Assessment of Knowledge, Attitudes and Practices towards COVID-19 among Malaysian Older Adults During the Pandemic
Hazwan Mat Din1*, Raja Nurzatul Efah Raja Adnan1, Siti Aisyah Nor Akahbar1, Halimatus Sakdiah Minhat2
1 Faculty Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Selangor.
2 Department of Community Health, Faculty of Medicine and Health Sciences, 43400 Serdang, Selangor.
*Corresponding Author: [email protected]
Accepted: 15 February 2021 | Published: 1 March 2021
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Abstract: Due to the factor of age and pre-existing medication conditions, older adults pose a higher risk of COVID-19 infection and experience more severe complication compared to others. Adherence preventive measures become one of the best ways in fighting COVID-19, which largely influenced by knowledge, attitudes, and practices (KAP). This study aims to determine level of knowledge, attitudes, and practices towards COVID-19 among Malaysian older adults. An online cross-sectional study was conducted among 501 Malaysian older adults from 18th to 21st June 2020. The KAP instrument consisted of demographics details, knowledge (14 items), attitudes (3 items) and practices (2 items), adapted from previous study.
Results of this study showed respondents had an overall correct rate of 91.3%, indicating a good knowledge level. Respondents showed positive attitudes towards social distancing (98.6%), compliance to health authorities’ precautions (99.0%) and successful control (84.6%) of spreading of COVID-19 in Malaysia. The respondents also taking preventive measures by refraining themselves from visiting crowded place (88.2%) and wore mask when leaving home (97.4%). Findings from this study showed respondents’ high knowledge level of COVID-19 translated into good and safe preventive measures. Even so, results revealed less educated and single older adults were less knowledgeable about COVID-19. This study revealed the Malaysia older adults have good KAP towards COVID-19. The results also suggest that more emphasis should be placed on less educated and single older adults, for COVID-19 prevention and health education.
Keywords: novel coronavirus, older person, awareness, perceptions
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1. Introduction
The Coronavirus Disease 2019 (COVID-19) is an infectious disease that is caused by a novel coronavirus, called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (1).
The first emergence of the respiratory disease was reported in Wuhan, China, at the end of 2019 (Fan et al., 2020). To date, COVID-19 has spread over 200 countries and has been declared a global pandemic by the World Health Organization (WHO). As of 22nd June 2020, there have been 8.7 million of confirmed cases, including at least 460 000 deaths worldwide (World Health Organization, 2020b).
The first case of COVID-19 in Malaysia was detected on 25th January 2020 involving three Chinese tourists (Reuters, 2020). The number of cases steadily increased and the nation recorded the first two deaths on 17th March 2020, involving an older adult aged 60 years old and an adult aged 34 years old (From the Desk of the Director-General of Health Malaysia,
2020b). Malaysian government enforced a movement control order (MCO) on 18th March 2020 as a mitigation effort to reduce community spread and the overburdening of the country's health system. Since then, as of 21st June 2020, Malaysia has recorded at least 8500 of cumulative cases including 295 active cases. As for deaths of COVID-19 infection in Malaysia, 121 deaths were reported with 111 of those were older adults (91.7%) (From the Desk of the Director-General of Health Malaysia, 2020a). These statistics are in line with WHO statement, which stated that older adults, and people of all ages with pre-existing medical conditions appear to develop serious illness more often than others (World Health Organization, 2020a).
Malaysia is experiencing ageing population as evidenced by the increasing proportion of older adults. Currently, approximately 3.4 million or 10% of the population are older adults and by 2030, Malaysia will become an aged nation with 15% older adult population (Department of Statistics Malaysia, 2019). As the number of older adults is large, it increases the risk of infection if the spread of the virus is uncontrollable in the community. Older adults experience a severe spectrum of Covid-19 infections especially those with underlying diseases such as hypertension, diabetes, cardiovascular diseases and lung diseases (Li et al., 2020). They are more prone to develop serious complications from the infection due to the effect of co- morbidities that lead to complicated multi-system diseases (Liu, Chen, Lin, & Han, 2020).
Consequently, older adults are admitted to the intensive care unit (ICU) and the mortality of older patients are higher (Guan et al., 2020).
As Malaysia is in a recovery phase, the battle against COVID-19 is still continuing. Some measures have been adopted by the Ministry of Health (MoH) and National Security Council to reduce the spread of COVID-19 including isolation and care for the infected people and suspected cases, social distancing, compulsory mask wearing in public places, and hygiene practices. Even so, COVID-19 imposed a higher fatality rate on older adult compared to others.
