A total of 1,000 individuals completed a survey and after excluding individuals with missing data, 970 individuals were included in the analysis (Table 1). The average age of participants was 47.44 years. Approximately half were females (51.4%). A total of 59.2% had a high school diploma, followed by bachelor’s degree (31.9%) and graduate or professional degree (9%). 30.9% respondents’ monthly household income is within 200-400 (10,000 KRW), followed by over 600 (28.1%), 400-600 (26.8%), and under 200 (14.1%). Most were married (62.3%), have no children (76.6%), and reside in urban areas (87.3%) (Table1).
Knowledge, attitudes and practice on COVID-19
Among the six knowledge items, the respondents have answered about 4 items correctly (M=4.21, SD=1.16). Respondents appear to be aware of the transmission of the virus through respiratory droplets of infected people (93.2% answered correct, 2.5% incorrect and 4.3% reported don’t know), but the high prevalence of misunderstanding was revealed of infection through eating or contact with wild animals (Table 2). Only 27.9% answered it is false, 42.2% believed it was true, and 29.9% said they were not sure. About half of the respondents (48.8%) about whether wearing a general medical mask helps prevention were correct, but 39.7% answered incorrectly, and 11.5% answered that they did not know.
The knowledge score varied by gender and education level (Table 2). Females (β = 0.06, p < 0.05) and individuals with higher level of education (β = 0.06, p < 0.05) were more likely to score COVID-19 knowledge accurately (Table3). Respondent’s age, income level, marital status, residence, and presence of children were not related to the knowledge level of COVID-19.
Respondents perceived the risk of becoming infected with COVID-19 (perceived susceptibility) as being lower than “neither high nor low” (score = 3) (M = 2.77, SD = 0.80) and the average perceived severity score was higher than perceived susceptibility, which was close to “high” (score = 4) (M = 3.77, SD = 0.85). Both efficacy belief on preventive measures (M=3.82, SD=0.44) and social distancing (M=3.66, SD=0.59) was high. The most frequently performed practice was wearing facial masks (M=3.82, SD=0.49), followed by hand hygiene (M=3.51, SD=0.66), and social distancing (M=3.11, SD=0.90) (Table 4).
The influence of knowledge on attitude
The role of knowledge on perceived susceptibility, severity and efficacy belief were examined (Table 5). After controlling sociodemographic factors, who have less knowledge (β = -0.12, p < 0.05) were more likely to have lower level of perceived susceptibility of COVID-19. Who had higher knowledge displayed higher efficacy belief for personal hygiene practices (β = 0.19, p < 0.05) such as wearing masks and washing hands and had higher efficacy belief for avoiding crowded places (β = 0.16, p < 0.05) (Table 5).
The influence of knowledge and attitude on practices
Three different preventive behaviors varied by knowledge and attitude of the respondents (Table 6). First, those with higher efficacy belief (β = 0.31, p < 0.05) were more likely to wear facial mask. Next, who had higher perceived susceptibility (β = 0.08, p < 0.05) and efficacy belief (β = 0.20, p < 0.05) were more likely to wash hands more frequently. Lastly, individuals who have higher efficacy belief (β = 0.22, p < 0.05) tended to avoid crowded places to prevent COVID-19. Efficacy belief have shown the strongest and significant effect, however, knowledge have not shown significant effect on the three practices (Table 6).
Relationship between knowledge, attitudes, and practices
The indirect effects of knowledge on preventive behaviors mediated by attitudes (efficacy) were significant (Table 7). Efficacy belief significantly mediated the relationship between knowledge and all three preventive behaviors – wearing facial mask, washing hands, and avoiding crowded places. However, perceived susceptibility negatively mediated the relationship between knowledge and hand-washing behavior.