COVID-19 Induced Anxiety and Protective Behaviors During COVID-19 Outbreak: Scale Development and Validation

  1. Abanoub Riad
  2. Yi Huang
  3. Liping Zheng
  4. Steriani Elavsky

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Abstract

Background

The outbreak of communicable diseases increases community anxiety levels; however, it demands protective behavioral changes with adjacent awareness of the emerging epidemic. This work aims to develop valid instruments to evaluate COVID-19 induced anxiety, protective behaviors, and knowledge towards COVID-19, and to explore the relationship between the three constructs.

Methods

A total sample of 215 university students were recruited to participate in an online self-administered questionnaire. The e-survey consisted of three instruments: COVID-19 Induced Anxiety Scale (CIAS) with 10 items, Protective Behaviors towards COVID-19 Scale (PBCS) with 14 items, and COVID-19 Related Knowledge Scale (CRKS) with 12 items.

Results

Item-total analysis and CFA models indicated that CIAS items no. 1, 2, 5, and 8 should be removed to achieve adequate internal consistency (Cronbach’s alpha=0.78) and structural validity. The protective behaviors towards COVID-19 can be estimated from 3 dimensions: Routine Protective Behaviors (RPB), Post-exposure Protective Behaviors (PPB), and Post-exposure Risky Behaviors (PRB). Meanwhile, PBCS showed good internal consistency (Cronbach’s alpha=0.85). Although the sample was unbalanced on gender, gender explained 5% of the variance in protective behaviors with females being more inclined to engage in protective behaviors. Structural Equation Model (SEM) implied that an individual’s COVID-19 related knowledge was associated with the three dimensions of protective behaviors (RPB, PPB and PRB) positively. However, the level of COVID-19 induced anxiety was linked to RPB and PPB positively but negatively to PRB.

Conclusion

The 6-item version of CIAS and the 14-item version of PBCS are promising tools for measuring COVID-19 induced anxiety and protective behaviors and can be adopted for future use during early phases of communicable diseases outbreaks. Knowledge is a key indicator for protective behavior; therefore, awareness strategies need to suppress infodemic impact. Severe stress must be monitored during early phases of outbreaks as it significantly increases the probability of risk behavior engagement.

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  1. ScreenIT

    SciScore for 10.1101/2020.05.05.20050419: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: 26 Ethical approval was waived by the Research Ethics Committee (EKV) of Masaryk University because this study did not involve biomedical samples nor did impose greater than minimal risks of information or psychological harms.
    Consent: 27 An electronic informed consent was obtained from each participant prior to filling the questionnaire.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    0 (SPSS Inc. Chicago, IL. 2020) and the Lavaan package in R were used for statistical analysis.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.05.05.20050419 on medRxiv