|Year : 2020 | Volume
| Issue : 2 | Page : 43-48
Assessment of impact of media, perceived knowledge, fear, and preventive measures associated with coronavirus disease-19 among dental undergraduates
Avijit Avasthi1, Tarun Kalra2, Nikita Suri3, Shaurya Negi4
1 Department of Public Health Dentistry, Baddi, Himachal Pradesh, India
2 Department of Prosthodontics, Baddi, Himachal Pradesh, India
3 Department of Oral Maxillofacial Surgery, Baddi, Himachal Pradesh, India
4 Dental Student, Baddi, Himachal Pradesh, India
|Date of Submission||21-Jul-2020|
|Date of Decision||24-Jul-2020|
|Date of Acceptance||19-Aug-2020|
|Date of Web Publication||23-Sep-2020|
Department of Public Health Dentistry, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh
Source of Support: None, Conflict of Interest: None
Objective: The aim of this study was to assess the impact of media, perceived knowledge, fear, and preventive measures on coronavirus disease-19 (COVID-19) among dental undergraduates. Materials and Methods: A validated 19-item self-administered questionnaire was disseminated to dental students pursuing dentistry from the various academic institutions across India. Participants were enrolled using convenience sampling, and students disseminated the online questionnaire to their contacts using snowball sampling by WhatsApp and E-mail. Data were subjected to the Statistical Package for the Social Sciences version 21.0, Armonk, NY: IBM Corp.). Descriptive statistics in the frequency and percentage were expressed. The Chi-square test was used to draw the comparison between categorical variables. Results: Out of 501 students, 79.3% females and 20.7% males participated. 54.7% relied on print and social media outlet to receive updated information on pandemic. Greater than 50% respondents had high perceived knowledge about COVID-19. More than one-third respondents felt anxious and feared of contracting infection from asymptomatic carriers. Female students adhered better when compared to males in practicing preventive measures to avoid COVID-19. Conclusion: Exposure to media could be responsible for adopting the preventives measures to avoid COVID-19. Higher perceived knowledge among students might be because of extensive viewing and reading about COVID-19. Certainly students expressed concern of contracting infection accidently and valued their health.
Keywords: Coronavirus disease-19, dental students, knowledge and fear
|How to cite this article:|
Avasthi A, Kalra T, Suri N, Negi S. Assessment of impact of media, perceived knowledge, fear, and preventive measures associated with coronavirus disease-19 among dental undergraduates. Dent Med Res 2020;8:43-8
|How to cite this URL:|
Avasthi A, Kalra T, Suri N, Negi S. Assessment of impact of media, perceived knowledge, fear, and preventive measures associated with coronavirus disease-19 among dental undergraduates. Dent Med Res [serial online] 2020 [cited 2020 Dec 6];8:43-8. Available from: https://www.dmrjournal.org/text.asp?2020/8/2/43/295869
| Introduction|| |
World is witness to the several outbreaks of infectious diseases for instance the Spanish Flu Pandemic of 1918 which occurred during turn of the 20th century. Approximately 100 million people perished from Spanish Flu Pandemic possibly because of H1N1 strain of influenza virus. Then, came in early 1980s HIV which is believed to have affected 40 million people globally. Although a rare infectious disease, but with significant advances in treatment involving (protease inhibitors and anti-retrovirals) people can live with it.
Other notable infectious diseases in the 21st century have been in particular severe acute respiratory syndrome (SARS) in 2003 and Swine Flu” or H1N1/09 Pandemic of 2009. SARS which emerged in China had ravaging effects with serious respiratory symptoms compounded with 10% mortality rate which became a global public health concern. SARS had agonizing effects on individuals, families, and communities., The H1NI Pandemic was initially considered a serious outbreak but later on the threat downgraded, still the outbreak devastated economically amounting to 1.5 billion US$ Dollar spent on the purchase and administration of vaccines. The H1NI pandemic-generated emotional reaction among people whether to get vaccine flu shots and many questioned the safety and long-term effects of influenza vaccine. Ebola Outbreak (2014–2016) in Central and West Africa and the ZIKA virus (2015–2016) were also of significant public health concern. ZIKA virus was connoted modern media pandemic; due to prominence in the social media. Media was being used to disseminate information and express the public sentiments about ZIKA virus.
