Older adults in SG display high levels of knowledge, attitude of COVID-19

Most older adults living in Singapore have good knowledge of the common symptoms of COVID-19 and awareness of government-endorsed preventive measures, according to a recent study.

“Good knowledge and attitudes about the preventive measures were associated with increased self-reported practice of measures,” the researchers said. “Nevertheless, we found profound gaps in knowledge, attitudes, and practice (KAP) among older adults, ethnic minorities, and those of low socioeconomic status, which require attention.”

Singapore residents aged ≥60 years participated in this population-based, cross-sectional, mixed-methods study conducted from 13 May 2020 to 9 June 2020. Self-reported KAP on 10 COVID-19 symptoms and six government-initiated preventive measures were assessed.

The researchers identified sociodemographic and health-related factors associated with KAP using multivariable regression models and explored the relationships between knowledge/attitude scores and practice categories using logistic regression. Then, they interviewed 78 participants about the practice of additional preventive measures and analysed the obtained data thematically.

Older Singaporeans achieved a mean awareness score of COVID-19 symptoms of 7.2/10. Fever (92.0 percent) was the most known symptom, while diarrhoea (33.5 percent) was the least known. Most participants knew all six preventive measures (90.4 percent) and deemed these effective (78.7 percent). Almost all of them practiced wearing a face mask (97.2 percent). [Singapore Med J 2023;64:657-666]

On the other hand, participants of Indian or Malay ethnicity and those living in smaller housing displayed lower mean scores for knowledge of COVID-19 symptoms. Much older participants also showed poorer attitudes towards preventive measures. Additionally, Indians were less likely to practice three out of six recommendations compared to Chinese.

Notably, a one-point increase in score for knowledge and for attitudes regarding preventive measures resulted in a greater likelihood of always practicing three of six and two of six measures, respectively.

In the qualitative interviews conducted, obtained data revealed that participants used other preventive measures such as maintaining a healthy lifestyle.

Pray, it works

The finding on positive attitudes towards government-endorsed preventive measures was similar to that during the SARS epidemic, in which Singaporeans showed high confidence with how the government handled the situation. [Emerg Infect Dis 2004;10:364-368]

Another interesting finding was that more than one in three participants held the belief that praying would keep themselves and others safe from COVID-19. This was similar to beliefs seen in older adults with chronic illnesses such as musculoskeletal conditions, circulatory problems, and cancer.

Although praying was found to contribute to positive health-related behaviours, preventive service use, and satisfaction with care, the researchers noted that faith-related activities should not replace the practice of evidence-based, government-endorsed preventive measures. [Am J Health Promot 2005;19:369-375]

“[O]ur study of KAP about COVID-19 and preventive measures provides a rare snapshot of how multiethnic elderly Asian residents understood and responded to this unprecedented time in Singapore,” the researchers said.

“Overall, most elderly Singaporeans had good knowledge of the common symptoms of COVID-19 and were aware of, optimistic about, and practised government-endorsed preventive measures,” they added.