Validation of Fear of COVID-19 Scale and Assessment of Fear of COVID-19 Among People Living in High-risk Zones in Sri Lanka During the First and Second Waves of the Pandemic

Abstract

Background and objective: Evaluation of fear associated with COVID-19 is imperative to mitigate the negative effects of the pandemic on community. The fear associated with COVID-19 has not been evaluated systematically in Sri Lanka. This study assessed the validity of the Sinhala version of Fear of COVID-19 scale (FCV-19S) and determined the fear of COVID-19 among people in high-risk zones in Sri Lanka during the first and second waves of the pandemic. Methods: The FCV-19S, a seven-item tool was cross-culturally adapted and self-administered among 148 individuals, conveniently selected from the general public from Galle, Sri Lanka. The psychometric properties including reliability and validity were evaluated. Subsequently, the validated FCV-19S was self-administered among 325 individuals from high-risk zones of Sri Lanka to assess the fear of COVID-19 and associated factors. Results: FCV-19S showed a high test re-test reliability measured with intra-class correlation=0.86 (0.81-0.90). Cronbach’s alpha was 0.87 after deleting the item 3 that did not meet satisfactory validity criteria. The remaining six items showed single-factor structure (Eigen value >1, cumulative variance; 60.8%) in Factor Analysis with Principal Component Analysis. A moderate positive correlation between FCV-19S score and Depression, Anxiety and Stress Scale–21 (DASS-21 score) (r=0.63, p<0.001) was observed confirming the concurrent validity. Only 40.6% (n=132) experienced high level of fear. Those with secondary education (OR=0.43) and tertiary education (OR=0.34) had low level of fear compared to those with no education and only with primary education. Those living with family members (OR=7.96) compared to those living alone and being positive or suspected of COVID-19 or exposed to a COVID-19 patient (OR=3.71) compared to those with no history of disease had high level of fear. Conclusions: Modified, 6-item, Sinhala version of FCV-19S showed adequate psychometric properties. The proportion of people who experienced fear in high-risk zones of COVID-19 was relatively high. Education, living conditions and history of exposure were associated with fear.