To prevent the spread of COVID-19, especially among older adults and guarantee the final success, adherence to these control measures are essential, which is largely affected by their knowledge, attitudes, and practices (KAP) towards COVID-19 in accordance with KAP theory (Ajilore, Atakiti, & Onyenankeya, 2017; Tachfouti, Slama, Berraho, & Nejjari, 2012). Recent study reported that KAP towards COVID-19 level among Malaysian was good. However, the findings focused on non-older adult population. The older age group reported in the study was 50+ years (Azlan, Hamzah, Sern, Ayub, & Mohamad, 2020). Considering the high risk of fatality rate among older adult in this time of pandemic, attention towards the older adult population is crucial. Therefore, this study aims to determine the level of knowledge, attitudes, and practices towards COVID-19 among older adults in Malaysia.
2. Method Recruitment
This cross-sectional survey was conducted among older adult population. According to United Nations, 60+ years is used to refer to the older population (Kowal & Dowd, 2001). This study was conducted from 18th June to 21st June 2020, one week after Malaysian government announced the start of recovery movement control order (RMCO) to combat COVID-19. Given social distancing and restricted movement, it was not feasible to conduct a community-based sampling or face-to-face interview during this period, the researchers decided to collect the data through an online survey. The data were collected via a self-reported questionnaire, using Google Form. Relying on the researchers’ networks with older adult community and the status of Malaysian Research Institute on Ageing (MyAgeingTM) as a national institute, a link to the survey was distributed via WhatsApp groups and Facebook. The link was also posted on the
MyAgeingTM’s official website and Facebook page. The inclusion criteria were age 60+ years and able to answer the survey through online google form. The ethical approval for this study was obtained from University Ethic Committee for Involving Human Subject (Reference no:
JKEUPM-2020-231)
As the sample size increases, the external validity and generalizability of the study also increase (Cavana, Delahaye, & Sekeran, 2001). This study aimed to maximize reach and gather data from as many respondents as possible. According to Department of Statistics Malaysia, there were estimated 3.35 million of older adults in 2019 (Department of Statistics Malaysia, 2019).
A sample size calculator was used to estimate required sample size, to achieve the study objectives and sufficient statistical power (Raosoft, 2020). The calculator arrived at 385 respondents, with margin of error of ±5%, a confidence interval of 95%, a 50% response distribution, and 3.35 million older adults.
Measures
The questionnaire used in this study consisted of two parts: demographics and KAP.
Demographic variables were age, gender, race, educational status, marital status, working status and current place of residence. Age was categorized into three categories: 60-64, 65-70 and 70+ years. Races were categorized into four major races in Malaysia: Malays, Chinese, Indian and others. The level of educational status was measured by grade of school education:
primary, secondary, and tertiary. Marital status was measure in binary format: single or married. For those who are divorced, widowed or never married, they were considered as single. Working status was categorized intro three categories: Unemployed, paid work and self- employed. Housewife and retiree were considered as unemployed.
The KAP about COVID-19 questionnaire was adapted from Kebede, Yitayih, Birhanu, Mekonen, and Ambelu (2020) and other similar studies (Al-Hanawi et al., 2020; Zhong et al., 2020). The 14 items questionnaire of knowledge covered four categories of knowledge which were (a) symptoms, (b) risk and prognosis, (c) mode of transmission and safety, and (d) prevention in COVID-19. The items response varied from “True”, “False” and “Don’t know”.
The total knowledge scores ranged from 0 to 14, with higher score indicating better knowledge of COVID-19. To express the knowledge level in category, the researchers decided that score under 74.9% as moderate, 75-84.9% as good and above 85% as excellent. The reliability of the questionnaire for the knowledge section was reported to be reliable with reported Cronbach’s alpha of 0.71 (Zhong et al., 2020). Attitudes towards COVID-19 were measured by three items assessing respondent’s agreement of (a) social distancing (b) compliance to MoH precautions to avoid spreading of COVID-19 (c) confidence of Malaysia in winning the fight against COVID-19. For each of these items, respondents were asked to state their level of agreement, from “Agee”, “Disagree” or “Not sure”. The final measurement, practices towards COVID-19, were measured by two items related to practices and behavior, including (a) going to crowded places and (b) not wearing a mask when leaving home. For each of these items, respondents were asked to answer “Yes” or “No”.
