Chinese workers knowledge, attitudes and practices regarding COVID-19

The spread of the deadly COVID-19 disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be prevented and controlled by awareness and the practice of correct hand hygiene, wearing masks, and social distancing. In new research, scientists in China have looked at the knowledge, attitudes, and practices regarding COVID-19 among Chinese workers. The research paper titled, “Knowledge, attitudes, and practices related to Coronavirus disease 2019 during the outbreak among workers in China: A large cross-sectional study,” is published in the latest issue of the journal PLOS Neglected Tropical Diseases.

What was the study about?

Today, COVID-19 has affected over 30.9 million people around the world and claimed over 959,000 lives. The disease first emerged in December 2019 as a cluster of unexplained fever and respiratory infection in Wuhan, Hubei Province, China. Since then, it has spread rapidly from Wuhan to across the entire globe. To date, there are no specific antiviral agents for the treatment of the infection and no vaccines to prevent the spread of the infection.

The SARS-CoV-2 infection and the dynamics of its spread need to be understood, and certain practices need to be adopted to prevent the spread of the disease. A sound level of knowledge, correct attitude towards the disease, and prescribed practices can prevent the spread of the infection. This has been seen in the prevention of the spread of Ebola infection, the researchers wrote.

This study attempted to understand the knowledge, attitudes, and practices (KAP) of Chinese workers regarding COVID-19. This has not been studied yet, wrote the team.

What was done?

This was a cross-sectional study based on 180,000 Chinese factory workers from a labor-intensive factory in Shenzhen, China. The data was gathered between 2 February 2020 and 7 February 2020 via the Chinese survey website Wenjuanxing. This provided questionnaires that could be analyzed in real-time.

Among the questions asked were information regarding sociodemographic characteristics, knowledge regarding COVID-19, attitudes regarding the infection, and practices to prevent infection.

From the questionnaires sent out, a total of 142,584 responses were collected. Thus the response rate was 79.2 percent. Some of the responders were found to have responded more than once. Thus those responses from the same IP address were excluded to prevent overlap. These were 15,035 responses.

Scoring was thus

  • Those that completed 15 or questions correctly in the 20-question knowledge section were considered to have “good” knowledge of COVID-19. Those with less than 15 scores were considered to have “poor” knowledge.
  • Attitudes were measured using a 6-item scale, measuring attitudes towards preventive measures, willingness, and concerns. Those answering less than 4 items correctly were considered to have a poor attitude
  • Practices were measured on a 6-item scale on personal hygiene. Scores of over 4 were considered good practice.
  • Three additional questions were included. These were;
    • “Are you concerned about COVID-19-related information? (very concerned, concerned, not concerned)”
    • “Are you feeling panic about COVID-19? (a great deal of panic, panic, little panic, or none)”
    • “How do you access information about COVID-19? (mobile social software [WeChat, QQ, and Weibo], office website [government websites], TV, newspaper, and others)”

What was found?

The results of the study were as follows;

  • Average knowledge scores out of a total score of 20 were 16.3
  • The average attitude score was 4.5 out of 6 points
  • The average practice score was 5.8 out of 6 points
  • KAP related to COVID-19 was high
  • 29.4 percent (36,373 respondents) disagreed that gargling with saltwater could prevent infection with SARS-CoV-2
  • 47.7 percent of respondents disagreed that vitamin C and Banlangen granules could effectively protect against COVID-19
  • Knowledge levels were lower among older participants
  • Older participants also scored poorly on practice questions
  • Knowledge and practices were better among more-educated respondents.

Conclusions and implications

The authors write that this study shows that, in general, Chinese workers have a good awareness regarding COVID-19. They added, “...health authorities still need to provide correct information on COVID-19 prevention and strengthen health interventions, particularly for older and less-educated workers.”

The team explains that in contrast to the findings seen regarding Ebola, the awareness regarding COVID-19 was higher among Chinese workers two months since the outbreak. They said that the most important reason for this could be the measures taken by China, such as extending the Spring Festival holiday, preventing reopening of schools and factories, travel and transport restrictions and bans, etc. Various media were used to spread information, and official guidelines were also released to increase awareness. They added that messages and official statements helped alleviate fears and panic and gave the public a “sense of security and confidence.”

They wrote, “These results suggested that health authorities need to ensure correct information on COVID-19 prevention and strengthen health interventions, particularly for older and less-educated workers, to combat rumors and misinformation and reduce public panic.”

Knowledge, attitudes, and practices related to Coronavirus disease 2019 during the outbreak among workers in China: A large cross-sectional study Li ZH, Zhang XR, Zhong WF, Song WQ, Wang ZH, et al. (2020) Knowledge, attitudes, and practices related to Coronavirus disease 2019 during the outbreak among workers in China: A large cross-sectional study. PLOS Neglected Tropical Diseases 14(9): e0008584. https://doi.org/10.1371/journal.pntd.0008584

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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