COVID-19 Knowledge, Attitudes, Practices and Perceived Risk: Cross-Sectional Mixed Methods (Preprint)

BACKGROUND The COVID-19 pandemic has been characterized by miscommunication about the required precautions resulting in public confusion. Knowledge, attitudes, behaviors and perceived risk highlight the importance of education translated into actions to reduce the risk of global infections. OBJECTIVE The purpose was to investigate the knowledge, attitudes and practices (KAP), and perceived risk associated with COVID-19 among patients with multiple sclerosis (MS), healthcare providers and laypeople during the first 6-months of the pandemic. METHODS A descriptive, cross-sectional, partially mixed-methods explanatory sequential design was employed, using convenience sampling. Data were collected through a demographic and a KAP questionnaires including perceived risk assessment. Quantitative data were analyzed with descriptive and inferential statistics, while qualitative comments underwent thematic analysis. RESULTS A total of 148 participants were included: 43 MS patients, 50 healthcare providers, and 55 laypeople. Most participants (90%) possessed basic knowledge about COVID-19. The participants exhibited a range of attitudes and behaviors related to COVID-19. Lay participants have reported mostly a moderate perceived risk for COVID while patients with MS and healthcare providers reported mainly a high perceived risk to contract the virus (X2(6)=12.650, p=.049). Immunosuppressive state and vaccine hesitancy did not predict the COVID perceived risk. Additionally, perceived risk was correlated with the avoidance of crowded and public places. Qualitative analysis revealed themes of uncertainty, anxiety, fear, vulnerability and accountability associated with the perceived risk of contracting COVID-19. CONCLUSIONS COVID-19 knowledge is linked to positive attitudes and preventive behaviors. To address future pandemic threats, KAP-focused educational and public health initiatives are essential in fostering appropriate health behaviors.