Table 1: Questionnaire of knowledge, attitudes and practices toward COVID-19
Questions Options
Knowledge
K1. The main clinical symptoms of COVID-19 are fever,
fatigue, dry cough, and myalgia. True, false, don’t know K2. Unlike the common cold, stuffy nose, runny nose,
and sneezing are less common in persons infected with
the COVID-19 virus. True, false, don’t know
K3. There currently is no effective cure for COVID-19, but early symptomatic and supportive treatment can
help most patients recover from the infection. True, false, don’t know K4. Not all persons with COVID-19 will develop to
severe cases. Only those who are elderly, have chronic illnesses (diabetes, hypertension, heart diseases etc.), and are obese are more likely to be severe cases.
True, false, don’t know K5. Eating or contacting wild animals would result in
the infection by the COVID-19 virus. True, false, don’t know K6. Persons with COVID-19 cannot infect the virus to
others when a fever is not present. True, false, don’t know K7. The COVID-19 virus spreads via respiratory
droplets of infected individuals. True, false, don’t know K8. Ordinary residents can wear general medical masks
to prevent the infection by the COVID-19 virus. True, false, don’t know K9. It is not necessary for children and young adults to
take measures to prevent the infection by the COVID-19
virus. True, false, don’t know
K10. To prevent the infection by COVID-19, individuals should avoid going to crowded places such as train
stations and avoid taking public transportations. True, false, don’t know K11. Isolation and treatment of people who are infected
with the COVID-19 virus are effective ways to reduce
the spread of the virus. True, false, don’t know
K12. People who have contact with someone infected with the COVID-19 virus should be immediately isolated in a proper place. In general, the observation period is 14 days.
True, false, don’t know
Attitudes
A1. Do you agree that COVID-19 will finally be
successfully controlled in Malaysia? Agree, disagree, don’t know
A2. Do you have confidence that Malaysia can win the battle against the COVID-19 virus?
Agree, disagree, don’t know
Practices
P1. In recent days, have you gone to any crowded place? Yes, no P2. In recent days, have you worn a mask when leaving
home? Yes, no
Note: Bold options are the correct answer for knowledge questions
Statistical Analysis
The objective of this study was to determine the KAP towards COVID-19 among study population. Frequency of correct rate for knowledge section and agreement rate for attitudes and practices were described. Normality for knowledge scores was assessed using histogram and box-and-whisker plot. A bell-shaped curve on histogram is interpreted as normal distribution. At univariate level, knowledge scores according to demographic characteristics were compared using independent t-test (Gender, marital status, and place of residence) or one- way ANOVA (Age groups, races, educational level and working status). Next, multivariate analysis using multiple linear regression was conducted to identify factors associated with practices variables, using total practice score as the main outcome. Unstandardized regression coefficient (β), standard error (SE) and R squared (R2) were reported for the significant factors.
All analysis was conducted with IBM SPSS statistics for windows version 22.0 (Armonk, NY, USA) and statistical significance level was set at P <0.05 (two-tailed).
3. Results
A total of 501 respondents joined the survey and completed the questionnaire. The average age of the respondent was 64.55 years old (Standard deviation [SD]: 4.77, range:
60 – 86). Among the respondents, 333 (66.5%) were women, 325 (64.9%) were Malay, 375 (74.9%) had tertiary education, 392 (78.2%) were currently married, 377 (75.2) were not working and 445 (88.8%) were living in urban area. The demographic variables were summarized in Table 2.
The correct response rate of the 14 items on knowledge of the COVID-19 ranged from 55.3-99.2%. The overall mean of COVID-19 knowledge was 12.84 (SD: 1.38, range: 0-14), corresponding to 91.7% correct rate on this knowledge assessment. The knowledge level category for moderate, good and excellent were 3.1%, 4.1% and 92.8%, respectively. For each category of the knowledge assessment, correct rate for symptoms was 85.5% (Mean:
1.71, SD: 0.46, range: 0-2), 96% for risk and prognosis (Mean: 1.93, SD: 0.28, range: 0-2), 78.3% for mode of transmission (Mean: 2.35, SD: 0.71, range: 0-3) and 98.1% for prevention (Mean: 6.85, SD: 0.61, range: 0-7) (Table 3). Mean comparison showed educational level (Mean difference [MD]: Secondary vs. primary = 0.59[P =0.398], tertiary vs primary = 1.26 [P = 0.003], tertiary vs secondary = 0.66 [P <0.001]) and marital status (MD: Married vs single = 0.31 [P =0.040]) were significantly associated with knowledge level (Table 2).
