COVID-19 Pandemic among the Students of Mongar Higher Secondary School, Bhutan: A Cross-Sectional Study

Non-pharmacological measures, such as hand hygiene and face mask use, continue to play an important role in the fight against the COVID-19 pandemic. However, there is a paucity of studies on the adherence to these measures among students in Bhutan. Therefore, we aimed to investigate hand hygiene and face mask-wearing behaviours, as well as their associated factors, among the students of Mongar Higher Secondary School, Bhutan. We conducted a cross-sectional study amongst the students of Mongar Higher Secondary School in Bhutan. The students self-answered the questionnaire on web-based Google Forms. Multivariable logistic regression for good hand washing and face mask use was conducted in order to identify statistically significant socio-demographic covariates. The correlation between hand hygiene and mask use was investigated using Pearson’s correlation coefficient. A total of 533 students completed the survey questionnaire, 52.9% (282) of whom were female students. Facebook (44.3%, 236) and TV (35.5%, 189) were the two most popular sources of information on COVID-19 prevention and control. Good (scores of ≥80% of total scores) hand hygiene and face mask use were reported in 33.6% (179) and 22.1% (118) of students. In multivariable logistic regression, male students presented 79% (adjusted odds ratio [AOR] = 1.79, 95% confidence interval [CI] = 1.23−2.613) odds of engaging in good hand hygiene, compared to female students. Compared to grade 9, those in grade 10 were 60% (AOR = 0.4, 95% CI 0.158−0.998) less likely to engage in good hand hygiene. Boarding students presented 68% (AOR = 1.68, 95% CI 1.001, 2.813) higher odds of wearing a face mask compared to day students. There was a significant positive correlation between good hand hygiene and face mask use (r = 0.3671, p-value < 0.001). Good hand hygiene and face mask use were reported in less than one-third of the study participants. It is recommended to continue educating students on good hand hygiene and face mask use through popular information sources.

Knowledge, attitude and practices towards COVID-19 preventive measures among adults in Bhutan: A cross-sectional study

The COVID-19 pandemic posed a major global health challenge. Preventive measures against the spread of COVID-19 require the involvement of all sections of society. Knowledge and attitude towards COVID-19 preventive measures influence human practices. We describe the knowledge, attitude and practice (KAP) of COVID-19 preventive measure in Bhutan. This was a cross-sectional survey using multistage-cluster sampling involving participants from all 20 districts of the country. The knowledge was assessed using 12 items, attitude using 6 Likert items and practice using 10 items. There was total of 1708 respondents. The mean knowledge was 10.7, (SD = 1.5; range 0-12); 86.38% had good knowledge, 10.95% had average knowledge, 2.69% had poor knowledge. The common sources of knowledge were television (84.9%) and family and friends (74.7%). Those younger than 30 years were associated with good knowledge. The fear of contracting COVID-19 was reported by 96% and 86.4% agreed that appropriate preventive measures can help control the spread of COVID-19. Nearly all the respondents (97%) wore mask while going out and majority practiced good hand hygiene (87.9%) and proper cough etiquette (84.1%). The knowledge on COVID-19 preventive measures was good and the majority held positive attitudes and practices.

Knowledge and practices toward COVID-19 among healthcare students: A cross-sectional study at the University of Zambia

Background

The COVID-19 pandemic led to the disruption of physical classes for university students globally, as large gatherings fuelled the transmission of the virus. In the efforts to mitigate its transmission and return to normality, prevention measures, including vaccination, have been encouraged. Therefore, it is critical to understand the knowledge and practices of students regarding COVID-19. This study assessed the knowledge and practices toward COVID-19 among healthcare students at the University of Zambia.

Materials and methods

This questionnaire-based cross-sectional study was carried out from August 2021 to October 2021 among 478 healthcare students (pharmacy, physiotherapy, nursing, biomedical, medicine, and radiography). We used a previously validated questionnaire to measure knowledge and practice. The predictors of knowledge and practices were assessed using logistic regression with robust estimation of standard errors. Statistical analysis was conducted using Stata/BE version 17.0.

Results

Of the 478 respondents, 243 (50.8%) were females. A larger proportion, 175 (36.6%) were in Pharmacy training, and 156 (32.6%) were in their fifth year of study. The overall mean knowledge score of the participants was 87.9 (SD = 16.1), being higher at 89.6 (SD = 14.3) among medical students and the lowest at 86.7 (SD = 17.1) among Pharmacy students, although this was statistically non-significant (p = 0.488). The overall mean practice score was 60.0 (SD = 24.7), being significantly higher at 63.5 (23.4) among nursing, physiotherapy and environmental students compared to other students (p = 0.048). In multivariable analysis, the participant training program was non-significantly associated with knowledge and practice toward COVID-19. However, increased age (AOR = 1.09, 95% CI: 1.01-1.117) and residing in urban areas (AOR = 1.79, 95% CI: 1.07-3.01) than in rural areas were associated with higher odds of good practice toward COVID-19.

