The COVID-19 illness is extremely contagious and spreads from person to person, posing a major health risk to entire populations. The severity of the symptoms can vary depending on the immunological system of the person. The symptoms include a fever, cough, breathing problems and a loss of smell. Severe instances can result in pneumonia, multiple organ failure and death [1-3].

When an infected individual coughs or sneezes, respiratory droplets with a diameter of 5 to 10 m are released into the air and quickly spread through the mouth or nose. It is crucial that the general population is well informed about the symptoms, risk factors and preventive measures that should be taken to avoid contracting the disease, such as social isolation, proper hand cleanliness and the use of face masks [4-7].

Numerous studies have been conducted on COVID-19 in various regions of India, but they are largely absent from the hilly state of Himachal Pradesh, which has a diverse array of traditions and cultural patterns. Therefore, using an online survey, this study was conducted to evaluate the general public's knowledge, attitudes and practices regarding the COVID-19 in Himachal Pradesh.

Objectives of the Study

To evaluate the Knowledge, Attitude and Practices Regarding COVID-19 among General Population of Himachal Pradesh.

Research Methodology:

• Research Approach-Descriptive

• Research Design-Cross-sectional survey design

• Study area: Hilly state of Himachal Pradesh

• Study duration- between Jan 2023 and March 2023

• Study population-All adults above 18 years of age who were staying in the Himachal Pradesh for 12 months or more

• Sample size-400 Adults assuming 50% have adequate knowledge regarding COVID-19, 5% absolute error, 95% confidence level and 5% non- response rate

• Sampling Technique-convenience and snowball Sampling technique

• Study tool: A google form questionnaire consisting of questions regarding socio-demography, Knowledge, Attitude and Practices Regarding COVID-19 was created. The questionnaire was initially pre-tested on a small number of people to identify any difficulty in understanding by the respondents

Description of Tool 

Demographic data survey instrument: The demographic form elicited information on participants’ background: age, gender, marital status, religion, employment, education and many more.

Questionnaire: The questionnaire contains 30 structured closed ended questions regarding Knowledge, Attitude and Practices Regarding COVID-19. The participants have to choose right option. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 30 and minimum score was zero. Scoring was done on the basis of marks as:

>80%(24-30)=very good,

60-79%(18-23) =Good,

41-59% (12-17)=Fair,

<40% (<12)=poor

• Validity of tool - by the experts in this field

• Inclusive Criteria- who were willing to participate in the study.

• Exclusion Criteria-who were not willing to participate in the study

Data Collection

Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like WhatsApp groups, Facebook, Instagram and LinkedIn in both rural and urban area of Himachal Pradesh till the 400 responses were collected. Responses were then recorded in a Google Excel spreadsheet.

Data Analysis

Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage. 

The present study was cross sectional descriptive study carried out to evaluate the Knowledge, Attitude and Practices Regarding COVID-19 among the general population of Himachal Pradesh. In the present study, among the total of 400 participants, 42% (168) fall were below 40 years of age while 58% (232) were above 40 years. 59% (236) of participants were male and 41% (164) were female (Table 1). Among the total, 124 (31.0%) study participants had very good (24-30 marks) awareness regarding COVID-19, 211 (52.75%) had good (18-23 marks), 46 (11.5%) had fair (12-17 marks) and 19(4.75%) had poor (<12 marks) awareness regarding COVID-19 (Table 2).

Table 1: Knowledge, Attitude and Practices Regarding COVID-19

Table 2: Awareness regarding COVID-19among study participants

Young adults, men and educated people made up the majority of the respondents in this Himachal Pradesh statewide online cross-sectional poll.

The respondents in the current study were sufficiently knowledgeable about COVID-19 prevention and control, but they still needed to learn more about clinical manifestations and COVID-19 transmission routes. The responders were upbeat about COVID-19's ability to be controlled. Even though wearing a mask is required, many respondents admitted that they didn't wear one when leaving the house and many others didn't take the recommended COVID-19 precautions. However, in general, the people of Himachal Pradesh had either adequate knowledge or practices regarding the COVID-19.

Similar to this, most of the participants (70%) in the study conducted by Beenish Fatima Alam et al. [4] claimed to have thorough understanding of the unique COVID-19 disease. The average knowledge score was 9.482.88 out of 16, which is a good level of understanding of the condition. Figure 1 displays the percentages of knowledge questions that had the correct response: 83% were aware of the quarantine period; 82% wore face masks whenever they left their homes; 98% knew where the disease originated; 70% correctly identified fever and breathing difficulties as the disease's most prevalent symptoms; 69% correctly identified contact with infected surfaces or each other as a possible method of transmission; and 21% correctly identified aerosol from running noses as a possible method of transmission. During the pandemic, the responders to a different survey by Dkhar et al. [5] shown good understanding, a positive attitude and prudent practises regarding COVID-19.

Our research revealed that, in contrast to the early stages of the COVID-19 pandemic, sound knowledge hasn't significantly changed people's attitudes or behaviors. Therefore, the goal of health education should be to encourage the public to adopt better attitudes and behaviors. For instance, the general public ought to be inspired to adopt the proper perspective towards actions that can avoid COVID-19 [8,9]. Additionally, the 3Cs and 3Ws should be explained in greater detail to them, improving their understanding of the practices [10]. Greater focus should be given to vulnerable groups, including young adults, men and single people, as well as those with lower levels of education, lower incomes and those living in rural areas. In short, this study offers timely information that the government and public health organizations can use to create more effective COVID-19 policies and treatments.

Limitations

The scope and extent of the conducted research may be minimized because the study's sample size and time frame are limited to 400 respondents and three months. It is a quick sample obtained via social media, which has its own restrictions. Social media statistics are dynamic and subject to change depending on their popularity as well as the level of education and informational access of a particular user group. Because of this, the majority of the participants were grads or higher. Since this survey was only carried out in one state of India, its results cannot be applied to the entire country. Future research ought to concentrate on a broader, more representative sample of the entire country.

The general population had good knowledge, attitudes and practices about COVID-19, according to the results of our poll. Our study clearly shows that improved knowledge fosters a good mindset, which in turn influences better practice. Our study also shown how timely adaptation and awareness-raising through education can assist health authorities in developing plans based on areas that need improvement. It should be encouraged to learn more and to be more conscious.

Ethical Approval

Ethical Considerations-Participants confidentiality and anonymity was maintained.

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