Did Low Risk Perception Mediate the COVID-19 Second Wave in Bangladesh? A Cross-sectional Study on Risk Perception and Preventive Practice
Authors: Rahman Farah Naz , Rahman AKM Fazlur , Hossain Shah Monir , Faiz Mohammad Abul , Faisel Abu Jamil , Anwar ATM Iqbal , Hossain Moudud , Hussain Tarek Mahmud , Mahbub Tania , Ali Liaquat 
Published: August 2021

ABSTRACTObjectiveThis study assessed the risk perception and preventive behavioral practice towards COVID-19 just prior to the second wave of corona, as well as the impact of perceived risk on preventive practices.Design, setting, participants, and outcome measuresA cross-sectional study was conducted between December 2020 and January 2021, involving 1382 respondents aged 18 years and above from all eight divisions in Bangladesh. We used multiple linear regression to identify sociodemographic predictors of risk perception and multiple logistic regression to determine the relationship between risk perception and preventive practice.ResultsLow risk perception regarding COVID-19 was present among one-fifth of the respondents (19.8%). Younger age, being male, low education, single marital status, and rural residence were significantly associated with a low perceived risk of COVID-19. Hand washing and wearing mask were practiced by 80% and 67% of respondents, respectively. A low prevalence was noticed for social distancing (31%), avoiding social gathering (31%), and covering face while coughing/sneezing (18%). Furthermore, respondents with a high risk perception were found to be more likely than those with a low risk perception to practice all recommended COVID-19 preventive behaviors-hand washing (OR=2.4, 95% CI=1.5, 3.7), mask use (OR=3.4, 95% CI=2.3, 5), social distancing (OR=3.7, 95% CI=2.4, 5.6), sanitizer use (OR=2.7, 95% CI=1.8, 4.1), avoiding gathering (OR=2.3, 95% CI=1.6, 3.5), avoid touching face and mouth (OR=2.8, 95% CI=1.5, 5.3), and covering mouth while coughing/sneezing (OR=7, 95% CI=3.6, 13.4).ConclusionConsiderable number of Bangladeshi adults had low risk perception and low practice of some vital COVID-19 preventive behaviors before the onset of second wave of corona. All preventive practices were also influenced by respondent’s risk perception. This highlights the importance of strengthening and optimizing risk communication strategy even when the number of corona cases are low.STRENGTHS AND LIMITATIONS OF THIS STUDYThe study explored the perceived risk and preventive practices for COVID-19 in Bangladesh right before the recent onset COVID-19 second wave in the South Asian region, and included a larger sample size than previous studies.Unlike most other studies on COVID-19 risk perception that used online surveys, this study administered a face-to-face data collection from both urban and rural settings across all the eight divisions of Bangladesh.This is the first study in Bangladesh that investigated the effect of perceived risk of COVID-19 on the practice of a range of preventive behaviors, and used an analytical approach to quantify risk perception.Respondents’ self-reported information on COVID-19 preventive behavior practice is subject to be influenced by recall and desirability bias.The study was unable to explore the respondents’ frequency and adherence to preventive practices, as well as the influence of psychological factors on preventive behaviors.