METHODS
A cross-sectional online survey was conducted in March 2020(three weeks
after the onset of outbreak in country) to assess the knowledge,
attitude, and practices (KAP) about COVID-19 among Iranians. Data were
collected by a self-administrated questionnaire, which was developed
based on validated questionnaires used in recent study by Zhong et
al . (Zhong et al., 2020), country instruction for novel
Coronavirus(MOHME, 2020), and also current issues come up. Since
sampling was not possible in the whole country and also due to
concurrence of the Iranian New Year holidays with the beginning of home
quarantines, the best way to achieve an unbiased sample was sending
randomly the questionnaire link to the groups and channels of popular
messengers in Iran such as WhatsApp, Telegram and one internal
messenger. Prior to the response, all potential participants were
provided adequate information about the survey and only those who click
on the satisfaction button were included in the study. During the two
weeks that the questionnaire was available, 2986 individuals visited it,
and finally, 1628 individuals completed it. It should be noted that the
sample was fairly similar to the Iranian public on age, gender,
education, and also pattern of their distribution.
The content validity of the questionnaire was confirmed by a panel of
experts consisting of 3 environmental and occupational health
specialists, 1 epidemiologist, 1 public health expert, and 1 infectious
diseases specialist. After checking the applicability of the questions,
the suggestions provided by experts were incorporated and the
questionnaire was piloted with 10 participants to check relevance,
clarity and ambiguity of questions and estimate the time required to
complete the questionnaire. Afterward, an online platform of the
questionnaire was made using Porsline.ir , an Iranian web-based
questionnaire and survey form builder.
The questionnaire had 29 questions/items and divided into 4 sections.
The first section solicited 8 demographic variables (first column of
Table 2). The knowledge, attitude and practice sections had 13, 4, and 4
questions/items, respectively. The KAP questions/ items (Table 1)
covered issues such as clinical symptoms of the disease, treatment
protocol, transmission routes, and prevention/control measures including
physical distancing, disinfection, home quarantine, and etc.
Table 1- Questions/Items used in each section of the
questionnaire
Knowledge questions with correct responses were scored 1 and wrong and
“I don’t know” responses were scored 0. Grading of correctness (5
points Likert scale) was used for responding to attitude and practice
questions, and they were scored from 0 to 4 depending on the options.
According to this grading system, the lowest and highest score of
knowledge section were 0 and 13, respectively, and the lowest and
highest score of both attitude and practice sections were 0 and 16,
respectively. In order to have a unique scale, all scores were
transformed to a scale of 0 to 100 using equation 1.
SSn = 100 × SQn − Smin/ [Smax − Smin]
Where SSn is scaled score of question n,
SQn is the obtained score of question n and
Smax and Smin are highest and lowest
score of section that the question n is in it.
The statistical analyses were carried out using SPSS version 16.0. Also,
significance was assessed by the T-test and ANOVA. A P value
<.05 was considered to indicate statistical significance.