Use of Rapid Online Surveys to Assess People's Perceptions During Infectious Disease Outbreaks: A Cross-sectional Survey on COVID-19

  1. Pascal Geldsetzer

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Given the extensive time needed to conduct a nationally representative household survey and the commonly low response rate of phone surveys, rapid online surveys may be a promising method to assess and track knowledge and perceptions among the general public during fast-moving infectious disease outbreaks.

Objective

This study aimed to apply rapid online surveying to determine knowledge and perceptions of coronavirus disease 2019 (COVID-19) among the general public in the United States and the United Kingdom.

Methods

An online questionnaire was administered to 3000 adults residing in the United States and 3000 adults residing in the United Kingdom who had registered with Prolific Academic to participate in online research. Prolific Academic established strata by age (18-27, 28-37, 38-47, 48-57, or ≥58 years), sex (male or female), and ethnicity (white, black or African American, Asian or Asian Indian, mixed, or “other”), as well as all permutations of these strata. The number of participants who could enroll in each of these strata was calculated to reflect the distribution in the US and UK general population. Enrollment into the survey within each stratum was on a first-come, first-served basis. Participants completed the questionnaire between February 23 and March 2, 2020.

Results

A total of 2986 and 2988 adults residing in the United States and the United Kingdom, respectively, completed the questionnaire. Of those, 64.4% (1924/2986) of US participants and 51.5% (1540/2988) of UK participants had a tertiary education degree, 67.5% (2015/2986) of US participants had a total household income between US $20,000 and US $99,999, and 74.4% (2223/2988) of UK participants had a total household income between £15,000 and £74,999. US and UK participants’ median estimate for the probability of a fatal disease course among those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 5.0% (IQR 2.0%-15.0%) and 3.0% (IQR 2.0%-10.0%), respectively. Participants generally had good knowledge of the main mode of disease transmission and common symptoms of COVID-19. However, a substantial proportion of participants had misconceptions about how to prevent an infection and the recommended care-seeking behavior. For instance, 37.8% (95% CI 36.1%-39.6%) of US participants and 29.7% (95% CI 28.1%-31.4%) of UK participants thought that wearing a common surgical mask was “highly effective” in protecting them from acquiring COVID-19, and 25.6% (95% CI 24.1%-27.2%) of US participants and 29.6% (95% CI 28.0%-31.3%) of UK participants thought it was prudent to refrain from eating at Chinese restaurants. Around half (53.8%, 95% CI 52.1%-55.6%) of US participants and 39.1% (95% CI 37.4%-40.9%) of UK participants thought that children were at an especially high risk of death when infected with SARS-CoV-2.

Conclusions

The distribution of participants by total household income and education followed approximately that of the US and UK general population. The findings from this online survey could guide information campaigns by public health authorities, clinicians, and the media. More broadly, rapid online surveys could be an important tool in tracking the public’s knowledge and misperceptions during rapidly moving infectious disease outbreaks.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.03.13.20035568: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: Following an informed consent form, the questionnaire asked participants about i) the cause, current state, and future development of the Covid-19 epidemic; ii) the risk of a fatal disease course; iii) knowledge of symptoms and recommended healthcare-seeking behavior; iv) measures to prevent a Covid-19 infection; and v) their perception of the risk posed by individuals of East-Asian ethnicity in their community.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableFor this study, Prolific established strata by age group (18 - 27, 28 - 37, 38 - 47, 48 - 57, or ≥58 years), sex (male or female), and ethnicity (White, Black or African American, Asian or Asian Indian, Mixed, or “Other”), as well as all combinations of these strata.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    For approximately how many of the questions did you first look up the answer on Google or somewhere else before responding?
    Google
    suggested: (Google, RRID:SCR_017097)

    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:
    This study has several limitations. First, while the sample of participants is representative of the US and UK general population by age, sex, and ethnicity, and the distribution of participants by household income and education was similar to that in the US and UK general population, participants may still differ from the general population on a variety of other characteristics. These characteristics may be both correlated with their knowledge and perceptions of Covid-19 as well as with their decision to participate in the study and/or to create a profile with Prolific. Second, the estimates of discrimination against individuals of East-Asian ethnicity may be an underestimate because some participants may not have wanted to volunteer their discriminating tendencies to themselves or to the researcher. However, I as the researcher had no access to any identifying information about the research participants and participants were reminded of this fact prior to answering the question. In addition, such social desirability bias has been found to be lower in online surveys than in telephone or in-person surveys.[26, 27] Third, it was possible for participants to randomly click responses in order to devote the least amount of time to earn the $1.50 reward. In my view, this issue is unlikely to have caused major bias in this study because i) there was no evidence of a bimodal distribution in the time taken to complete the survey (see Figure S1), ii) while it was physically possible t...

    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 10.2196/18790
  3. Version published to 10.1101/2020.03.13.20035568v2 on medRxiv
  4. Version published to 10.2196/preprints.18790
  5. Version published to 10.1101/2020.03.13.20035568v1 on medRxiv