Conclusion

The healthcare students generally showed good knowledge levels and poor practices toward COVID-19. Further, there was no evidence of a difference in knowledge of COVID-19 among healthcare students. These findings suggest the need for implementation strategies to be centered on improving the practices of students toward COVID-19.

Knowledge, attitudes, and practices of university students regarding COVID-19: a cross-sectional study in Vietnam

Objective

This cross-sectional study investigated the knowledge, attitudes, and practices (KAP) of Vietnamese university students regarding COVID-19.

Methods

A validated questionnaire (Cronbach's alpha = 0.71) was used to survey 1,025 students. A convenience sampling method was used for recruiting students from April to May 2022. The Wilcoxon rank-sum test and the Kruskal–Wallis rank-sum test/Dunn test for multiple comparisons were employed to compare students' KAP scores between two groups and among three groups or more, respectively. Factors associated with students' COVID-19 KAP scores were determined via univariate and multivariate linear regression models. Variables in the multivariate linear regression models were chosen using the Bayesian Model Averaging method in R software version 4.2.0.

Results

A majority of students had good knowledge (75.61%), positive attitudes (98.24%), and good practices toward COVID-19 (94.93%). Regarding the COVID-19 knowledge, the proportions of students who knew that mosquito bites and exposure to/eating wild animals would not lead to COVID-19 infection were not high (47.22 and 34.34%, respectively). More importantly, 70.34% of students thought that vitamins and minerals could help prevent or cure COVID-19. Antibiotics were the first choice for COVID-19 treatment of 438 students (42.73%). Nearly half of students (48.0%) bought antibiotics to keep at home in case of COVID-19 infection. The average KAP scores of medical students (19.97 ± 3.99, 45.10 ± 3.94, 9.72 ± 1.78) and females (18.67 ± 4.44, 44.79 ± 3.79, 9.36 ± 1.84) were significantly higher than those of non-medical students (16.48 ± 4.37, 43.33 ± 4.03, 8.68 ± 1.87) and males (17.01 ± 4.55, 42.79 ± 4.39, 8.77 ± 1.97), respectively (p < 0.001). Older students were more likely to have good knowledge and practices than the younger ones (p < 0.001). In addition, students using websites of the World Health Organization/the Ministry of Health and scientific articles to seek COVID-19 information were significantly associated with higher KAP scores when compared with those not using these sources (p < 0.001, p < 0.001, and p = 0.00139, respectively).

Conclusion

Students' KAP scores significantly varied by age, sex, major, and sources of COVID-19 information. Although many students had sufficient knowledge, positive attitudes, and good preventive practices toward COVID-19, additional education and training strategies are paramount, especially for non-medical students and males.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14442-9.

Associations of COVID-19 Risk Perception, eHealth Literacy, and Protective Behaviors Among Chinese College Students Following Vaccination: A Cross-Sectional Study

Background

In spite of strict regulation of coronavirus disease 2019 (COVID-19) preventive measures and containment in China, there are still confirmed cases sporadically occurring in many cities. College students live in groups and have active social activities so that it will trigger a serious public health event once an infection event occurs. Thus, identifying the status and related factors of protective behaviors among them after receiving vaccination will be crucial for epidemic control. This study aimed to gather information on the protective behaviors and to identify the associations of COVID-19 risk perception, eHealth literacy, and protective behaviors for Chinese college students following vaccination.

Methods

A cross-sectional survey of college students engaged in protective behaviors post vaccination was conducted using the COVID-19 risk perception scale, eHealth literacy scale, and protective behaviors following vaccination questionnaire in one of the groups. Multiple linear regression analysis was used to confirm the correlation among the COVID-19 risk perception, eHealth literacy, and protective behaviors for Chinese college students.

Results

A total of 5,641 Chinese college students were included. Male students comprised 59.01% with an average age of (21.39 ± 2.75) years and most students rating their health as very good (44.85%) or pretty good (46.98%). A smaller percentage (13.76%) believed that they would likely or most likely be infected with COVID-19 after getting vaccinated. In addition, more than 1 in 10 (10.35%) college students had ever suspected to suffer from post-vaccination reactions following the COVID-19 vaccination. The mean score of protective behaviors was 26.06 ± 3.97. Approximately one-third (30.42%) of the students always or often did not wear a mask when going out. Some college students (29.25%) did not maintain distance of at least 1 m from others in social situations. Older female college students who were in good health and perceived as being at a low risk of getting infected with COVID-19, and those never suspected to suffer from post-vaccination reactions expected to engage in post-vaccination protective measures. Those with a higher level of perceived risk, severe risk perception and eHealth literacy, and a lower level of unknown risk perception were more likely to engage in further protective behaviors after getting vaccinated.

Conclusions

Overall, the level of protective behaviors among the Chinese college students following vaccination could be improved, especially for male, younger college students in poor health. This study revealed the predictive effects of risk perception and eHealth literacy on protective behaviors, recommending that the negative and positive effects of risk perception should be balanced in epidemic risk management, and eHealth literacy promotion should also be emphasized for public health and social measures.