Development and validation of Health Belief Model based instrument to assess secondary school student's adherence to COVID-19 self-protective practices in Jimma, Oromia, Ethiopia.

BACKGROUND: The study aimed in developing and validating a Health Belief Model (HBM) based instrument used for cross-sectional studies among secondary school students in Jimma town, Oromia, Ethiopia. METHODS: A school-based cross-sectional study was conducted from May 25 to June 10, 2021. The sample size was 634, and students were randomly selected from public and private secondary schools. The 81 items were developed reviewing different literatures based on the constructs of HBM. The constructs were perceived severity, perceived vulnerability, perceived benefit, perceived barrier, self-efficacy, cues to action, perceived school support and self-protective practice. Data were collected using a self-administered questionnaire. The data were cleaned, entered into and analyzed using SPSS 23.0. A principal axis factoring with varimax rotation was carried out to extract items. Items with no loading factor or cross-loaded items were deleted. Items having factor loading coefficient of ≥0.4 were retained. An internal reliability was ensured at Cronbach's alpha >0.70. All items with corrected item-total correlation coefficient below 0.30 were deleted from reliability analysis. RESULTS: In this study, 576 respondents were participated making a response rate of 90.8%. A total of thirty items were extracted and loaded in to eleven factors with cumulative variance of 56.719%. Percieved social support, percieved benefit, percieved school responsibility, self-efficacy, and practice items were internally consistent. Percieved vurnerability was neither valid nor reliable construct. Similarly, from the extracted factors, attitude towards face mask use and percieved peer influence were not internally consistent. Lastly, percieved benefit, self-efficacy and percieved school responsibility significantly predicted student's adherence to COVID-19 self-protective practices. CONCLUSIONS: The study found that perceived benefit, perceived school support, social support, self-efficacy, perceived school environment cleanness, perceived school responsibility, perceived school health education, attitude to use face mask, perceived severity, cues to action and perceived peer influence were valid. Finally, perceived benefit, self-efficacy and perceived school responsibility significantly predicted student's adherence to COVID-19 self-protective practices.

COVID-19 self-protective practices and associated factors among secondary school students in Jimma town, Jimma, Oromia, Southwest Ethiopia.

Background: Since there is limited evidence regarding COVID-19 self-protective practices among school students, this study assessed COVID-19 self-protective practices and associated factors among secondary school students. Methods: A school-based cross-sectional study was conducted in Jimma town, Oromia regional state, Southwest Ethiopia from 25 May 2021 to 10 June 2021. The total sample size was 634, and students were randomly selected from public and private secondary schools. A self-administered questionnaire was used for data collection. The data were entered into Epidata 3.1 and analyzed using SPSS 21.0 software. Descriptive statistics, such as proportion and mean, were computed to describe the findings. The composite index was computed for each dimension. A linear regression analysis was used to identify the predictors of self-protective practice. A local polynomial smoothing graph was done using Stata 12 software to visualize the relationship between a significant variable and an outcome variable. Results: A total of 576 respondents participated in this study, which made a response rate of 90.85%. The mean score for overall knowledge was 31.40 (SD ±8.65). Knowledge about COVID-19 symptoms and preventive practices had a mean score of 23.93 and 45.96, respectively. The mean scores for perceived vulnerability, severity, benefits, barriers, self-efficacy, and school support were 26.37, 33.21, 43.13, 16.15, 33.38, and 25.45, respectively. The mean score for self-protective practice was 28.38 (SD ±11.04). As perceived benefit (AOR = 0.199, p = 0.000, 95% CI: 0.094-0.304), perceived school support (AOR = 0.125, p = 0.009, 95% CI: 0.032-0.218), and self-efficacy (AOR = 0.186, p = 0.000, 95% CI: 0.102-0.270) increased, COVID-19 self-protective practices also increased and vice versa. However, age (AOR = -0.873, p = 0.006, 95% CI = -1.495, -0.251), perceived vulnerability (AOR = -0.107, p = 0.021; 95% CI = -0.199, -0.016), and maternal educational status (no formal education) (AOR = -5.395, p = 0.000, 95% CI = -7.712 to 3.077) had negatively associated with self-protective practices. Conclusion: COVID-19 self-protective practice is unsatisfactory. Perceived benefit, perceived school support, and self-efficacy are positively associated with it. However, students' age, perceived vulnerability, and maternal educational status (no formal education) were negatively associated with COVID-19 self-protective measures among secondary school students. The findings underscore that there is a need to conduct risk communications among students. Similarly, awareness creation intervention should target mothers with no formal education.