Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey — TEI-tagged view

Bao‐Liang Zhong, Wei Luo, Hai-Mei Li, Qian-Qian Zhang, Xiao-Ge Liu, Wen-Tian Li, Yi Li · 2020 · health-psychology · doi:10.7150/ijbs.45221 · TEI xml · tagged edition · index · concepts · authors
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Other fields define these differently the same word, defined another way in another discipline
logistic regression 3 fields
Tags on this paper every tag the record carries, whether or not the words occur in the text below — a number is how many papers in the corpus carry that tag; a tag with no number is unique to this paper
knowledge questionnaire attitudes practices2 socioeconomic status3 KAP theory panic emotion case fatality rate survey70
Method, as described: self-developed online questionnaire - 12 knowledge items, and attitudes and practices measured with two questions - recruited through the authors' own networks and popular media in Hubei

Our tag layer for this paper

Cross-disciplinary analysis
content-tags & facets: phenomenon · claim-type · cross-domain-transfer · mechanism · claim-relation · replication-status · limitation — grounded in the full text
phenomenonhigh self-reported knowledge, optimism and mask-wearing in a self-selected online sample during an accelerating epidemic— “The overall correct rate of the knowledge questionnaire was 90%. The majority of the respondents (97.1%) had confidence that China can win the battle against COVID-19. Nearly all of the participants (98.0%) wore masks when going out in recent days.”
claim-typeexistence— “The overall correct rate of the knowledge questionnaire was 90%. The majority of the respondents (97.1%) had confidence that China can win the battle against COVID-19. Nearly all of the participants (98.0%) wore masks when going out in recent days.”
method — evidence— “An online sample of Chinese residents was successfully recruited via the authors' networks with residents and popular media in Hubei, China. A self-developed online KAP questionnaire was completed by the participants.”
object of study — evidence— “The knowledge questionnaire consisted of 12 questions regarding the clinical characteristics and prevention of COVID-19.”
research question — evidence— “In multiple logistic regression analyses, the COVID-19 knowledge score (OR: 0.75-0.90, P<0.001) was significantly associated with a lower likelihood of negative attitudes and preventive practices towards COVID-2019.”
contribution — evidence— “Given the significant associations between these demographic variables and KAP towards COVID-19 revealed in this study, we may have overestimated knowledge and rates of preventive practices and underestimated rates of positive attitudes towards COVID-19 of Chinese residents.”
mechanismthe proposed pathway is knowledge -> attitude and practice: a higher COVID-19 knowledge score is associated with a LOWER likelihood of negative attitudes and of poor preventive practices, OR 0.75-0.90, P<0.001— “In multiple logistic regression analyses, the COVID-19 knowledge score (OR: 0.75-0.90, P<0.001) was significantly associated with a lower likelihood of negative attitudes and preventive practices towards COVID-2019.”mechanisms[0]
mechanismknowledge and attitudes act on transmission indirectly through panic, which the paper says can itself complicate prevention— “Lessons learned from the SARS outbreak in 2003 suggest that knowledge and attitudes towards infectious diseases are associated with level of panic emotion among the population, which can further complicate attempts to prevent the spread of the disease 8 , 9 .”mechanisms[1]
supports health education programmes as a lever on attitudes and behaviour, on the strength of the knowledge-score association— “In multiple logistic regression analyses, the COVID-19 knowledge score (OR: 0.75-0.90, P<0.001) was significantly associated with a lower likelihood of negative attitudes and preventive practices towards COVID-2019.”claim_relations[0]
critiques generalising KAP findings from an online sample to the Chinese population, which the paper refuses to do for its own results— “Due to the limited sample representativeness, we must be cautious when generalizing these findings to populations of a low socioeconomic status.”claim_relations[1]
senseKAP - AS OPERATIONALISED HERE, AND THE THREE ARE NOT EQUAL. Knowledge is 12 items with a correct answer. Attitudes and practices are ONE QUESTION EACH: confidence that China can win, and whether a mask was worn recently. A three-part construct measured 12 : 1 : 1— “Assessments on residents' attitudes and practices towards COVID-19 included questions on confidence in winning the battle against COVID-19 and wearing masks when going out in recent days.”senses[0]
sensethe sample - `recruited via the authors' networks with residents and popular media in Hubei`. THE RECRUITMENT CHANNEL IS ALSO THE EXCLUSION CRITERION: it reaches people with internet access, and the paper says the populations most at risk are the ones without it— “An online sample of Chinese residents was successfully recruited via the authors' networks with residents and popular media in Hubei, China. A self-developed online KAP questionnaire was completed by the participants.”senses[1]
sense`most Chinese residents` in the conclusion, WITH ITS QUALIFIER ATTACHED IN THE SAME sentence - `of a relatively high socioeconomic status, in particular women`. The qualifier is inside the claim rather than in a caveat afterwards, which is what makes it survive being quoted— “Most Chinese residents of a relatively high socioeconomic status, in particular women, are knowledgeable about COVID-19, hold optimistic attitudes, and have appropriate practices towards COVID-19.”senses[2]
controlthe achieved sample is compared against the most recent NATIONAL POPULATION STATISTICS of China, rather than described on its own terms — failed— “Nevertheless, compared to the most recent national population statistics of China 21 , our… — rules out a self-selected sample being read as a population sample - the comparison is what turns 'our respondents' into 'over-representative of women, well-educated people, and people engaging in mental labor'controls[0]
controlthe DIRECTION of the resulting bias is worked out per outcome, using the associations the study itself measured between the demographic variables and KAP — held
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
— rules out a caveat that says only 'may not generalise' - here the reader is told which numbers are too high and which are too low
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controls[1]
controlwhether attitudes and practices were measured adequately — failed
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— rules out nothing - the assessment is called 'unstandardized and inadequate' by the authors, who state that both should have been developed via focus group and interview and built as multi-dimensional measures
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controls[2]
controlwhether the populations most likely to score poorly are in the sample at all — failed
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— rules out nothing - older adults and rural people have limited internet access, which is the channel the survey recruited through, and the paper says so
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controls[3]
controlexcluding the nine respondents who reported having been infected before analysing the sample — held
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— rules out the possibility that people who already had the disease answer knowledge and practice items from experience rather than from public information
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controls[4]
controlbackward stepwise selection in the regression models rather than entering all variables — held
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— rules out associations that survive only because a correlated demographic is held in the model
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controls[5]
controla yes/no consent item that had to be answered before the questionnaire opened, under ethics approval — held
