Risk perceptions and attitudinal responses to COVID-19 pandemic: an online survey in Ethiopia

Abstract

Background: Effective risk communication is one of the critical strategies in the response to COVID-19. This study examined risk perceptions and attitudinal responses to COVID-19 among the educated section of the society in Ethiopia.

Methods: An internet-based survey was conducted from April 22 to May 04, 2020, in Ethiopia. A questionnaire addressing the perception of health threat-combination of perceived vulnerability (PV) and perceived seriousness (PS), and perceived efficacy-combinations of perceived response efficacy (PRE), perceived self-efficacy (PSE), and perceived collective efficacy (PCE). The data were analyzed using SPSS 21.0. Descriptive statistics were computed after the standardization of the scores. The scores for overall efficacy and threat were split by median value and response classifications were generated through threat by efficacy interactions. For statistical significance, 95% CI and p-value < 0.05 were used.

Results: A total of 929 respondents submitted their responses. Eight hundred and twenty-eight (89.1%) of the respondents were male and 753 (81.1%) were Christian. The perceived threat to COVID-19 was generally low (median = 58.3). The median score for overall efficacy, PRE, and PSE were 79.8, 87.5, and 80.0, respectively. However, the median value (66.7) for PCE was relatively low. Perceived threat significantly varied by age, education, occupation, and place of residence (p < 0.05). Perceived efficacy significantly differed by gender, residence, and use of some sources of information (p < 0.05). In terms of response to COVID-19, 290 (31.2%), 239 (25.7%), 175 (18.8%) and 225 (24.2%) of the respondents were in the responsive, pro-active, avoidant, and indifferent attitudinal categories, respectively. The avoidant and indifferent groups constituted a fear control response (mal-adaptive motivation towards COVID-19 protective behavior) whereas responsive and pro-active categories formed a danger control response (self-protective motivation). These responses varied significantly by residence, region, religion, and sources of information (p < 0.05).

Conclusions: Understanding people's perceived health threat and efficacy is a critical step toward creating risk communication campaigns. Hence, this study provided an insight that has the potential to inform the COVID-19 risk communication campaigns targeting the educated section of the society, by ensuring a balanced combination of threat appeals and efficacy messages for improved self-protective responses.

Keywords: Attitude; Attitudinal response; COVID-19; Collective efficacy; Coronavirus; Efficacy; Ethiopia; Extended parallel process model; Health threat; Perceived severity; Risk communication; Risk perception; Self-efficacy; Vulnerability.

Fig. 1

Source of information about COVID-19, May 2020. Internet sources were the major source of information about COVID-19 followed by Televisions stations (a)

Fig. 2

Knowledge of symptoms of COVID-19, Ethiopia, May 2020

Fig. 3

Kernel density estimation to visualize the shape and nature of relationship among the measures of perceived threat and perceived efficacy, May 2020, Ethiopia. With exception of perceived collective efficacy (PCE), all measures of efficacy were consistently higher whereas measures of health threat-specially perception of vulnerability was very low (b). Overall health threat and efficacy were also show clear difference between perception of threat (very low) and efficacy (.e. perceptions of the effectiveness of the COVID-19 preventive measures and beliefs one’s own ability to exert personal control to perform protective behavior) (b)

Fig. 4

Perceptions of a threat to COVID-19 and efficacy of protective measure by residence, May 2020

Fig. 5

Perceptions of a threat to COVID-19 and perceived efficacy of protective measure by occupational categories, May 2020