Page 106 - IJPS-7-2

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

Table 2. (Continued)
Knowledge score Attitude score Practice score
Median [IQR] P‑value a Median [IQR] P‑value a Median [IQR] P‑value a
r b P‑value r b P‑value r b P‑value
Age 0.150 0.002 0.201 <0.001 0.186 <0.001
Household crowding index −0.244 <0.001 −0.085 0.087 −0.074 0.136
Fear score 0.010 0.834 0.108 0.030 0.279 <0.001
Anxiety score −0.188 <0.001 −0.099 0.047 −0.012 0.816
Note: P-values marked in bold are significant (P<0.05) ; The Mann–Whitney U-test was used to compare two groups; the Kruskal–Wallis test was used
a
to compare three groups; Spearman correlation test was used
b
toward COVID-19; however, being of other religions versus thus increasing their awareness of diseases and other
Christian was significantly associated with more negative ailments. Participants with a family member working
attitudes. Furthermore, more appropriate practice during in the medical field also had a more acceptable attitude
the COVID-19 pandemic was associated with high scores toward COVID-19, suggesting that better health education
on knowledge, attitude, and fear of COVID-19, in addition could increase knowledge, change attitudes and behaviors,
to spending more time on COVID-19 information per day. and prevent infectious illnesses (Verelst et al., 2016).
Stratification by sex showed different correlates for COVD- In this study, the high household crowding
19 KAP; most importantly, males with higher attitude scores index was associated with lower knowledge about
had better practice (but not knowledge), while females with COVID-19, explained by the fact that respondents with
better knowledge and more acceptable attitudes had better a high household crowding index have low income and
practices. low education levels and thus lack knowledge about
The present study validated scales of KAP toward COVID-19 (Chai et al., 2022). The previous literature
COVID-19 by examining their reliability and validity revealed that high household crowding index is associated
in the Lebanese population, as, to date, few studies have with disease transmission, which is related to several
validated such type of scales in Lebanon (Abounoori et al., factors, such as poor socioeconomic status (Chipeta et al.,
2021; Wake, 2020). The principal component analysis 2022) and poor knowledge about the disease progression
results showed that the constructed and validated KAP and transmission. In the same line, participants who did
scales could tackle all aspects of knowledge, attitude, not know whether they had indirect or direct contact with
and practice over a broad range of factors. The KAP COVID-19 patients had lower knowledge in both males
scales in this study had an adequate internal consistency and females, explained by the fact that those with higher
(reliability), similar to the previous findings from Korea knowledge and awareness of transmission modes avoid
(Park, 2021). The knowledge scale showed a moderate contact with COVID-19 cases/suspected cases. Increased
internal reliability value (Cronbach’s alpha = 0.615), awareness and better attitudes among individuals who were
similar to the results of a Spanish study (Aguilar-Latorre in contact with previous COVID-19 patients can promote
et al., 2021), which evaluated participant knowledge health-seeking behaviors to obtain more information from
in different areas, including sanitizing methods and reliable sources and avoid getting the infection.
techniques, symptoms related to COVID-19, diseases due Similar to the previous findings, an increase in age was
to coronavirus, and transmission modes. Consistent with also linked to lower awareness of COVID-19 (Adhena &
the previous findings among the Iranian population, the Hidru, 2020; Akalu et al., 2020; Wolf et al., 2020; Zhong
practice scale had excellent internal reliability (Cronbach’s et al., 2020). Older adults use technology and social
alpha = 0.899) (Abounoori et al., 2021; Wake, 2020).
media less frequently, which could explain their poorer
Regarding knowledge correlates, participants working knowledge. Another reason might be the decline in
in the medical field or with family members working in the cognition, hearing, and vision, making it difficult to read
medical field had high knowledge about COVID-19, in line or comprehend medical instructions. Our results showed
with recent findings from China and Lebanon (Domiati that participants of other religions had negative attitudes
et al., 2020; Huynh et al., 2020). A possible explanation toward COVID-19 compared to Christians, consistent
could be that, usually, health-care professionals are well- with the previous findings (Defar et al., 2021). A possible
positioned to get information from reliable sources, explanation is that participants of other religions are
integrate it, comprehend it, and explain it to their families, susceptible populations/groups highly bound to cultural

Volume 7 Issue 2 (2021) 100 https://doi.org/10.36922/ijps.v7i2.342