Abstract
Background: The evolving outbreak of coronavirus disease 2019 (COVID-19) is requiring social distancing and other measures to protect public health. However, messaging has been inconsistent and unclear. Objective: To determine COVID-19 awareness, knowledge, attitudes, and related behaviors among U.S. adults who are more vulnerable to complications of infection because of age and comorbid conditions. Design: Cross-sectional survey linked to 3 active clinical trials and 1 cohort study. Setting: 5 academic internal medicine practices and 2 federally qualified health centers. Patients: 630 adults aged 23 to 88 years living with 1 or more chronic conditions. Measurements: Self-reported knowledge, attitudes, and behaviors related to COVID-19. Results: A fourth (24.6%) of participants were "very worried"about getting the coronavirus. Nearly a third could not correctly identify symptoms (28.3%) or ways to prevent infection (30.2%). One in 4 adults (24.6%) believed that they were "not at all likely"to get the virus, and 21.9% reported that COVID-19 had little or no effect on their daily routine. One in 10 respondents was very confident that the federal government could prevent a nationwide outbreak. In multivariable analyses, participants who were black, were living below the poverty level, and had low health literacy were more likely to be less worried about COVID-19, to not believe that they would become infected, and to feel less prepared for an outbreak. Those with low health literacy had greater confidence in the federal government response. Limitation: Cross-sectional study of adults with underlying health conditions in 1 city during the initial week of the COVID-19 U.S. outbreak. Conclusion: Many adults with comorbid conditions lacked critical knowledge about COVID-19 and, despite concern, were not changing routines or plans. Noted disparities suggest that greater public health efforts may be needed to mobilize the most vulnerable communities.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 100-109 |
| Number of pages | 10 |
| Journal | Annals of internal medicine |
| Volume | 173 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jul 21 2020 |
Funding
Disclosures: Dr. Wolf reports grants from the NIH during the conduct of the study; grants from Merck, the Gordon and Betty Moore Foundation, the NIH, and Eli Lilly outside the submitted work; and personal fees from Sanofi, Pfizer, and Luto outside the submitted work. Dr. Serper reports personal fees from BioVie outside the submitted work. Ms. Batio reports grants from the NIH during the conduct of the study. Dr. Ladner reports grants from the National Institute of Diabetes and Digestive and Kidney Diseases during the conduct of the study. Dr. Persell reports grants from Omron Healthcare and Pfizer outside the submitted work. Dr. Bailey reports grants from the NIH during the conduct of the study; grants from Merck, the NIH, and Eli Lilly outside the submitted work; grants and personal fees from the Gordon and Betty Moore Foundation outside the submitted work; and personal fees from Sanofi, Pfizer, and Luto outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors /icmje/ConflictOfInterestForms.do?msNum=M20-1239. The study was supported by National Institutes of Health projects. The funding sources had no role in the design, conduct, or analysis of the study or the decision to submit the manuscript for publication. Grant Support: By grants R01AG030611, R01AG046352, R01DK110172, and R01NR015444 from the National Institutes of Health (NIH).
ASJC Scopus subject areas
- Internal Medicine
