Participants and setting
A cross-sectional study was carried out from November 21 to December 25, 2020, with 384 adults (20 to 80 years) in Ardabil (Ardabil is an ancient city in northwestern Iran and the capital of Ardabil Province) to assess the educational needs among adults in COVID-19 pandemic through a web-based survey (because it was not feasible to do a community-based national sampling survey during this government-imposed lockdown). The sample size was determined based on inclusion criteria, 95% confidence level, and 80% test power. Eligibility criteria to participate in this survey were to be adults (20 to 80 years), being a resident of Ardabil, being a social media user and having a smartphone, and willing to participate in the study.
Data collection procedure
Data were collected via a questionnaire designed with the Google survey tool. The link of the survey form was shared randomly as an invitation of participation through social media groups, people's volunteers. The researchers also shared the link to their contact list. The questionnaire included questions in 2 parts. Part one (socio-demographic information): age, gender, education level, occupation, marital status, monthly family income, and part two (educational need assessment): knowledge, attitude, and practices towards the COVID-19 pandemic. The researchers received a total of 454 eligible participant’s feedback, but of those responses, 384 completed questionnaires were selected for the study.
Data management and analysis
Fully completed questionnaires were extracted from Google forms and exported to the Microsoft Excel 2010 software for coding. Then, data were exported to Statistical Package for Social Science (SPSS) version 23 software. Data analysis consisted of descriptive and analytical statistics.
Measures
Socio-demographic information was obtained through close-ended and open-ended questions. The questions were related to their age, gender, education level, occupation, marital status, monthly family income (this variable was divided into a low socio-economic class family income<30 million Rial, moderate socio-economic class family income 30-10 million Rial, and high socio-economic class family income>10 million Rial). For need assessment, participant’s knowledge about COVID-19 was assessed using 6 questions, which were adapted from previous researches with “true,” “false” or “not sure”. Each correct response to a knowledge item has been assigned 1 point, 0 points have been assigned to each incorrect/not sure response. For knowledge items, the total score ranged from 0-6. The higher score indicated the adequacy of knowledge about COVID-19. Bloom’s cut-off of 80% (≥4.8) was used to define adequate knowledge.
The attitude section included 5 questions, and the responses were assessed using a 3-point Likert scale: “Disagree”, “Not sure” and “Agree”; each weighing 5 to 15 respectively, and ≥12 was set as a cut-off value for positive attitudes towards COVID-19.
The practice section consisted of 4 questions that were adapted from the WHO recommendations for the prevention of COVID-19 transmission. The responses of each item were assessed with a 2-point Likert scale: “Never and “Always”; each weighing 0 to 4 respectively and a cut-off value of≥3.2 was set for good practices. Besides, two questions about the main source of information, favorite educational resource, and use of public transportation were also included.
The validity of the questionnaire was determined by two methods of face validity and content validity, which were confirmed by experts of health education, psychology, reproductive health. The total content validity index (CVI) in the “relevancy”, “simplicity”, and “clarity” were equals to 83.6, 92.9, and 91.7. The reliability of the questionnaire was further evaluated through internal consistency (α=0.83) and test-retest (r=0.82).