Assessment of Knowledge and Attitudes Over Time in Postacute COVID-19 Environments: Protocol for an Epidemiological Study
Authors: Martínez-Baz Iván , Bullón-Vela Vanessa , Soldevila Núria , Torner Núria , Palma David , García Cenoz Manuel , Pérez Glòria , Burgui Cristina , Castilla Jesús , Godoy Pere , Domínguez Angela , Toledo Diana 
Published: November 2023

Background
Globally, COVID-19 is in transition from the acute pandemic phase into a postacute phase, and special attention should be paid at this time to COVID-19 control strategies. Understanding public knowledge and attitudes plays a pivotal role in controlling COVID-19’s spread and provides information about the public’s adherence to preventive and control measures.

Objective
This study protocol describes the planning and management of a survey to investigate the persistent or changing trends in knowledge and attitudes regarding COVID-19, vaccination, and nonpharmaceutical preventive measures among COVID-19 cases’ household contacts aged 18 years and older, after the acute phase of the pandemic in Catalonia and Navarre in Spain. The secondary objectives include investigating the rate of secondary transmission in households, taking into account the demographic characteristics, clinical manifestations, and preventive measures toward COVID-19.

Methods
A telephone questionnaire was designed to assess the changing trends in knowledge, preventive measures, and attitudes toward COVID-19 in 3 rounds (after identification as a household contact, 3 months later, and 6 months later). The questionnaire was developed following an extensive literature review and through discussions with a panel of experts who designed and assessed the validity of the questionnaire in terms of relevance, consistency, completeness, and clarity. The questionnaire consists of the following 7 sections: social and demographic characteristics (ie, gender, age, educational level, and workplace), comorbidities and risk factors (according to the recommendations from the COVID-19 vaccination strategy), epidemiological data (ie, exposure time, relationship with index cases, and frequency of use of nonpharmaceutical preventive measures), COVID-19 vaccination status (ie, the number and date of doses received), knowledge and attitudes toward COVID-19 (assessed using a 5-point Likert scale—totally agree, agree, neither agree nor disagree, disagree, and totally disagree), and sources of information (including traditional mass media, social media, and official sources).

Results
A pilot study was performed in May 2022 to evaluate the questionnaire with 22 household contacts. Preliminary findings indicated that the questionnaire was feasible and acceptable in the general population. The average response time was 15 minutes, with greater variations in responses by older participants. After the pilot study, recruitment of participants began and is expected to be completed at the end of the year 2023, after which the final results will be available in 2024.

Conclusions
Despite the low transmission levels of SARS-CoV-2 and the relaxation of containment measures, the implementation of the survey during the postacute phase will provide valuable insight to assist public health decision-making and control the transmission of SARS-CoV-2 and other respiratory viruses, thereby attenuating the negative effects of COVID-19 at individual and population level.

International Registered Report Identifier (IRRID)
DERR1-10.2196/52114