Attitudes and Knowledge With Covid-19 Prevention Behavior in Pabelan Village

Abstract


INTRODUCTION
Corona Virus  entered Indonesia for the first time confirmed in March 2020 and since then the number of COVID cases has increased every day. Indonesia is one of the countries with the highest number of confirmed cases of Covid-19 in Asia. Covid-19 cases have increased significantly with a positivity rate of 14,2%. This Coronavirus causes death in both animals and humans with signs and symptoms including respiratory infections ranging from mild flu to severe symptoms (Indonesian Ministry of Health, 2021).
Covid-19 prevention is disseminated through socialization and direction on Covid-19 disease and its prevention. This is done to prevent the spread of the disease and the incidence of Covid-19. However, the phenomenon that occurs is still many people who do not understand related to prevention including social distancing, healthy clean living behavior, and the Covid-19 vaccine. There are still many people who have not carried out government directives either washing hands with soap or hand sanitizer, avoiding touching the face when hands are dirty, proper coughing and sneezing etiquette as well as the use of masks and maintaining distance. The use of masks must be according to the standards of medical masks and cloth masks for no more than 4 hours, Practice social distancing with a distance of at least 1 meter and avoid crowds with various physical contacts, Do not travel outside except during emergencies, do not touch eyes, nose, mouth with dirty hands (Gunawan et al., 2021).
The number of Indonesians who have not made the government's appeal is due to the low literacy ability of the community. The public thinks they know more about the condition of the Covid-19 pandemic and there are still many people who do not have access to information media. This has resulted in a lack of public knowledge about the Covid-19 pandemic, even though good knowledge related to Covid-19 is important to reduce the incidence of Covid-19. Having good knowledge about Covid-19 disease is very important so as not to cause an increase in the number of Covid-19 disease cases. Important things to know about Covid-19 disease are how Covid-19 is transmitted, how to prevent, treat, and complications that can occur if someone is infected with Covid-19 disease. The results of previous research indicate that there is a relationship between knowledge and attitudes with covid prevention behavior (Utami et al., 2020).
Knowledge is very important in determining one's behavior because knowledge forms beliefs that will then become the basis for a person in making decisions and determining behavior toward certain objects. Knowledge is also the most important domain in the formation of behavior. In addition to knowledge from the community, knowledge, attitudes, and actions from community leaders or governments are able to describe their behavior to encourage the community in prevention efforts. So that the community is able to behave properly. Behavior is a portion of a person's actions that can be learned and observed. One of the factors that influence human behavior or society is the level of knowledge (Suprayitno et al., 2020) Community knowledge, attitudes, and actions are three important components in the formation of behavior in society, especially healthy behavior. The initial stage where a person knows an object using all the senses is called knowledge. After a person is in the knowing stage then there will be reactions influenced by thoughts, feelings, and concerns that form a readiness before taking action. There are two kinds of attitudes, namely closed and open. It is said that someone has carried out an action where the reaction resulting from the attitude has been influenced by external and internal factors so that an open attitude is formed (Utami et al., 2020). The study aims to determine the relationship between attitudes and knowledge with Covid-19 prevention behavior.

