Assessment of Knowledge and Attitudes Over Time in Postacute COVID-19 Environments: Protocol for an Epidemiological Study

Abstract

Background Globally, COVID-19 is in transition from the acute pandemic phase into a postacute phase, and special attention should be paid at this time to COVID-19 control strategies. Understanding public knowledge and attitudes plays a pivotal role in controlling COVID-19’s spread and provides information about the public’s adherence to preventive and control measures. Objective This study protocol describes the planning and management of a survey to investigate the persistent or changing trends in knowledge and attitudes regarding COVID-19, vaccination, and nonpharmaceutical preventive measures among COVID-19 cases’ household contacts aged 18 years and older, after the acute phase of the pandemic in Catalonia and Navarre in Spain. The secondary objectives include investigating the rate of secondary transmission in households, taking into account the demographic characteristics, clinical manifestations, and preventive measures toward COVID-19. Methods A telephone questionnaire was designed to assess the changing trends in knowledge, preventive measures, and attitudes toward COVID-19 in 3 rounds (after identification as a household contact, 3 months later, and 6 months later). The questionnaire was developed following an extensive literature review and through discussions with a panel of experts who designed and assessed the validity of the questionnaire in terms of relevance, consistency, completeness, and clarity. The questionnaire consists of the following 7 sections: social and demographic characteristics (ie, gender, age, educational level, and workplace), comorbidities and risk factors (according to the recommendations from the COVID-19 vaccination strategy), epidemiological data (ie, exposure time, relationship with index cases, and frequency of use of nonpharmaceutical preventive measures), COVID-19 vaccination status (ie, the number and date of doses received), knowledge and attitudes toward COVID-19 (assessed using a 5-point Likert scale—totally agree, agree, neither agree nor disagree, disagree, and totally disagree), and sources of information (including traditional mass media, social media, and official sources). Results A pilot study was performed in May 2022 to evaluate the questionnaire with 22 household contacts. Preliminary findings indicated that the questionnaire was feasible and acceptable in the general population. The average response time was 15 minutes, with greater variations in responses by older participants. After the pilot study, recruitment of participants began and is expected to be completed at the end of the year 2023, after which the final results will be available in 2024. Conclusions Despite the low transmission levels of SARS-CoV-2 and the relaxation of containment measures, the implementation of the survey during the postacute phase will provide valuable insight to assist public health decision-making and control the transmission of SARS-CoV-2 and other respiratory viruses, thereby attenuating the negative effects of COVID-19 at individual and population level. International Registered Report Identifier (IRRID) DERR1-10.2196/52114

Absence of short-term changes in knowledge and attitudes among household contacts of COVID-19 cases during the post-acute phase of the pandemic in Catalonia and Navarre, Spain

“…We performed a prospective epidemiological study through a telephone survey. Details of the study design have been described previously ( 12 ). In brief, adult household contacts (18 years and over) of confirmed COVID-19 cases were selected in two regions of northern Spain, Catalonia and Navarre, from May 2022 to July 2023.…”

“…The process of instrument development and validation has been described elsewhere ( 12 ). The questionnaire was developed and adapted from previously validated questionnaires ( 13 , 14 ) and incorporated the WHO ( 2 ), ECDC ( 5 , 6 ), and Spanish Ministry of Health recommendations ( 15 ).…”

“…A committee of experts in the field develop all sections of the questionnaire to ensure the relevance, consistency, and clarity. The questions regarding to knowledge and attitudes were adapted from other instruments previously published, and a pilot test was performed prior to ensure the viability and reliability of the questionnaire ( 12 ). The questionnaire consisted of seven sections and was performed by qualified interviewers.…”

Level of knowledge, attitudes and the use of preventive measures among household contacts of COVID-19 cases after the acute phase of the pandemic

“…La metodología y cuestionario utilizado en el estudio han sido descritos anteriormente 8 . En resumen, todos los contactos domiciliarios fueron testados mediante una prueba rápida de antígenos para SARS-CoV-2 tras la notificación del caso confirmado, y mediante reacción en cadena de la polimerasa (PCR) siete días después en aquellos contactos que dieron negativo en la primera prueba.…”

“…El cuestionario utilizado 8 fue diseñado a partir del utilizado por Hong Xu y col 9 y Pascal Geldsetzer 10 , y basado en las recomendaciones realizadas por la OMS, el Centro Europeo para la Prevención y Control de Enfermedades (ECDC) y el Ministerio de Sanidad español 1 - 4 . Su estructura se evaluó mediante una prueba piloto 8 .…”