The study was done in Shashamane Town, one of the towns in the Oromia national Region, in west Arsi zone. Shashamane is located at south of Addis Ababa about 250 km. The town lies roughly 70 08’ 51’’N to 70 18’ 19’’N latitude and 38 0 32’ 43’’E 380 41’ 07’’E longitude. The town is located at the upper greatest east African rift valley. It has a sub-tropical middle land climatic zone. Agriculture is the likelihood of the majority of the study population.
Sample size determination
The single population proportion formula was used to calculate the sample size by considering a study conducted at Diredawa which revealed covid 19 prevention practice 0f 40.7 % (18) and using 95% confidence interval, 0.05 margin of error, and a 10% non-response rate. The final sample size was 407.
From the seven sub-cities of Shashemane, three were selected using a simple random sampling method, and then 407 participants were selected by systematic random sampling technique, using the sampling frame of households from the 3 sub-cities. The total number of households was proportionally allocated to ( Abosto, bulchana and Arada sub cities ) based on the number of households within each of them. Any individual who was a resident of the area, age over 18 years old, and who are healthy were included. Study variables include - Age of the Participant, Sex, marital status Occupation, Educational status, Average monthly Income, Family size, Source of information.
Instrument and Outcome measurement
We developed the questionnaire based on a literature review and adapted it from WHO resources. It includes sociodemographic information, behavioral characteristics, knowledge, attitude, and practices towards COVID-19 prevention actions (19-21,24). The attitude variable was converted into a dummy variable of unfavorable and favorable attitudes. For each item participants who answered (a) strongly disagree, (b) disagree, or (c) neutral were combined into one group and categorized as an unfavorable attitude” and those participants who responded (d) agree or (e) strongly agree were labeled as having “favorable attitude”. Overall, the attitude was generated from the dummy variables created from the Likert scale items and those participants who had “favorable attitude” for all the attitude questions were grouped as “favorable attitude” and all else were categorized as “unfavorable attitude”. (24) Regarding the participants' adherence, those who practiced ≥75% of the COVID-19 preventive practices were labeled as having “good adherence”
Also, there were 12 (twelve) knowledge measuring questions, in which each question scored 0 and 1 (0 = No, 1 = Yes). We considered those study participants who scored below the mean value out of twelve questions as they have poor knowledge and those who scored a mean and above the mean value as they have good knowledge (18).
Data collection, management, and analysis
Socio-demographic data was cleaned manually and entered into the computer using Epidata version 3.3 and statistical analysis was made using SPSS version 25, whereas, Descriptive summary (Frequency distribution, proportion, mean & standard deviation) was used to summarize the variable. Continuous variables like age and income were first transformed into categorical variables before they were analyzed. First, the frequency of all the variables in the questionnaire was determined. Bivariate & multivariable logistic regression was done to assess the association of factors with Adherence to covid-19 prevention measures, by calculating odds ratios, their 95% confidence limits, and P-value less than or equal to 0.05 was taken as statistically significant. Important variables were entered and analyzed using multivariable logistic regressions to control for confounding variables. All the assumptions of regression analysis (model adequacy and multi-co linearity of independent variables) were checked to be satisfied using appropriate methods.
Data quality control
Data quality control was ensured by conducting a pretest on about 5% of the sample size that was randomly selected from participants out of the study population and then the data were checked for internal consistency and modifications were made accordingly.
An ethical Approval Letter was taken from Paradise college. Informed consent was obtained from each respondent and they were told to have the full right to give up the interview any time he/she wishes. The purpose of the research was well communicated and never exposed the privacy of the participants. A consent paper was prepared and participants gave consent before the data collection started.