RESEARCH METHODS
The research uses instruments that have been tested for validity and reliability. The research consisted of 3 instruments, namely questions about attitudes, knowledge, and behavior with a total of 29 questions. This research is analytical research with a cross-sectional design with data collection only done once. This study was conducted to analyze the relationship of knowledge with attitudes and behaviors to prevent Covid-19 infection. This research was conducted in Pabelan Village, Kartosuro, Sukoharjo Regency. The inclusion criteria for this study were the Pabelan Village Community, male and female, aged > 21 years, and residents who were not infected with Covid-19. The sampling technique in this study was carried out using a simple random sampling technique with a sample size of 51 respondents. The data collected in this study were primary data obtained using questionnaires filled out directly online and offline by respondents. The result is then processed through the process of data checking or validation, coding, recapitulation, tabulation, and statistical analysis using the software. Data analysis used was univariate and bivariate data analysis. Univariate analysis displayed frequency distributions in tabular form. The results of the study were carried out univariate analysis for sample characteristics and bivariate analysis using the chi-square test.  Based on the table above, it is known that 31,37% of respondents have a good attitude and Covid prevention behavior is lacking. Meanwhile, as many as 29,41% of respondents have good Covid prevention attitudes and behaviors. The results of the bivariate analysis based on the data above found that there was no relationship between attitudes and Covid prevention behavior in Pabelan Village because the p value > 0,05 (1,00). Based on the data above, it is known that as many as 33,33% of respondents have good knowledge and good Covid prevention behavior. The majority of respondents as many as 37,25% have good Covid prevention knowledge and behavior. The results of the bivariate analysis in the table above value p = 0,235 (p > 0,05) which means there is no relationship between knowledge and Covid prevention behavior.

Attitude
COVID-19 prevention efforts can see from a person's attitude toward the infection. The first attitude assessment is to ask directly what attitude should be in response to news about COVID-19. The results showed that most respondents as many as 60,8% had a good attitude towards Covid-19 prevention. This can be based on the existence of information related to Covid which is massive in all media so it creates a good attitude in society. This is in line with research (Suryaatmaja, et. al, 2020) which results in the majority of respondents having a very good attitude. Attitude is a predisposing factor in a person performing certain behaviors. In carrying out disease prevention, attitude is one of the factors that influence a person in preventing the outbreak of a disease because in efforts to prevent disease must be related to the attitude of the community. Attitudes are also influenced by knowledge, good knowledge about covid-19 prevention is also the basis for a good attitude in covid-19 prevention behavior, which means that knowledge of thinking plays an important role in attitude formation. The attitude of the community in responding to every government policy in breaking the chain of distribution and transmission of Covid-19 is also very important. Meanwhile, countries considered successful in dealing with the Covid-19 outbreak were China, Vietnam, Japan, and South Korea. The country's success in dealing with the Covid-19 outbreak is inseparable from the monitoring and supervision carried out by the government which is supported by public compliance with the rules and policies made by the government (Sembiring & Meo, 2020).
Human behavior is determined by the attitude adopted by a person because attitude will provide an affective dimension. This dimension will create a reaction to respond in a relatively fixed way through good and bad attitudes. Attitudes towards objects of goods and people will have an impact on the behavior carried out by society. A good attitude will create good behavior, and vice versa. Factors that influence attitudes towards attitude objects are personal experiences that leave a strong impression and the influence of others who are considered important .
Attitudes are also influenced by the many appeals and rules that apply. The Covid-19 pandemic has made the government through mass media and communication media such as television and social media inform about the prevention of Covid-19. This also creates fear in some people, because fear in health communication can change a person's attitude and behavior. Someone who is afraid of the impact of something, be it the severity or susceptibility of a disease, will change one's health behavior. In this case, it is possible that mass media and other communication media increase fear of Covid-19, causing preventive behavior (Nasution et al., 2021).
The actions of respondents in this study that fall into the category of good action against Covid-19 are 60,8% of respondents, which are defined by having made an effort to wash their hands with water and soap, wear a mask when coughing/runny nose, and cover their mouth and nose with tissue when sneezing or coughing. The results showed that the majority of people in Pabelan Village have a good attitude towards Covid-19 prevention. This can be influenced by various factors, including information obtained by the public related to the pandemic. The information obtained by the public causes fear and anxiety regarding the impact and effects of Covid-19 disease, thus creating a good attitude regarding the prevention of Covid-19.

