COVID-19 Induced Anxiety and Protective Behaviors During COVID-19 Outbreak: Scale Development and Validation
10 Pages Posted: 8 Jun 2020
Date Written: May 6, 2020
Abstract
Background: The outbreak of communicable diseases increases community anxiety levels; however, it demands protective behavioral changes with adjacent awareness of the emerging epidemic. This work aims to develop valid instruments to evaluate COVID-19 induced anxiety, protective behaviors, and knowledge towards COVID-19, and to explore the relationship between the three constructs.
Methods: A total sample of 215 university students were recruited to participate in an online self-administered questionnaire. The e-survey consisted of three instruments: COVID-19 Induced Anxiety Scale (CIAS) with 10 items, Protective Behaviors towards COVID-19 Scale (PBCS) with 14 items, and COVID-19 Related Knowledge Scale (CRKS) with 12 items.
Results: Item-total analysis and CFA models indicated that CIAS items no. 1, 2, 5, and 8 should be removed to achieve adequate internal consistency (Cronbach’s alpha=0.78) and structural validity. The protective behaviors towards COVID-19 can be estimated from 3 dimensions: Routine Protective Behaviors (RPB), Post-exposure Protective Behaviors (PPB), and Post-exposure Risky Behaviors (PRB). Meanwhile, PBCS showed good internal consistency (Cronbach’s alpha=0.85). Although the sample was unbalanced on gender, gender explained 5% of the variance in protective behaviors with females being more inclined to engage in protective behaviors. Structural Equation Model (SEM) implied that an individual’s COVID-19 related knowledge was associated with the three dimensions of protective behaviors (RPB, PPB and PRB) positively. However, the level of COVID-19 induced anxiety was linked to RPB and PPB positively but negatively to PRB.
Conclusion: The 6-item version of CIAS and the 14-item version of PBCS are promising tools for measuring COVID-19 induced anxiety and protective behaviors and can be adopted for future use during early phases of communicable diseases outbreaks. Knowledge is a key indicator for protective behavior; therefore, awareness strategies need to suppress infodemic impact. Severe stress must be monitored during early phases of outbreaks as it significantly increases the probability of risk behavior engagement.
Note: Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflict of Interest: The authors declare that there is no conflict of interest.
Ethical Approval: Ethical approval was waived by the Research Ethics Committee (EKV) of Masaryk University because this study did not involve biomedical samples nor did impose greater than minimal risks of information or psychological harms.
Keywords: COVID19, Protective Behaviors, Induced Anxiety, Scale Development
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