More recent to gain attention because of widespread mortality, and morbidity is the coronavirus disease (COVID-19). The disease spreads when an infected person coughs or sneezes discharging droplets of saliva and spread through nasal discharge associated with pneumonia and severe respiratory complications. The sporadic clustering of cases which occurred in Wuhan the epicentre of outbreak with 570,288 confirmed deaths and globally 12 964 809 confirmed cases. The WHO on January 30, 2020 declared it a “Public Health Emergency of International Concern.”
Heavy reliance on social media (e.g., Twitter, What's App, Facebook, and Wikipedia) to get updated information about public health issues influences our behavior, opinions, and actions. Mass media campaigns through print media (newspaper, articles, and posters) and social media outlets (i.e., What's app, Face book, Apple updates, Instagram, and Twitter) convey on the daily basis information about the source of origin of disease, disease transmission, and preventive measures with likelihood of inducting positive behavioral change. When there is excessive media coverage of health crisis, it results in psychological distress, posttraumatic stress disorders, and effect on physical health. In today's era of 24 × 7 global news, viewers may tend to erroneously estimate the threat from disease. The so called media-fuelled distress resulted in people resorting to panic-buying during COVID-19 crisis which eventually led to the scarcity of essential items such as N-95 masks, gloves, hand-sanitizers, and 1st aid kits. With passage of time, some of us might show relaxation in standard precautions (social distancing, wearing of face mask, hand hygiene practices, etc.)., Highlighting exponential increase in the number of cases of pandemic could in still positive behavior change initially, but misinformation by media may lead to fear, panic, and mass hysteria.
Thus, media should engage in responsible manner to disseminate information which would help in the reinforcement of appropriate health protective behavior. One of the measures to address misinformation is to verify the authenticity of factual content before circulation in public domain. Reliance on authoritative sources such as Center for the Disease Control and Prevention (CDC) and World Health Organization (WHO) will serve valuable purpose in dispelling speculative stories and regulate excessive exposure to media.
Researchers place emphasis on what people know at a particular moment, rather than addressing fallibility on the current knowledge which may enhance motivation to learn. Perceived knowledge is also expected to mediate the impact of new information on assessing the importance of earlier information. In accordance to Social Cognitive Theory Human self-development, adaptation, and change are embedded in social systems. Social cognitive theory is based on four mechanisms (attention, retention, production, and motivation) which explain how individuals react through learning through mass media. It is believed that people tend to observe, assimilate, and adopt behaviours when exposed to media. Monitoring media coverage during H1N1 crisis resulted in the adoption of preventive behavioral measures among people. Media revelation may lead to high likelihood of developing preventive action and high level of perceived knowledge. Thus, an individual's perceived knowledge of an outbreak should be a precursor of taking COVID-19 prevention measures.
It has been repeatedly argued that focus on contagious nature of pandemic and sensationalism of news is responsible for evoking fear and anxiousness in minds of people. People because of fear might get motivated to take precautionary measures. Accordingly, fear influenced by media exposure may implement preventive actions.
Thus, the aim of this study is to assess the impact of media, perceived knowledge, fear, and knowledge related to the preventive measures on COVID-19 among dental students.
| Materials and Methods|| |
The study was conducted by enrolling BDS undergraduates and interns from various dental colleges of India, by creating a 19-item Self-Administered Questionnaire on google survey forms and the web link was shared through social media platforms such as E-mail and via WhatsApp (https://docs. google. com/forms/d/e/1FAIpQLSe9XlBrdEB9GJT87_vyvdL1xchbj3HjfowVzqJ2YSGCc1SvEg/viewform? vc=0andc=0andw=1andusp=mail_form_link). This study was approved by the Institutional Ethics Committee of Bhojia Dental College and Hospital, Baddi, (Himachal Pradesh). The principal investigator contacted students via E-mail and Whatsapp who were willing to participate in the study using convenience sampling. In addition, virtual snowball sampling was used in which participating students shared the online questionnaire on social media platforms such as E-mail and Whatsappamong their peers pursuing dental under graduation from other dental colleges across India. Consent was obtained from students before prefilling the questionnaire. 19-item questionnaire consisted of 4 parts: demographic information, impact of media, perceived knowledge, fear and preventive measures of COVID-19. Demographic information gathered was age, gender, year of dentistry, and name of dental institution. Pretesting of the questionnaire was done among small sample to assess the validity and the internal consistency obtained was (Cronbach's alpha α = 0.73) of the questionnaire. The impact of media on Covid-19 was assessed by asking; how often you use the following media (newspaper, television, mobile app, Instagram, what's app, and twitter) to get updated for COVID-19? on a 5-point Likert scale with responses ranked from (1 = not at all, 2 = not really, 3 = undecided, 4 = somewhat and 5 = very much). Similarly, rest of item responses in context to perceived knowledge related to COVID-19 was ranked from (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree to 5 = strongly agree). Questions pertaining to perceived knowledge were enough information to inform someone about COVID-19, Knowledgeable about COVID-19, well informed about the possible prevention measures and confident about my knowledge about COVID-19.