Table 2: Demographics characteristics and respondent knowledge score
Characteristic Frequency
(%)
Knowledge score (Mean ± SD)
t/F P-value
Age 60-64 328 (65.5) 12.93±0.99 1.75a 0.176
65-69 100 (20.1) 12.68±1.96 70+ 73 (14.5) 1269±1.85
Gender Male 168 (33.5) 12.90±1.09 0.60b 0.546 Female 333 (66.5) 12.92±1.51
Race Malay 325 (64.9) 12.81±1.43 0.49a 0.690
Chinese 123 (24.6) 13.00±1.04 Indian 29 (5.8) 12.83±2.11 Others 24 (4.7) 12.75±1.15
Education
level ≤Primary 13 (2.6) 11.77±3.56 14.94a <0.001**
Secondary 113 (22.6) 12.36±1.67 Tertiary 375 (74.9) 13.03±1.38
Marital status Single 109 (21.8) 12.61±1.85 2.06b 0.040**
Married 392 (78.2) 12.91±1.22* Working
status
Unemployed 377 (75.2) 12.83±1.41 0.75a 0.471 Paid work 41 (8.2) 12.71±1.87
Self-
employed 83 (16.6) 13.00±0.86 Place of
residence Rural 56 (11.2) 12.55±12.37 1.02b 0.309 Urban 445 (88.8) 12.88±1.20
Abbreviation: SD = Standard deviation, t/F = t/F value
aIndependent t-test
bOne-way ANOVA
Table 3: Respondents’ knowledge of COVID-19.
Variable
Frequency (%) Correct
response Incorrect response Knowledge of symptoms
The main clinical symptoms of COVID-19 are fever,
fatigue, dry cough, and myalgia. 469 (93.6) 32 (6.4) Unlike the common cold, stuffy nose, runny nose, and
sneezing are less common in persons infected with the
COVID-19 virus 391 (78.0) 110 (22.0)
Correct rate for the category 85.5%
Knowledge of high risk and prognosis
There currently is no effective cure for COVID-19, but early symptomatic and supportive treatment can help
most patients recover from the infection 494 (98.6) 7 (1.4) Not all persons with COVID-19 will develop to severe
cases. Only those who are elderly, have chronic illnesses (diabetes, hypertension, heart diseases etc.), and are obese are more likely to be severe cases
471 (94.0) 30 (6.0) Correct rate for the category 96.0%
Knowledge about mode of transmission and infectiousness
Eating or contacting wild animals would result in the
infection by the COVID-19 virus 277 (55.3) 224 (44.7) Persons with COVID-19 cannot infect the virus to others
when a fever is not present. 414 (82.6) 87 (17.4)
The COVID-19 virus spreads via respiratory droplets of
infected individuals 485 (96.8) 16 (3.2)
Correct rate for the category 78.3%
Knowledge about ways of prevention
One way of prevention of COVID 19 is not touching the
eye, nose by unwashed hands 487 (97.2) 14 (2.8)
Ordinary residents can wear general medical masks to
prevent the infection by the COVID-19 virus 483 (96.4) 18 (3.6) Proper washing hand with soap and water is one
method of preventing COVID-19 494 (98.6) 7 (1.4) It is not necessary for children and young adults to take
measures to prevent the infection by the COVID-19
virus. 487 (97.2) 14 (2.8)
To prevent the infection by COVID-19, individuals should avoid going to crowded places such as train
stations and avoid taking public transportations. 491 (98.0) 10 (2.0) Isolation and treatment of people who are infected with
the COVID-19 virus are effective ways to reduce the
spread of the virus 497 (99.2) 4 (0.8)
People who have contact with someone infected with the COVID-19 virus should be immediately isolated in a proper place. In general, the observation period is 14 days
496 (99.0) 5 (1.0) Correct rate for the category 98.1%
Overall correct rate 91.7%
On the assessment of attitudes towards COVID-19, large majority of the respondents agreed the importance of social or physical distancing (98.6%) and compliance with MoH precautions (99.0%) to stop spreading of COVID-19. When asked whether they agree that COVID-19 will finally be successfully controlled in Malaysia, 424 (84.6%) respondents agreed to the question while others were disagree (3.0%) or unsure (12.4%) (Table 4).
