EPH97 Application of Self-Protective Behaviors in Balancing Objective and Subjective COVID-19 Risk Assessments Among Residents in an Urban Setting

Abstract

We examined the association between self-perceived and Latent Class Analysis (LCA) assessed risk of COVID-19 infection and evaluated their relationships with sociodemographic and modifiable behavioral factors among residents of Onitsha, an urban city in Nigeria. We analyzed data from a cross-sectional survey (n=140) conducted in March 2020. The survey elicited information on the participants’ demographic characteristics, COVID-19 knowledge, attitude, preventive practice, level of preparedness, misconceptions, and COVID-19 information gaps. Participants were classified as being “not at risk” or “at risk” based on self-perceived risk of COVID-19 infection (subjective) and LCA-segmented risk clusters (objective). We applied the Chi-square test and used Kendall rank correlation analysis to determine the relationship between demographic characteristics and self-protective behaviors by the risk assessment methods. There was a significant association between subjective (32.4%) and objective (50.7%) assessments of COVID-19 risk (X2=5.38, p<0.05) among the survey participants. However, those who perceived themselves at risk of COVID-19 were 58% less likely to be classified as such when assessed objectively (OR: 0.42, 95%CI: 0.20-0.88, p<0.05). In contrast, those who perceived themselves to be at no risk were 2.38 times (OR: 2.38, 95%CI: 1.13-4.99, p<0.05) more likely to be at risk when assessed objectively. Significantly negative and low correlation was observed between subjective and objective assessments ((Kendall's tau-b (τb)= -0.193,p<0.05). Relationship between knowledge and attitude of residents toward COVID-19 were in opposite direction (τb= 0.431,p<0.01 (subjective) and τb= -0.339,p<0.01 (objective)). Adoption of preventive practices was negatively correlated with information gap among persons assessed both subjectively (τb= -0.379,p<0.01) and objectively (τb= -0.404,p<0.001) for COVID-19 risks. Objective assessment allowed for the integration of self-protective behaviors in the model, making it a reliable framework for identifying at risk group and tailoring intervention program aimed at curbing the devastating impact of COVID-19 among the city residents.