Knowledge, Concerns, and Behaviors of Individuals During the First Week of the Coronavirus Disease 2019 Pandemic in Italy

• Published in: JAMA network open 2020-07, Vol.3 (7), p.e2015821-e2015821
• Main Authors: Pagnini, Francesco, Bonanomi, Andrea, Tagliabue, Semira, Balconi, Michela, Bertolotti, Mauro, Confalonieri, Emanuela, Di Dio, Cinzia, Gilli, Gabriella, Graffigna, Guendalina, Regalia, Camillo, Saita, Emanuela, Villani, Daniela
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Behavior; Betacoronavirus; Coronavirus Infections - epidemiology; Coronavirus Infections - psychology; Coronavirus Infections - transmission; Coronaviruses; COVID-19; Disease Transmission, Infectious - prevention & control; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Italy - epidemiology; Locus of control; Male; Online Only; Original Investigation; Pandemics; Pandemics - prevention & control; Pneumonia, Viral - epidemiology; Pneumonia, Viral - psychology; Pneumonia, Viral - transmission; Public Health; Quality of Life; Questionnaires; SARS-CoV-2
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2020.15821

At the beginning of a public health crisis, such as the coronavirus disease 2019 (COVID-19) pandemic, it is important to collect information about people's knowledge, worries, and behaviors to examine their influence on quality of life and to understand individual characteristics associated with these reactions. Such information could help to guide health authorities in providing informed interventions and clear communications. To document the initial knowledge about COVID-19 and recommended health behaviors; to assess worries (ie, one's perception of the influence of the worries of others on oneself), social appraisal, and preventive behaviors, comparing respondents from areas under different movement restrictions during the first week after the outbreak; and to understand how worries, perceived risk, and preventive behaviors were associated with quality of life and individual characteristics among Italian adults. This convenience sample, nonprobablistic survey study recruited adult participants with a snowballing sampling method in any Italian region during the first week of the COVID-19 outbreak in Italy from February 26, 2020, to March 4, 2020. Data were analyzed from March 5 to 12, 2020. Information was collected from citizens living in the quarantine zone (ie, red zone), area with restricted movements (ie, yellow zone), and COVID-19-free regions (ie, green zone). Levels of knowledge on the virus, contagion-related worries, social appraisal, and preventive behaviors were assessed with ratings of quality of life (measured using the Short Form Health Survey). Additionally, some individual characteristics that may be associated with worries and behaviors were assessed, including demographic characteristics, personality traits (measured using Big Five Inventory-10), perceived health control (measured using the internal control measure in the Health Locus of Control scale), optimism (measured using the Revised Life Orientation Test), and the need for cognitive closure (measured using the Need for Closure Scale). A total of 3109 individuals accessed the online questionnaire, and 2886 individuals responded to the questionnaire at least partially (mean [SD] age, 30.7 [13.2] years; 2203 [76.3%] women). Most participants were well informed about the virus characteristics and suggested behaviors, with a mean (SD) score of 77.4% (17.3%) correct answers. Quality of life was similar across the 3 zones (effect size = 0.02), but mental health was negatively associate