Questions pertaining to fear about COVID-19 comprised of risk of getting infected if leaving house, accidental contact with asymptomatic person, feeling of anxiousness, immediate family member getting sick with COVID-19, and scared about getting infected with COVID-19. Fear was assessed on a 5-point Likert scale with responses ranked from (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree to 5 = strongly agree). Questions related to knowledge about the preventive measures of COVID-19 consisted of knowledge of cough etiquette, hand hygiene using soap, alternative to hand washing, wearing face-mask when stepping out of home, maintaining physical distance of 1 meter in close proximity, reporting to doctor about loss of taste and loss of smell, wearing of rubber gloves when touching objects, spread of COVID-19 through blood secretions, and vaccine being cure for COVID-19 were assessed on a 5-point Likert scale with responses ranked from (1 = not at all, 2 = not really, 3 = undecided, 4 = somewhat, and 5 = very much).
The data obtained were imported in Microsoft Excel Sheet and analyzed using the Statistical Package for the Social Sciences software version 21.0, Armonk, NY: IBM Corp.). Descriptive statistics in frequency and percentage was expressed. The Chi-square test was used to draw the comparison between the categorical variables. Level of significance was set at 0.05 and considered statistically significant.
| Results|| |
A total of 501 students participated in the online questionnaire. Predominantly, female undergraduates (79.3%) outnumbered male (20.7%) undergraduates.The mean age of students was 21.6 (standard deviation: 1.87) years. 54.7% relied very much on media (newspaper, television, WhatsApp, and Instagram) to get updated about COVID-19. The perceived knowledge of students when assessed stated 66.7% agree being knowledgeable about COVID-19, 61.7% were in a position to provide knowledge if questioned about the virus. 57.9% expressed confidence about the knowledge of COVID-19 and 57.3% were well informed about the possible preventive measures of COVID-19. Assessment of fear about COVID-19 was ascertained by assessing five items. 49.3% were concerned succumbing to disease in close proximity with asymptomatic patient. 42.7% felt home bound was better than venturing out of home and 36.9% were anxious about COVID-19. Interestingly, 32.3% responded neutral response concerning someone in their immediate family may get sick from COVID-19 during the next 6 months. However, 37.9% of the respondents were scared about getting infected with COVID-19. The preventive actions to be adhered in view of COVID-19 were also assessed. 91.8% respondents gave utmost priority to wear facemask when going outside. 79.6% adhered very much to hand hygiene practice of washing hands for 20 s and 72.6% used alcohol-based scrub as alternative to hand washing with soap. 77.6% observed physical distancing of at least 1 m when mingling with public and 55.7% were wearing rubber gloves when touching an object. 55.3% felt need of a visit to doctor if they felt loss of taste/loss of smell. An important observation was that vaccine might somewhat (38.9%) cure for COVID-19. Only a quarter of respondents (25.5%) believed COVID-19 transmitted through blood secretions [Table 1].
|Table 1: Impact of media, perceived knowledge, fear, and preventive actions on coronavirus disease-19|
Click here to view
Irrespective of gender, >50% respondents relied very much on media outlets to get updated about COVID-19. Female students felt that they are more knowledgeable about COVID-19 when compared with male students (P < 0.03). Students ranked in agreement that they were in constant fear in contracting infection through close proximity with asymptomatic carrier [Table 2].
