Risk Perceptions, Knowledge and Behaviors of General and High-Risk Adult Populations towards COVID-19: A Systematic Scoping Review
Authors: Clavel Nathalie , Badr Janine , Gautier Lara , Lavoie-Tremblay Mélanie 
Published: February 2021

Background

The COVID-19 pandemic represents a major crisis for governments and populations around the globe. A large number of studies have been conducted worldwide to understand people’s awareness and behavioral response towards the disease. The public’s risk perceptions, knowledge, and behaviors are key factors that play a vital role in the transmission of infectious diseases. Our scoping review aims to map the early evidence on risk perceptions, knowledge, and behaviors of general and high-risk adult populations towards COVID-19.

Methods

A systematic scoping review was conducted of peer-reviewed articles in five databases (MEDLINE-Ovid, EMBASE-Ovid, PsycINFO-Ovid, Web of Science, and CINAHL-EBSCO) on studies conducted during the early stage of COVID-19 (January to June, 2020). The gray literature was also searched through Open Grey, Scopus, Wonder, Social Science Research Network, MedRxiv, and websites of major public health organizations. Twenty studies meeting the inclusion criteria were included, appraised and analyzed.

Results

During the early stage of the pandemic, levels of risk perceptions, knowledge, and behaviors towards COVID-19 were moderate to high in both general and high-risk adult populations. The perceived severity of the disease was slightly higher than the perceived susceptibility of getting COVID-19 during the first wave of COVID-19. Adults were knowledgeable about preventive behaviors, including hand-washing, mask-wearing, social distancing, and avoidance behaviors. Nevertheless, an important knowledge gap regarding the asymptomatic transmission of COVID-19 was reported in many studies. Our review identified hand-washing and avoiding crowded places as dominant preventive behaviors at the early stage of the pandemic. Staying at home, reducing social contacts, and avoiding public transport were less widespread in general populations than in high-risk adult groups. Being a female, older, and more educated was associated with better knowledge of COVID-19 and appropriate preventive behaviors.

Conclusion

This scoping review offers a first understanding of general and high-risk adults’ risk perceptions, knowledge, and behaviors towards COVID-19 during the early stage of the COVID-19 pandemic. Further research should be undertaken to assess psychological and behavioral responses over time. Research gaps have been identified in the relationship between ethnicity and risk perceptions, knowledge, and behaviors towards COVID-19.

Contribution to the field statement

Since the beginning of the pandemic, a large number of primary studies have been conducted worldwide to understand people’s awareness and behavioral response towards COVID-19. Nevertheless, no review has mapped the early evidence on the perceptions, knowledge, and preventive behaviors of adult populations towards the transmission of this new disease. To the best of our knowledge, this is the first scoping review that offers an understanding of the general and high-risk adults’ risk perceptions, knowledge, and behaviors (RPKB) towards COVID-19 during the early stage of the COVID-19 pandemic. This review also identified sociodemographic factors associated with adults’ RPKB regarding COVID-19. As the virus does not affect individuals equally, knowing these factors can help to mitigate the negative effects of COVID-19 in certain population groups by developing targeted communication strategies that will facilitate their engagement in preventive measures. Finally, research gaps have been identified in the relationship between ethnicity and RPKB towards COVID-19. The existence of a disproportionate number of COVID-19 fatalities within Black populations should signal the possible gaps in RPKB towards COVID-19 in these communities. Additional studies on ethnic health disparities can help public health authorities to introduce targeted actions towards these communities during the COVID-19 pandemic.