Knowledge, Attitude, and Practice of Novel Coronavirus (COVID-19) Among Young Adults in Iraq
Authors: Alsamarai Abdulghani Mohamed , Alsamarai Mohamed Almoustafa , Alobaidi Amina Hamed 
Published: December 2024

Background:
Society's information regarding practices, attitudes, and knowledge influences the society's
behaviors and practices toward COVID-19 and affects preventive measures and disease control.

Aim:
This study aims to assess the knowledge, attitude, and practices towards COVID-19 in the young adults of the
Iraqi general population.

Materials and Methods:
Cross-sectional study web-based survey conducted between 30th September 2023 to 31st
January 2024. The data was gathered through an electronic questionnaire. The survey was conducted in the Iraqi
population and included male and female participants aged ≥ 18 years. A self-administered structured questionnaire
was used for data gathering. The questionnaire consists of items to get information from the participants: risk
factors, knowledge, attitudes and practices toward SARS-CoV-2 infection, and social and demographic characteristics.
An Arabic version of the questionnaire was prepared. The questionnaire consists of the knowledge part, which
includes 11 questions, while attitudes include 10 questions and practices include 8 questions. The knowledge was
evaluated on the basis of the correct answer and converted to a score of 5. While for the attitudes, a 5-point Likerttype
scoring system was created for responses (1- strongly disagree; 2- disagree; 3-neutral; 4- agree; 5- strongly
agree). For the practices, a 5-point Likert score is used for response evaluation (5- always; 4- often; 3- sometimes; 2-
rarely; 1-never). The questionnaire link was sent online to the participants via Facebook, Instagram, Telegram, and
WhatsApp. The questionnaire participants replied in the Microsoft Excel sheet. An ANOVA test was used to determine
the differences in significance between the KAP items and within the section of each KAP. Post-hoc test used
for analysis of significance between K and A, K and P, A and P. The significance of the differences between groups
was determined using the chi-square test. The analysis was performed using SPSS version 20.

Results:
There were 1484 participants, with a survey response rate of 86.7% (1484/1712). The majority of the participants
(69.3%) were in the age group of 18 to 25 years, and 85.9% of them were B.Sc., M.Sc., Ph.D., and college students.
90.5% were from urban areas, and 27.6% participated in an online course for COVID-19. The mean score of
knowledge was 3.04 ± 0.84, which means that the mean correct answer of the knowledge item was 61%. The highest
correctly answered question (87%) was regarding the preventive measures for COVID-19 infection, followed by the
main symptoms of COVID-19 (76.5%). The lowest correctly answered question (27%) was regarding the mortality rate
of COVID-19, followed by complications of COVID-19 (38.1%). The total knowledge mean score was 61% of the scale
(score 3.04/5), and this indicated that 61% of the population has good knowledge regarding the COVID-
19 pandemic. Additionally, there were high significance (p < 0.01) differences between the knowledge item score and the
correct answer. A post-hoc test indicated a significant difference (p = 0.0305) in item scores between knowledge and
practices, but there was no significant difference between knowledge versus attitudes or between attitudes versus practices.
Attitudes mean score was 3.6 and 72% frequency of correct answers for the items. A significant number of participants
expressed worry about themselves, their family members, friends, or society (64.8%) getting infected. Thus, about
1/3 of the participants were not worried about getting an infection. However, 18.4% of participants did not express any as
they gave a neutral answer. It is interesting that 80.3% of the participants believed that an asymptomatic patient could
transmit the virus to others. The survey indicated a rate with an average of 12.5% to 36% of neutral responses to the
addressed questions. The mean score of practice was 9.98 and the correct answer frequency was 79.6%. The majority of
participants (83.3%) reported an acceptable practice. Individual questions were answered correctly in a range of 88.1% to
94.7%, with the exception of carefully removing PPE and discarding it in the proper place (17.1%).

Conclusions:
The young adults Iraqi general population had a good KAP standard. Attitudes and practice scores
were higher than those of knowledge. The knowledge score mean value was 3.04 and the correct answers frequency
was 61%, with the items score range of 1.4 and 4.4, while the correct answers frequency range was 27% and 87%.
The mean score of attitudes was 3.6 with a range of 2.8–4.2, while the correct mean frequency was 72% with a range
of 56% to 84%. The mean score of practices was 3.98 with a range of 1.6 to 4.5, while the mean frequency of the
correct answer was 79.6% with a range of 32% to 90%.