Page 101 - IJPS-7-2

International Journal of
Population Studies Knowledge, attitudes, practices, and COVID-19 in Lebanon

attitude, and behaviors toward COVID-19 for better and a snowball sampling technique to recruit a sample of
more focused public health measures among subgroups. 405 Lebanese adults. An anonymous self-administered
A knowledge (K), attitude (A), and practice (P) questionnaire was created on Google Forms and then
study can be used to understand public awareness of shared on different social media platforms (WhatsApp,
COVID-19 and evaluate preventive measure gaps. It also Facebook, and Instagram). All Lebanese adults with access
to the internet were eligible to participate. Participants
gives insights into the characteristics and perceptions of were informed of the study objectives before they enrolled,
society and subgroups, which, in turn, enables authorities and participation in the study was voluntary.
to take effective action. The number of KAP studies in
Eastern Mediterranean countries during the COVID-19 2.1.2. Sample size calculation
pandemic is limited (Abdelhafiz et al., 2020; Al Ahdab,
2021; Alnasser et al., 2021; Kakemam et al., 2020). At the The G-Power software version 3.1.94 calculated a
time of the COVID-19 breakout, the general public in Iran minimum sample of n=395 with an effect size of 0.02
had a positive perception of the disease (Kakemam et al., (small), considering an alpha error of 5%, a power of 80%,
and allowing for 15 predictors to be included in the model.
2020), while in Syria, KAP toward COVID-19 was modest A total of 405 participants were included in the study.
(Al Ahdab, 2021).

The present study was conducted in Lebanon for 2.2. Methods
several reasons, most importantly, the accessibility to the 2.2.1. Questionnaire and scales
population and the unique context of severe economic The online survey included two sections and was available
crises, which have resulted in a decline in the quality of in English and Arabic.
medical care and likely contributed to the sharp rise in
COVID-19 cases (Shallal et al., 2021) and more deaths The first section of the questionnaire consisted of
since hospitals have had to ration their supplies or sociodemographic characteristics, that is, age, sex,
risk closing (United Nations, 2021). To the best of our marital status (currently married vs. no), education level
knowledge, six studies measured KAP toward COVID-19 (university level vs. not), employment status (employed
in Lebanon in English (Abou-Abbas et al., 2020; Domiati in medical field, employed in non-medical field, and
et al., 2020; Saadeh et al., 2020; Sakr et al., 2021; Zeenny unemployed), religion (Christian, Muslim, and others),
et al., 2020). Of those, five probed youth (Sakr et al., 2021), the number of occupants and the number of rooms in the
nurses (Saadeh et al., 2020), hospital pharmacists (Zeenny house, excluding the kitchen and bathrooms, and whether
et al., 2020), physicians (Abou-Abbas et al., 2020), and or not any family member worked in the medical sector.
community pharmacists (Zeenny et al., 2021). The sixth It also included questions about having tested positive for
study used non-validated measures to evaluate KAP in a COVID-19 versus not, having ever tested for COVID-19
sample of 410 Lebanese adults from the general population, versus not, and having a family member who has been
of whom 75% reported having adequate knowledge to infected with COVID-19 (yes, no, and do not know). The
protect themselves from COVID-19 (Domiati et al., 2020). household crowding index was calculated by dividing the
Thus, given the limited evidence about factors related to number of people living in the home by the number of
KAP during the COVID-19 pandemic in Lebanon and the rooms (excluding the kitchen and bathrooms). The second
scarce information regarding sex disparities, the assessment section included the following assessment scales:
of KAP toward COVID-19 was deemed essential as it helps 2.2.1.1. Knowledge, attitude, and practice (KAP) toward the
evaluate preventive measures and health education needs COVID-19 pandemic
among Lebanese individuals (Raina, 2013).
The KAP toward COVID-19 scales was inspired by the
Therefore, this study aimed to validate a scale that previous studies conducted among health practitioners and
measures KAP toward COVID-19 among the general the general population (Domiati et al., 2020; Ferdous et al.,
Lebanese population and to explore KAP-related factors 2020; Al-Hanawi et al, 2020; Reuben et al., 2020, Saadeh
and sex disparities. et al., 2020; Saefi et al., 2020; Sindkhedkar et al., 2020;
Zeenny et al., 2021). More details on the items used for each
2. Data and methods of the below scales can be found in the supplementary file.
2.1. Data sources
2.2.1.1.1. Knowledge scale
2.1.1. Study design and methods
A set of 14 multiple-choice items with single- and multiple-
A cross-sectional online survey was carried out in Lebanon option answers was used to test general knowledge of
between December 20, 2020, and January 5, 2021, using COVID-19. All answers were coded as binary variables

Volume 7 Issue 2 (2021) 95 https://doi.org/10.36922/ijps.v7i2.342