This study was performed 6 weeks after the COVID-19 outbreak and critically affected the area in northern Iran. The current study reports the knowledge, attitudes, and practices (KAP) regarding the pandemic among the SBC members. COVID-19 has created a global pandemic. It is important to encourage the public to adopt precautionary behaviors, which are based on a correct understanding of the epidemic and the appropriate responses necessary among people . Many studies have evaluated the various levels of KAP about the COVID-19 outbreak showing good levels of knowledge among participants [18, 20]. Social media and global networks have been used in various health applications and improve people’s knowledge during pandemics .
In this study, most of the mothers had acceptable level of knowledge which may be affected by their age, occupation, location, educational status, and their main source of information. Zhong et al.  suggested that knowledge regarding COVID-19 was significantly lower in males, younger ages (16-29 y/o vs older), never married, bachelor’s degree and below and unemployed people. In an Egyptian survey , no difference was found between knowledge of males and females, but those who were 50 years and younger, residents of urban areas, and university-educated participants had better knowledge scores. Since all of our participants were married and female, we were unable to compare marital status and gender regarding knowledge, but it can explain the good knowledge score in our study. Also, we found that the knowledge of mothers who were older than 27 years, had higher education levels, and employed mothers were better; perhaps because they use social media or search medical websites seeking the best available information about the disease. As was predictable, the information of healthcare worker mothers was higher than others. Also, Moro et al. found that knowledge of healthcare workers was better than other staff members of hospitals .
The present study showed that knowledge of mothers regarding some questions was better; they knew the main clinical symptoms of COVID-19, they agreed that taking measures to prevent the infection is necessary for children and infants, infections may be more severe in some comorbidities, avoided going to crowded places, agreed that isolation and treatment of COVID-19 infected people or quarantine of those who had contact with sick people are important to prevent spreading the virus. Other studies also showed similar good information among people [17, 18, 20].
In the present study, in some important measures, the mother’s knowledge was not satisfactory: their belief about possibility of transmission of COVID-19 infection through contact with domestic/wild animals and infection by smokers and addicted people was concerning. Also, the idea that COVID-19 is just transmitted in the febrile period of infection and the necessity of wearing masks to prevent infection were other blind spots of our participants. The reason for this may be due to an inconsistency about wearing masks and transmission of the disease by animals in the literature or social media [18, 20].
In this study, mothers older than 27 years, who were not healthcare workers, and those without any family history of infection were more hopeful about the eventual control of the disease in the world. Housewives were more hopeful about control of the disease in the country. In Wuhan, China, 90.8% of respondents agreed that this epidemic will be finally controlled, and this attitude was significantly different regarding the educational level and knowledge about COVID-19 .
A considerable number of mothers in this study experienced sleep disturbance and mothers with a family history of infection suffered from sleep problems more frequently. This may be due to concerns about the health of their family members. Rajkumar et al. reported that anxiety, depression and self-reported stress are common psychological problems during the COVID-19 pandemic, and may be associated with disturbed sleep .
The present study showed that the practices of mothers were good in 91%. They tried to pay attention to preventive measures heterogeneously, and only 13% of them went to crowded places. Most of them have stayed at home, kept social distancing, and avoided traveling, even during the New Year holiday. Although the government never locked down any city or province completely, all mothers practiced such preventive measures by themselves. In Zhong et al.’s study , during the lockdown of Hubei province, nearly 3.6% had gone to crowded places and 2% did not wear a mask when leaving home. In their study, adhering to different preventive measures of COVID-19 infection was worst in males and people with lower knowledge scores, single persons, and people who were not residents of Hubei were less possible to wear a mask when leaving home .
Our study had some limitations. First, it was a local survey in a city and suburbs. Therefore, the result cannot be generalized to the entire country. Since members of SBC were in specified fertility age groups and had access to social media, their knowledge might be higher than other people. We could not evaluate all aspects of KAP and only limited and some important aspects were studied. Evaluation of the psychosocial effects of a pandemic on people and relationships with such important factors on the KAP is recommended.