|Table 2: Comparing Impact of media, perceived knowledge and fear associated with coronavirus disease-19 gender-wise using Chi-square test|
Click here to view
Female students were more anxious about COVID-19 in comparison with male students with statistically significant difference (P < 0.04). Female students expressed apprehension about their family members getting affected with COVID-19 which was in stark contrast to neutral response by male students. However, male students were more scared about getting infected with COVID-19 in comparison to female students. Comparison across gender in context to knowledge about the preventive actions of COVID-19 was also observed. Female students observed better precautionary measures such as physical distancing, better compliance to hand hygiene practices, and wearing rubber gloves in view of COVID-19 with statistically significant differences. Nevertheless, male students fared better in using facemask and performing hand washing with soap for a minimum period of 20 s. Similarly, reporting to doctor if there was symptom of loss of taste and loss of smell was observed among undergraduates [Table 3].
|Table 3: Gender wise comparison of preventive actions associated with coronavirus disease-19 using Chi-square test|
Click here to view
The respondents were confused regarding the spread of viral infection through blood secretions and sounded less optimistic of vaccine being ultimate cure for COVID-19.
| Discussion|| |
The current study highlighted the impact of media, perceived knowledge, fear and preventive knowledge associated with COVID-19.
Social media tools provided major knowledge related to COVID-19 which was similar to findings from other studies across the world;,,,,, however, it was contrary to the source of knowledge obtained by medical students., The credibility of source of knowledge is questioned when information is obtained through social media outlets. Students might not be well aware of CDC and WHO conveying up-to-date information about pandemic and never questioned the authenticity of information gathered through social media outlets. Level of agreement regarding the knowledge about COVID-19 was satisfactorily high among dental students and similar responses were obtained among health sciences students.,,, Majority of students followed preventive measures such as avoiding those who are coughing, washing hands, wearing face-mask, using alcohol-based disinfectants, and maintaining physical distancing as discernible from previous outbreaks.,,,,,,,,,, Respondents somewhat believed in the practice of wearing rubber gloves when touching objects but rubber gloves provide false assurance of not getting infected. CDC recommends the use of gloves when discharging care in health-care settings. Gloves are to be worn when coming in contact with blood, stool, and body fluids, for example, saliva, vomit, mucus, and urine. Less than one-third of respondents expressed concern of their immediate family members contracting COVID-19 which differed from the perception of general public. Approximately half of the undergraduates felt risk of getting infected through accidental contact with asymptomatic in agreement with earlier public health emergencies.,,, Although fear of getting infected was consistent to previous outbreaks,,,, 32.3% of students had neutral reaction to fear of getting infected. Students had mixed response to spread of virus through blood secretions and similar knowledge was obtained from previous research.
Students were less convinced in vaccine serving a remedy for COVID-19 which differed from earlier studies,,,, exploring the knowledge of students in vaccine proving a potential cure for pandemics and this could be related to concern about side-effects, potency of vaccine, cost of vaccine, and willingness for acceptance of vaccine. There has been additional claim of anti-virals used to treat COVID-19 patients; however, substantive evidence yet to be proved.
Our study has certain limitations. The study was conducted on dental students who would be in a better position to understand the intricacies of COVID-19. Therefore, the above findings cannot be generalized on general public. However, in view of pandemic and its consequences, there is a need of advocating knowledge in students about aerosol-generating procedures which can be deferred.
| Conclusion|| |
Thus, constant viewing of COVID-19 news ignited fear in students developing COVID-19, but consistent tracking on latest updates instilled the preventive measures to combat COVID-19.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Damir H. Brief history of pandemics (Pandemics Throughout History). Psychiatry Pandem 2019;2019:7-35. DOI: 10.1007/978-3-030-15346-5_2.
Cohen MS, Hellmann N, Levy JA, DeCock K, Lange J. The spread, treatment, and prevention of HIV-1: Evolution of a global pandemic. J Clin Invest 2008;118:1244-54.
World Health Organization. Summary of Probable SARS Cases with Onset of Illness. World Health Organization; 1 November, 2002 to 31 July, 2003.
Maunder RG. Was SARS a mental health catastrophe? Gen Hosp Psychiatry 2009;31:316-7.
Ofri D. The emotional epidemiology of H1N1 influenza vaccination. N
Engl J Med 2009;361:2594-5.
Kindhauser MK, Allen T, Frank V, Santhana RS, Dye C. Zika: The origin and spread of a mosquito-borne virus. Bull World Health Organ 2016;94:675-686C.
Collinson S, Khan K, Heffernan JM. The effects of media reports on disease spread and important public health measurements. PLoS One 2015;10:e0141423.
