Awareness, knowledge and trust in the Greek authorities towards COVID-19 pandemic: results from the Epirus Health Study cohort

  1. Afroditi Kanellopoulou
  2. Fotios Koskeridis
  3. Georgios Markozannes
  4. Emmanouil Bouras
  5. Chrysa Soutziou
  6. Konstantinos Chaliasos
  7. Michail T. Doumas
  8. Dimitrios E. Sigounas
  9. Vasilios T. Tzovaras
  10. Agapios Panos
  11. Yiolanda Stergiou
  12. Kassiani Mellou
  13. Dimitrios Papamichail
  14. Eleni Aretouli
  15. Dimitrios Chatzidimitriou
  16. Fani Chatzopoulou
  17. Eleni Bairaktari
  18. Ioanna Tzoulaki
  19. Evangelos Evangelou
  20. Evangelos C. Rizos
  21. Evangelia Ntzani
  22. Konstantinos Vakalis
  23. Konstantinos K. Tsilidis

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Abstract

Background

To assess the level of knowledge and trust in the policy decisions taken regarding the coronavirus disease (COVID-19) pandemic among Epirus Health Study (EHS) participants.

Methods

The EHS is an ongoing and deeply-phenotyped prospective cohort study that has recruited 667 participants in northwest Greece until August 31st, 2020. Level of knowledge on coronavirus (SARS-CoV-2) transmission and COVID-19 severity was labeled as poor, moderate or good. Variables assessing knowledge and beliefs towards the pandemic were summarized overall and by sex, age group (25–39, 40–49, 50–59, ≥60 years) and period of report (before the lifting of lockdown measures in Greece: March 30th to May 3rd, and two post-lockdown time periods: May 4th to June 31st, July 1st to August 31st). A hypothesis generating exposure-wide association analysis was conducted to evaluate the associations between 153 agnostically-selected explanatory variables and participants’ knowledge. Correction for multiple comparisons was applied using a false discovery rate (FDR) threshold of 5%.

Results

A total of 563 participants (49 years mean age; 60% women) had available information on the standard EHS questionnaire, the clinical and biochemical measurements, and the COVID-19-related questionnaire. Percentages of poor, moderate and good knowledge status regarding COVID-19 were 4.5, 10.0 and 85.6%, respectively. The majority of participants showed absolute or moderate trust in the Greek health authorities for the management of the epidemic (90.1%), as well as in the Greek Government (84.7%) and the official national sources of information (87.4%). Trust in the authorities was weaker in younger participants and those who joined the study after the lifting of lockdown measures ( p -value≤0.001). None of the factors examined was associated with participants’ level of knowledge after correction for multiple testing.

Conclusions

High level of knowledge about the COVID-19 pandemic and trust in the Greek authorities was observed, possibly due to the plethora of good quality publicly available information and the timely management of the pandemic at its early stages in Greece. Information campaigns for the COVID-19 pandemic should be encouraged even after the lifting of lockdown measures to increase public awareness.

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  1. Version published to 10.1186/s12889-021-11193-x
  2. Version published to 10.1101/2020.11.10.20229146v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2020.11.10.20229146: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the Research Ethics Committee of the University of Ioannina and is conducted in accordance with the Declaration of Helsinki.
    Consent: All participants provide written informed consent prior to participation in the study.
    Randomizationnot detected.
    Blindingnot detected.
    Power AnalysisDichotomous variables with prevalence of less than 10% and variables pertaining to a specific subgroup of participants (e.g. reproductive variables in women) were also excluded for statistical power reasons.
    Sex as a biological variableDichotomous variables with prevalence of less than 10% and variables pertaining to a specific subgroup of participants (e.g. reproductive variables in women) were also excluded for statistical power reasons.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were performed using STATA (version 14; StataCorp, College Station, TX, USA)
    STATA
    suggested: (Stata, RRID:SCR_012763)
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    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: We detected the following sentences addressing limitations in the study:
    Several limitations should also be considered in interpreting our findings. The sample size was relatively small, but several of our findings have been previously observed in larger studies. The study sample constituted only by residents of the region of Epirus and had a higher participation of women and individuals with university education; thus, findings might not be generalizable to the general public. As a validated questionnaire to assess knowledge on the COVID-19 pandemic is not yet available, we constructed an aggregated variable to assess knowledge of SARS-CoV-2 transmission and COVID-19 severity that showed relatively poor variation, as most individuals reported good levels of knowledge.

    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

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  4. Version published to 10.1101/2020.11.10.20229146v1 on medRxiv