Factors associated with knowledge, attitudes, and practices of the general Lebanese population toward the coronavirus disease 2019

Abstract

People’s practice, including adherence to disease prevention strategies, is influenced by their knowledge and attitude, which differ by sex. This study aimed to validate a tool that measures knowledge, attitude, and practice (KAP) toward COVID-19 and explore the related factors, including socioeconomic features and sex disparities. An online cross-sectional study conducted between December 20, 2020, and January 5, 2021, enrolled 405 participants from the general Lebanese population using a snowball sampling technique. The COVID-19 KAP scales were constructed and validated. After confirming the validity of the generated scales, the results showed that a university education level (adjusted odds ratio [aOR] = 3.90) was related to a better knowledge of COVID-19. A higher household crowding index (aOR = 0.41), a higher anxiety (aOR = 0.88), and do not know if there was an indirect contact with a COVID-19 patient (aOR = 0.44) were significantly associated with low knowledge of COVID-19. Having a family member working in the medical field (aOR = 1.76) and higher COVID-19 fear scores (aOR = 1.04) were associated with a more acceptable attitude toward COVID-19. Furthermore, higher knowledge scores (aOR = 1.14), higher attitude scores (aOR = 1.41), higher COVID-19 fear scores (aOR = 1.10), and more time spent on COVID-19 information (aOR = 1.91) were associated with good practice during the COVID-19 pandemic. However, these associations differed by sex, except for the crowding index, which were inversely associated with knowledge in both sexes, while education level and indirect exposure to COVID-19 were significant only among females. Knowledge about COVID-19 did not affect attitudes, but a good attitude was related to better practice in both sexes. Moreover, higher fear and more time spent on COVID-19 information were significantly associated with better practice among females. Overall, this study validated tools to highlight the knowledge, attitude, and practice among the general population during the COVID-19 outbreak in Lebanon. Our findings suggest the need for health education programs tailored differentially according to sex, taking into account education, age, and socioeconomic status to raise awareness of COVID-19 and promote more acceptable attitudes and sustained safe practices among the general Lebanese population.