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— rules out participation without informed consent in a survey distributed by social media reposting
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controls[6]
weighthealth education programmes as a lever on attitudes and behaviour, on the strength of the knowledge-score association — 0.85
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claim_relations[0]
weightgeneralising KAP findings from an online sample to the Chinese population, which the paper refuses to do for its own results — 0.8
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claim_relations[1]
outcomecontrol — failed
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controls[0]
outcomecontrol — held
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Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[1]
outcomecontrol — failed
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[2]
outcomecontrol — failed
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[3]
outcomecontrol — held
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[4]
outcomecontrol — held
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[5]
outcomecontrol — held
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
controls[6]
limitationA SIGNED ERROR TERM, NOT A LIMITATIONS PARAGRAPH. The sample is over-representative of women, the well-educated and mental labourers, and the paper states the consequence per figure: `we may have OVERESTIMATED knowledge and rates of preventive practices and UNDERESTIMATED rates of positive attitudes`
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limitations[0]
limitationthe population the findings apply to is narrowed explicitly - `strictly speaking, our findings can only be generalized to Chinese populations of a relatively high socioeconomic status, particularly women`
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limitations[1]
limitationTHE MEASURE IS DECLARED INADEQUATE BY THE PEOPLE WHO USED IT: the assessment of attitudes and practices is `unstandardized and inadequate` and, for want of time, `both were measured with two simple questions only`
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limitations[2]
limitationand the paper names who is missing and why: vulnerable populations - older adults, rural people - have limited access to internet and online health information, which is the same channel the survey recruited through
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limitations[3]
limitationcommunity-based national sampling was not feasible during the lockdown, so the survey is an online convenience sample and the paper says so
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limitations[4]
limitationrecruitment ran through the authors' own social networks and local media reposts, which decides who could see the poster at all
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limitations[5]
limitationattitudes rest on two questions and practices on two behaviours, against twelve for knowledge - the three KAP components are not measured at comparable depth
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limitations[6]
Content tags
content-observations: finding · quantity · variable · definition · key-term — grounded in the full text
finding
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finding
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finding
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finding
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finding
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finding
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content_tags.findings[5]
findingCOVID-19's case fatality rate in China was far below SARS, MERS and H7N9, which is the comparison the paper opens with
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content_tags.findings[6]
findingthe final sample was 65.7% women, 63.5% held a bachelor's degree or above, and 56.2% did mental labour
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content_tags.findings[7]
findingthe knowledge instrument reached acceptable internal consistency, which the paper states with the coefficient
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content_tags.findings[8]
quantitysurvey completers, of whom 65.7% women, 63.5% with a bachelor degree or above, 56.2% in mental labour
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content_tags.quantities[0]
quantityitems in the knowledge questionnaire - against one question each for attitudes and for practices
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content_tags.quantities[1]
quantityper cent overall correct rate on the knowledge questionnaire
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content_tags.quantities[2]
quantitycase fatality of COVID-19 against SARS, MERS and H7N9
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content_tags.quantities[3]
quantitythe share of Chinese COVID-19 patients progressing to the severe stage
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content_tags.quantities[4]
quantitythe analysed sample and its demographic composition
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variablesocioeconomic status
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content_tags.variables[0]
variableknowledge score
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content_tags.variables[1]
variabledemographic variables
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definitionknowledge questionnaire
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content_tags.definitions[0]
definitionknowledge questionnaire
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content_tags.definitions[1]
Concepts
terms this paper carries, each with the sentence it was cut from — the layer that joins one paper to another. Terms with no quote yet are on CONCEPTS.html.
conceptknowledge questionnaire — not defined in this paper's own words; 12 items on the clinical characteristics and prevention of COVID-19, scored for correctness
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concepts[0]
conceptattitudes — not defined in this paper's own words; measured by one question - confidence that China can win the battle against COVID-19
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concepts[1]
conceptpractices — not defined in this paper's own words; measured by one question - wearing a mask when going out in recent days
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concepts[2]
conceptsocioeconomic status — not defined in this paper's own words; proxied by educational attainment and occupation, and the axis along which the sample is unrepresentative
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concepts[3]
conceptKAP theory — not defined in this paper's own words; the framework that makes adherence a function of knowledge, attitudes and practices - the paper's whole justification for surveying belief during an epidemic
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concepts[4]
conceptpanic emotion — not defined in this paper's own words; the mechanism carried over from SARS by which knowledge and attitudes affect disease spread indirectly, through population fear rather than through behaviour alone
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concepts[5]
conceptcase fatality rate — not defined in this paper's own words; used here comparatively - the number is given alongside SARS, MERS and H7N9 so the reader calibrates a new disease against known ones
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concepts[6]
Statistics — cross-field join keys
field-invariant statistical terms, used in their statistical sense (gated on a number / symbol / test). A p-value or a standard deviation means the SAME thing in physics, biology, psychology and sociology — so these are the strongest cross-field join keys. Grounded verbatim.
logistic regression
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OR
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content_tags.statistics[1]
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content_tags.statistics[2]

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