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      Knowledge, attitudes, risk perceptions, and practices of adults toward COVID-19: a population and field-based study from Iran

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          Abstract

          Objectives

          To determine peoples’ knowledge, attitudes, risk perceptions, and practices to provide policymakers pieces of field-based evidence and help them in the management of the COVID-19 epidemic.

          Methods

          This population-based survey was conducted using multi-stage stratified and cluster sampling in Shiraz, Iran. A total of 1331 persons were interviewed. The questionnaires were completed by face-to-face interviews. Univariable and multivariable (linear regression) data analyses were done using SPSS.

          Results

          The participants answered 63% of questions regarding knowledge, and 78% of questions regarding practice correctly. Only, 4.8% knew about common symptoms of COVID-19 and 7.3% about warning signs that require referral to hospitals. Males, lower educated people, and elders had a lower level of knowledge and poorer practices. Knowledge was also lower in the marginalized (socially deprived) people. Knowledge and practices’ correlation was 37%. Overall, 43.6% considered themselves at high risk of COVID-19, and 50% considered it as a severe disease. This disease had negative effects on most participants’ routine activities (69.1%). The participants preferred to follow the news from the national TV/Radio, social networks, and foreign satellite channels, respectively.

          Conclusions

          Encouragement of people to observe preventive measures and decreasing social stress, especially among males, lower educated people, elders, and marginalized groups, are highly recommended.

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          Most cited references10

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          Is Open Access

          Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey

          Unprecedented measures have been adopted to control the rapid spread of the ongoing COVID-19 epidemic in China. People's adherence to control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we investigated Chinese residents' KAP towards COVID-19 during the rapid rise period of the outbreak. An online sample of Chinese residents was successfully recruited via the authors' networks with residents and popular media in Hubei, China. A self-developed online KAP questionnaire was completed by the participants. The knowledge questionnaire consisted of 12 questions regarding the clinical characteristics and prevention of COVID-19. Assessments on residents' attitudes and practices towards COVID-19 included questions on confidence in winning the battle against COVID-19 and wearing masks when going out in recent days. Among the survey completers (n=6910), 65.7% were women, 63.5% held a bachelor degree or above, and 56.2% engaged in mental labor. The overall correct rate of the knowledge questionnaire was 90%. The majority of the respondents (97.1%) had confidence that China can win the battle against COVID-19. Nearly all of the participants (98.0%) wore masks when going out in recent days. In multiple logistic regression analyses, the COVID-19 knowledge score (OR: 0.75-0.90, P<0.001) was significantly associated with a lower likelihood of negative attitudes and preventive practices towards COVID-2019. Most Chinese residents of a relatively high socioeconomic status, in particular women, are knowledgeable about COVID-19, hold optimistic attitudes, and have appropriate practices towards COVID-19. Health education programs aimed at improving COVID-19 knowledge are helpful for Chinese residents to hold optimistic attitudes and maintain appropriate practices. Due to the limited sample representativeness, we must be cautious when generalizing these findings to populations of a low socioeconomic status.
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            2019 Novel coronavirus: where we are and what we know

            There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.
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              Psychological responses of pregnant women to an infectious outbreak: A case-control study of the 2003 SARS outbreak in Hong Kong

              Objective The aim of the present study was to examine the behavioral and psychological responses of pregnant women during the 2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong. Methods Ethnographic interviews were first conducted to identify the common psychological and behavioral responses to the outbreak. This was followed by a case-control study of 235 consecutive pregnant women recruited during the SARS epidemic, and a historical cohort of 939 pregnant women recruited a year before the outbreak. Both cohorts completed standardized rating scales on depression, anxiety, and social support. Results Women in the SARS cohort adopted behavioral strategies to mitigate their risk of contracting infection. However, pregnant women tended to overestimate the risk of contracting SARS and nearly a third of the women were homebound. The anxiety level of the SARS cohort was slightly higher than that of the pre-SARS control. No statistical difference was found between the depression levels of the two cohorts. Conclusion The improved social support experienced by pregnant women during SARS might have buffered the stress associated with an outbreak. However, clinicians should monitor for overestimation of infectious risk among pregnant women.
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                Author and article information

                Contributors
                ali.kh.sampad@gmail.com
                Journal
                Int J Public Health
                Int J Public Health
                International Journal of Public Health
                Springer International Publishing (Cham )
                1661-8556
                1661-8564
                24 June 2020
                : 1-9
                Affiliations
                [1 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Health Policy Research Center, Institute of Health, , Shiraz University of Medical Sciences, ; Shiraz, Iran
                [2 ]GRID grid.411135.3, ISNI 0000 0004 0415 3047, Non-Communicable Disease Research Center, , Fasa University of Medical Sciences, ; Fasa, Iran
                [3 ]GRID grid.472315.6, ISNI 0000 0004 0494 0825, School of Veterinary Medicine, , Islamic Azad University, ; Kazerun, Iran
                [4 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, School of Rehabilitation, , Shiraz University of Medical Sciences, ; Shiraz, Iran
                [5 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Shiraz HIV/AIDS Research Center, Institute of Health, , Shiraz University of Medical Sciences, ; Shiraz, Iran
                Author information
                http://orcid.org/0000-0003-0707-4857
                Article
                1406
                10.1007/s00038-020-01406-2
                7311321
                32583009
                d5a9c363-4551-4a87-aab0-6f9a9dddb864
                © Swiss School of Public Health (SSPH+) 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 25 March 2020
                : 29 May 2020
                : 7 June 2020
                Categories
                Original Article

                Public health
                knowledge,attitude,risk perception,practice,health belief model,covid-19
                Public health
                knowledge, attitude, risk perception, practice, health belief model, covid-19

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