Abstract
BackgroundThe COVID-19 pandemic continues to pose an international public health threat. Prevention is of paramount importance to protect the high-risk group of older adults until specific treatments for COVID-19 become available; however, little work has been done to explore factors that promote preventive behaviors among this population.ObjectiveThis study aims to investigate the knowledge, perceived beliefs, and preventive behaviors towards COVID-19 of older adults in China and determine the factors that influence their practice of preventive behaviors.MethodsFrom February 19 to March 19, 2020, a cross-sectional, web-based survey was administered to Chinese older adults in all 31 provinces of mainland China using a convenience sampling method to assess the respondents’ knowledge, perceived beliefs, and preventive behaviors towards COVID-19. Standard descriptive statistics and hierarchical linear regression analyses were conducted to analyze the data.ResultsA total of 1501 participants responded to the survey, and 1263 valid responses (84.1%) were obtained for further analysis. The overall correct rate on the knowledge questionnaire was 87%, overall positive beliefs regarding COVID-19 were found, and the mean behavior score was 13.73/15 (SD 1.62, range 5-15). The hierarchical linear regression showed that respondents who were married or cohabitating and who lived in areas with community-level control measures were more likely to practice preventive behaviors (P<.01). Knowledge (β=0.198, P<.001), perceived susceptibility (β=0.263, P=.03), perceived benefits (β=0.643, P<.001), and self-efficacy in preventing COVID-19 (β=0.468, P<.001) were also found to be significantly associated with preventive behaviors.ConclusionsMost older residents had adequate knowledge and positive beliefs regarding COVID-19 and engaged in proactive behaviors to prevent the disease. Knowledge and beliefs were confirmed to be significantly associated with behavior responses. Our findings have significant implications in enhancing the effectiveness of COVID-19 prevention programs targeting the older population; these programs must be continued and strengthened as the epidemic continues.
Highlights
COVID-19, which was first detected in Wuhan, China, in December 2019, is an emerging infectious disease caused by a novel coronavirus (SARS-CoV-2)
It was found that Chinese older adults had good knowledge of COVID-19; the respondents had an overall correct rate of 87% on the knowledge questionnaire, which was slightly lower than a rate reported for the Chinese general population (90%) [40] but much higher than that reported for US residents (80%) [41]
The Chinese older adults in our survey demonstrated good knowledge, optimistic perceived beliefs, and appropriate behaviors toward COVID-19 during the pandemic, which are important factors to limit the spread of the disease
Summary
COVID-19, which was first detected in Wuhan, China, in December 2019, is an emerging infectious disease caused by a novel coronavirus (SARS-CoV-2). In the case of COVID-19, older people are at significantly higher risk of morbidity and mortality [10,11,12]. According to an epidemiological study on COVID-19 in China, people aged >60 years comprised 31.2% of the 44,672 confirmed cases and 81% of the total number of deaths [13]. The provinces of the respondents’ current addresses were divided into eastern, central, and western regions according to the National Bureau of Statistics of China and were categorized into three levels according to their numbers of confirmed COVID-19 cases; provinces with 1000 cases were rated as low, medium, and high-risk areas, respectively. The total knowledge score ranged from 0 to 7, with a higher score representing better knowledge of COVID-19
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