Table 4: Respondent attitudes and practices towards of COVID-19
Variable Frequency (%)
Agree Disagree Don’t know Attitudes
It is important to keep my distance from
others, to avoid spreading COVID-19 494 (98.6) 5 (1.0) 2 (0.4) Compliance with the Ministry of Health
precautions will prevent the spread of
COVID-19 496 (99.0) 3 (0.6) 2 (0.4)
Do you agree that COVID-19 will finally be
successfully controlled in Malaysia? 424 (84.6) 15 (3.0) 62 (12.4)
Practices Yes No
In recent days, have you gone to any
crowded place? 59 (11.8) 442 (88.2)
In recent days, have you worn a mask
when leaving home? 13 (2.6) 488 (97.4)
Practices towards COVID-19 were measured by two items: a) going to crowded places and b) not wearing mask when leaving home. The practices score is summarized in Table
4. The vast majority of respondents had not visited any crowded places (88.2%) and wore mask when leaving home (97.4%). There were still a portion of respondents who had visited crowded places (11.8%) and a smaller portion who had not worn mask when leaving home (2.6%). On assessment of associated factors of practices towards COVID-19 preventive measure, total knowledge score and working status were found to be significant (Table 5).
Table 5: Results of multiple linear regression on factors significantly associated with practices toward preventive measures of COVID-19
Variable Multiple Linear Regression
β (SE) 95% CI P-value
Total knowledge score 0.03 (0.01) 0.01, 0.05 0.037 Working status
Unemployed Reference
Paid work -0.02 (0.01) -0.14, 0.10 0.763
Self-employed -0.10 (0.05) -0.19, -0.01 0.024 4. Discussion
COVID-19 is rapidly emerging and a highly infectious disease that poses a major threat to a country’s public health. COVID-19 fatality rate seems to hit older adult population harder than any other age group. In addition to that, Malaysia are in a process of rapid population ageing facilitated from demographic changes. There is serious threat imposed by COVID-19 on older adult population. Due to absence of vaccine and aggressive spreading of the virus, preventive measures become one of the best ways in reducing infection rate and controlling the spread of the disease. This highlights the needs of public adherence to preventive and control measure which essentially influenced by knowledge, attitudes, and practices. Furthermore, as older adult being a high risk population, they deserve an unambiguous attention in this critical moment. It is therefore utmost importance that the knowledge, attitudes, and practices towards COVID-19 of older adult population be studied to facilitate the measures adherence.
Findings from the current study revealed respondents were very knowledgeable on COVID- 19. The overall correct rate of the questionnaire was 91.3%. These findings was fairly surprising because previous study had reported only satisfactory level among Malaysian older adults, for pandemics, such as Influenza A (H1N1) (Wong & Sam, 2011). Method of information acquiring among respondents may also influences the contradict findings. In the last ten years, older adults had been regarded as “Laggard” in using smartphone (21) but recent study had shown older adults nowadays were active smartphone users (Berenguer et al., 2016), including using internet for information acquisition. Aside from that, respondents might also have been benefited from health authority’s rigorous efforts in disseminating information of COVID-19 to the public via television, news and social media. The significant association between level of education and knowledge of COVID-19 showed that the less educated respondents seem to be less knowledgeable about COVID-19. This finding is supported by other studies that have found educational level as a predictor of knowledge of COVID-19 (Al- Hanawi et al., 2020; Zhong et al., 2020) and other emerging communicable disease (Al-Mohrej et al., 2016; Bawazir, Al-Mazroo, Jradi, Ahmed, & Badri, 2018).
On the assessment of knowledge of symptoms, a vast majority of respondents (93.6%) aware that COVID-19 is characterized by fever, fatigue, and myalgia. However, a considerably lower portion of respondents (78.0%) able to differentiate between COVID-19 and common cold.
Assessment of knowledge of risk condition and mode of transmission revealed majority of respondents were very knowledgeable except on the possibility of wild animal of transmitting the virus, which only 55.3% answered correctly. Centre for Disease Control and Prevention (CDC) states there is currently no evidence that domestic or captive wild animals can spread the novel coronavirus to people. One of reason that may back this finding is that spreading of false information on consuming wild animals such as bats, snakes and other reptilians result in the COVID-19 infection. The false news was circulated through online platform such as WhatsApp, Facebook, and Twitter at the start of the outbreak in Malaysia. Malaysia reported an increased rate of circulation of false news and information regarding COVID-19 during the MCO period (BERNAMA, 2020; Parzi, 2020). On assessment of last knowledge category, a vast majority (96.4-99.2%) of respondents were knowledgeable of preventive measures of COVID-19.