Garfin DR, Silver RC, Holman EA. The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychol 2020;39:355-7.
Tizzoni M, Panisson A, Paolotti D, Cattuto C. The impact of news exposure on collective attention in the United States during the 2016 Zika epidemic. PLoS Comput Biol 2020;16:e1007633.
Smith KC, Rimal RN, Sandberg H, Storey JD, Lagasse L, Maulsby C, et al
. Understanding newsworthiness of an emerging pandemic: International newspaper coverage of the H1N1 outbreak. Influenza Other Respir Viruses 2013;7:847-53.
Zhang L, Kong Y, Chang H. Media use and health behavior in H1N1 flu crisis: The mediating role of perceived knowledge and fear. Atlantic J Communicat 2015;23:67-80.
Bandura A. Social Cognitive Theory of Mass Communication J Med Psychol 2001;3:265-99
Karasneh R, Al Azzam S, Muflih S, Soudah O, Hawamdeh S, Khader Y. Media's effect on shaping knowledge, awareness risk perceptions and communication practices of pandemic COVID 19 among pharmacists. Res Social Adm Pharm 2020;23;S1551-7411(20)30430-7. Doi: 10.1016/j.sapharm.2020.04.027.
Akan H, Gurol Y, Izbirak G, Ozdatlı S, Yilmaz G, Vitrinel A, et al
. Knowledge and attitudes of university students toward pandemic influenza: A cross-sectional study from Turkey. BMC Public Health 2010;10:1-8.
Alzoubi H, Alnawaiseh N, Al-Mnayyis A, Abu-Lubada M, Aqel A, Al-Shagahin H. COVID-19-knowledge, attitude and practice among medical and non-medical university students in Jordan. J Pure Appl Microbiol 2020;14:17-24.
Olum R, Kajjimu J, Kanyike AM, Chekwech G, Wekha G, Nassozi DR, et al
. Perspective of medical students on the COVID-19 Pandemic: Survey of nine medical schools in Uganda. JMIR Public Health Surveill 2020;6:e19847.
Kamate SK, Sharma S, Thakar S, Srivastava D, Sengupta K, Hadi AJ, et al
. Assessing Knowledge, Attitudes and Practices of dental practitioners regarding the COVID-19 pandemic: A multinational study. Dent Med Probl 2020;57:11-7.
Salman A, Mustafa ZU, Asif N, Zaidi HA, Hussein K, Shehzadi N, et al
. Knowledge, attitude and preventive practices related to COVID-19: a cross-sectional study in two Pakistani university populations. Drugs Ther Perspect 2020:1-7. doi: 10.1007/s40267-020-00737-7 [Epub ahead of print].
Khasawneh AI, Humeidan AA, Alsulaiman JW, Bloukh S, Ramadan M, Al-Shatanawi TN, et al
. Medical students and COVID-19: Knowledge, attitudes, and precautionary measures. A descriptive study from Jordan. Frontiers Public Health 2020;8:1-9.
Taghrir MH, Borazjani R, Shiraly R. COVID-19 and Iranian medical students; A survey on their related-knowledge, preventive behaviors and risk perception. Arch Iran Med 2020;23:249-54.
Barr M, Raphael B, Taylor M, Stevens G, Jorm L, Giffin M, et al
. Pandemic influenza in Australia: Using telephone surveys to measure perceptions of threat and willingness to comply. BMC Infect Dis 2008;8:117.
Kamate SK, Agrawal A, Chaudhary H, Singh K, Mishra P, Asawa K. Public knowledge, attitude and behavioural changes in an Indian population during the Influenza A (H1N1) outbreak. J Infect Dev Ctries 2009;4:7-14.
Zhong BL, Luo W, Li MH, Zhang QQ, Liu XG, Li WT, et al
. 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. Int J Biol Sci 2020;16:1745-52.
Modi PD, Nair G, Uppe A, Modi J, Tuppekar B, Gharpure AS, Langade D. COVID 19 Awareness among healthcare students and professionals in mumbai metropolitan region: A questionnaire based survey. Cureus 2020;12:E7514. doi: 10.7759/cureus.7514.
Painter JE, Plaster AN, Tjersland DH, Jacobsen KH. Zika virus knowledge, attitudes, and vaccine interest among university students. Vaccine 2017;35:960-5.
[Table 1], [Table 2], [Table 3]