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A Descriptive Study to Assess the Knowledge and Expressed Practice of Community regarding Prevention of Corona Virus Disease

1Associate Professor, 2Tutor, 3,4M.Sc. Nursing Student, Rufaida College of Nursing, Jamia Hamdard, Delhi, India. DOI: https://doi.org/10.24321/0019.5138.20201


Introduction
A novel coronavirus called SARS-CoV-2 has resulted in the outbreak of an illness known as COVID-19. The corona virus disease has been identified as an outbreak of respiratory illness in Wuhan, Hubei Province, China beginning in December 2019. By January 31, 2020, this epidemic had spread to 19 countries with 11 791 confirmed cases, including 213 deaths. The World Health Organization declared it a Public Health Emergency of International Concern. COVID 19 has been characterized as a pandemic on March 12, 2020. 1 Outbreak occurred in December, 2019 in China, while first confirmed case of the disease in india was reported on January 30, 2020. The coronavirus is a virus that is found in animals and, sometimes, can be transmitted from animals to humans and then spread from one person to another person. 2 Corona Virus Infectious Disease-19 (COVID-19) is an infectious disease caused by a new or mutated virus. The disease causes flu like symptoms such as cough, fever, headache, confusion, feeling sleepy, lethargy, and weakness and in more severe cases, difficulty breathing. Corona Virus Infectious Disease primarily being respiratory illness spreads through contact with an infected person when they cough or sneeze. It also spreads when a person touches a surface or objects (fomites) that has the virus on it, and then touches his eyes, nose, or mouth. 3 All the government and non-governmental health care organizations got alarmed by the situation and social media platforms got flooded by the information regarding nature of this disease. Print, broadcast and internet played a crucial role in disseminating information about the spread and prevention of COVID-19. And in such an unprecedented situation, health care workers started helping the currently healthy, vulnerable, sick community besides the victims of COVID 19. Everyone witnessed the power of information, health education in fighting with the disease. Among the important measures suggested curbing the spread of the disease included wearing mask, social distancing and frequent hand washing with soap and water or alcohol based hand rubs or sanitizers. Another strategy adopted by the government was imposing lockdown in the country to check the spread of the disease.
In the voluntary as well as imposed lockdown period there was continuous news of violating the advisories put forward by the Government of India, researchers decided to conduct an online survey to assess the knowledge and practice of people about COVID 19. Study further aimed at seeking the relationship between knowledge and practice and their association with background variables. Online mode was chosen keeping the fact in mind that in India there are 629 million active mobile internet users, out of which, 337 million are there in urban areas of India. Region wise Delhi NCT has highest internet penetration rate followed by other metropolitan cities. 4 . Almost all countries had been affected by this deadly yet preventable disease till the time the study was undertaken. Number of people infected and dying was rising day by day leaving mankind helpless and locked down in their households to a great extent.

Methodology
The quantitative approach was adopted for the study with a descriptive survey design. Research variables were knowledge and practice of community as expressed by them regarding prevention of Corona Virus Disease. The sample comprised of 503 people, both male and female in any age group in any part of India, through purposive sampling technique. The study was delimited to the subjects, who had access to a smart phone, were internet users and were able to comprehend English and willing to participate in the study. The time period chosen for the study was mid-April, 2020 i.e. after about one month of lockdown in India.
An online survey technique was used to collect data by using a structured questionnaire to assess knowledge and practice regarding prevention of corona virus disease. Tool comprised of three sections; section I consisted of background data of subjects, section II comprised of questions pertaining to knowledge about COVID 19 including seven multiple choice questions and section III consisted of seven statements about practice. All the items in the knowledge questionnaire were scored and one point was assigned to each item for a correct response. A score 0 was allotted for each wrong response. The practice questionnaire consisted of statements against which they had to choose Yes or No. For correct practice, one point was assigned and for each wrong answer 0 was allotted. After giving consent to take the survey, subjects proceeded to the next section of the tool. If they gave the consent, only then they could proceed to the questionnaire. All the items in the tool were mandatory to answer before submission of the tool as incomplete questionnaire could not be submitted. To ensure the validity of the content, the tools were submitted to the five experts from the field of nursing, community medicine, sociology and community health nursing. Their suggestions were incorporated and tools were modified accordingly. The reliability of structured knowledge questionnaire was established by using K.R -20 formula and was found to be highly reliable i.e. 0.87. The reliability of structured practice questionnaire was established by using Cronbach Alpha test and was found to be highly reliable i.e. 0.89. Average time taken to respond to both the tools was around 5 minutes.
Once the tool was ready as Google Form, it was shot to a total of 1785 internet users by all researchers. A gentle reminder was sent to all of them after 3 days as a result of which 503 responded. Response rate was calculated to be as 28.2%. Descriptive and inferential statistics were employed to analyze the data.

Result Section I:
Description of the sample characteristics is given in table 1.
In addition to the data given in table 1, 100% participants had heard of the disease. Subjects who participated in the study were from 20 states/ union territories out of 37 states/union territories of India.

Section III
Description of the knowledge and practice of people regarding COVID 19 is given in table 3. of COVID-19 and their educational status. It is possible, that this was also driven by information available on the internet. We could not establish the same in our present study and can be looked into in a future analysis. No significant association

Discussion
The finding of this present study revealed that most of the subjects had adequate knowledge and appropriate practice regarding prevention of COVID-19 with more number of subjects having better practice than knowledge. This is in contrast to the normal belief that practice scores are lesser than the knowledge score. This may be attributed to the higher educational standards of the subjects, better access to internet and wide spread information through media.
The result of the current study is similar to the cross sectional study conducted by Zhong BL et al., 5 to assess the knowledge, attitude and practice on COVID-19 in China.
In their study the overall correct rate of the knowledge questionnaire was 90% and 98% of the participants had good practice score whereas in the present study it shows that 98.8% of community had adequate knowledge and 99.8% of the subjects expressed that they have been practicing appropriately regarding prevention of Corona virus diseases. High scores of knowledge and practice may be due to widespread information about the said disease by media. Current study also revealed that majority of the subjects got the information about COVID 19 through WhatsApp in addition to the print media and television.

Limitations
The study had a few inherent limitations such as people who had access to smart phone, internet friendly users, well versed with English language people only could participate in the survey. Most of the information available on Internet is in English, so the study participants were better informed about disease prevention. Despite having representation from 20 states/union territories, it broadly represents urban population. The study didn't look if the knowledge and or safe practice is being driven by internet knowledge or by educational knowledge.

Conclusion
Study concludes that community has adequate knowledge and appropriate level of expressed practice regarding prevention of Corona Virus Disease 19. The study findings may become the basis of further policy making by the health care administrators. Also, similar studies may be taken up targeting rural population.