Concerning attitudes, respondents showed positive attitudes towards health authorities’
initiatives to minimize the spread of COVID-19 in Malaysia. Those initiatives include social distancing of one meter distance when interacting with others and adopting MoH precautions (such as standard operating procedure) to prevent the spread of COVID-19. Majority (98.0%) of respondents agreed it was important to keep their distance and 99.0% of them agreed to comply with MoH precautions. It is noteworthy to highlight that a portion of respondents (84.6%) concurred that Malaysia will eventually be able to control COVID-19. These findings might be supported by actions taken by MoH to stop the spread and mortality of COVID-19 infections such as increase the number of hospital that can treat COVID-19 cases, enforcement of health screening at all points of entry and alliance involving 38 professional medical societies was established on March 1, 2020 to support the MoH in the area of healthcare (Shah et al., 2020). Even so, agreement of COVID-19 final success widely mixed indicating that while some respondents had high agreement in Malaysia ability to fight the disease, others did not. Malaysia experienced a drastic rise of COVID-19 cases nationwide at early March 2020 as result of recent mass public gathering involving religious activity. The rise saw a surge increase of fatality rate among older adults, due to age and pre-existing medical conditions (World Health Organization, 2020a). The incident was likely left a negative perception on the respondents about the nation ability to control the spread of COVID-19 among older adults.
Multivariate analysis showed that knowledge and working status were significant factors of practices. Knowledge level had been reported in other studies, as predictor of practices (Al- Hanawi et al., 2020; Zhong et al., 2020). However, this is rather surprising result for working status being significant factor for practices, which self-employed respondents seem to practice less preventive measure of COVID-19. The possible explanation is that due to nature of self- employed work activity, which involve outdoor environment and going to crowded places.
Nonetheless, finding from this study showed respondents’ high knowledge level of COVID-19 translated into good and safe preventive measures, during the RMCO. These also indicated how cautious were the respondents in battling to fight COVID-19. Majority (97.4%) wore mask when leaving home while 88.2% of the respondents refrained themselves from visiting crowded places. Respondents had adopted good and safe behaviours in controlling the spread of COVID-19. This may be the result of Malaysian authorities in implementing various phase of MCO (enhanced, conditional and recovery phase MCO) to control the pandemic. These findings also may be due to health authorities’ continuous efforts providing education and outreach materials via various platform to increase public understanding of COVID-19 and promote new cultural norms through behaviour changes.
5. Strength and Limitations
To the researchers’ knowledge, to date, this is the first study to measure KAP towards COVID-19 among older adult population, especially in Malaysia. Consequently, the findings may help health and related authorities in planning preventive strategies which specially tailored for the benefits of older adults population. However, interpreting the findings comes with some limitations. First, data of this study were collected through online platform which disregard sampling frame and method, unlike a community-based survey. However, considering the period of the study is conducted and its urgency, it is not possible to conduct a community-based survey due to restriction of movement and physical distancing (Ajilore et al., 2017). Second, there is possibility of bias as underprivileged populations may not have been able to participate in the study (Ajilore et al., 2017). When compared to current older adult population in Malaysia, the data were over-representative of women and Malay ethnic (Table 6). Lastly, the KAP instrument used in this study was mainly adapted from previous study in China (Zhong et al., 2020) and other countries (Al-Hanawi et al., 2020; Kebede et al., 2020). Even so, a comprehensive instrument assessment through validity and reliability aspect may have improved the findings. Due to limited time and urgency, only few items were included in the attitudes and practices sections (Ajilore et al., 2017; Zhong et al., 2020) which limiting potential factors that could have been measured in understanding KAP among older adult in Malaysia.
Table 6: Age group and gender comparison between Malaysian population and current study percentage
Characteristic Malaysian populationa (%) Current study (%)
Age 60-64 35.6 65.5
65-69 25.4 20.0
70+ 39.0 14.5
Gender Male 48.7 33.5
Female 51.3 66.5
Race Malay 47.0 64.9
Chinese 34.7 24.6
Indian 7.7 5.8
Others 10.6 4.7
aSource: Department of Statistics Malaysia, 2020 (Department of Statistics Malaysia, 2019)
6. Conclusions
In summary, this study was able to provide a comprehensive investigation of the knowledge, attitudes, and practices towards COVID-19 among Malaysian older adults. The results of this study suggest that Malaysian older adults have good knowledge and positive attitudes and good practices towards COVID-19. Being at early stage, being knowledgeable about causes and transmission of the disease will increase likelihood that older adults will become more aware of the spread of COVID-19, and of the preventive measures to slow transmission. The results of this study suggest that more focus should be placed on the less educated and single older adults. These findings may help policymakers to identify target population for, continuous education and prevention of COVID-19.
Acknowledgment
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of Interest None.
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