Knowledge
Based on the results of the study, it shows that most of the respondents 70,6% have good knowledge related to Covid-19 prevention. Knowledge is something that is captured through the five senses, namely sight, hearing, smell, touch and feeling towards an object so that it can be understood and understood by someone. Knowledge plays an important role in building strategies to deal with health crises, including during the Covid-19 pandemic. Knowledge of the characteristics of Covid-19 is greatly influenced by public access to information. Some potential aspects that trigger communication gaps in preparing for and responding during an influenza pandemic are socio-demographic characteristics (age, race and ethnicity), trust factors (seriousness of acceptance), and communication influences (media reporting, information on people's habits and level of knowledge about threats. The results of the study are in line with research conducted (Prihati et al., 2020) which shows that most respondents have a good level of knowledge. Knowledge is also influenced by education. From the results of the study, it is known that the education level of respondents is mostly Bachelor (S1). This is in accordance with the theory that the higher a person pursues, the easier it is for a person to get information. Education as a process in a series that will influence and cause changes in behavior in themselves, because the higher a person's education level, the easier it is for them to receive health information. Conversely, if a person has a low level of education, it will hinder a person's development of acceptance, health information and new values that are introduced. The level of education can influence clean and healthy living behavior, where the higher the level of education, the more mature it will be (Karuniawati & Putrianti, 2020).
Understanding of knowledge, especially environmental health and awareness of maintaining environmental health, including the application of Clean and Healthy Living Behavior (PHBS) principles. Promotive actions to increase public understanding are needed in order to increase their knowledge about self-isolation according to standard operating procedures. The work environment can make a person gain experience and knowledge both directly and indirectly. The environment influences the process of entry of knowledge into the individual. Factors that influence knowledge are education, exposure to information, experience and environment (Yanti et al., 2020) This is in accordance with the results of the study that From the whole picture of knowledge regarding the general description of the Covid-19 virus, almost all of them already know that this virus causes disease respiratory tract, most of the respondents answered correctly regarding the symptoms of Covid-19, namely fever, difficulty breathing, and coughing. Based on the results of research that has been explained, there are still variations in the level of knowledge of the Indonesian people about Covid-19. Statement items with the lowest percentage were found in questions about healing Covid-19, while knowledge items with the highest percentage were found in questions about using masks. In addition to knowledge about the right things about Covid-19, this researcher also assesses the description of public knowledge of hoaxes or misinformation. Statements in the form of incorrect information are still believed by a small number of respondents.

Behaviour
The results showed that most respondents as many as 52,9% had less behavior. Good behavior is an effort to prevent the transmission of Covid-19. Compliance in carrying out covid prevention is influenced by several factors, including knowledge, perception, motivation and confidence in disease control and prevention efforts, the environment, health services, and the ability to access existing resources. Knowledge Model Theory-Attitude-Behavior, knowledge is an essential factor that can influence behavior change, and and individuals can acquire knowledge and skills through the learning process.
The results of the study are in line with research conducted (Mujani & Irvani, 2020) which shows 70% of people behave well regarding the prevention of Covid-19. Research shows that people's compliance behavior is influenced by a number of factors, namely politics, attitudes, economics and demographic factors. Public trust in the government's success in overcoming Covid-19 affects behavior towards Covid-19 prevention.
Research conducted (Karuniawati & Putrianti, 2020) states that behavior is also influenced by age where healthy reproductive age is easier to receive information and direction so that it affects a person's behavior. This is in line with research conducted by researchers in Pabelan Village where respondents are predominantly of productive age. Age is a factor that can describe physical, psychological or social maturity and at least influences the learning process. As a person ages, there will be a change in behavior where they will find it difficult to receive information, they are less active, they are more susceptible to disease and tend to ignore clean living habits (Putra, et al., 2020).

The Relationship of Attitude to Behavior
Based on the results of the study, it was found that the p value = 1,00 (p > 0,05) which means there is no relationship between attitudes and Covid-19 prevention behavior. This is in accordance with research (Azrimadaliza et al., 2021) that there is no relationship between attitude and Covid-19 prevention behavior through increasing body immunity. However, the percentage data shows that the attitude of Covid-19 prevention is also supported by good Covid-19 prevention behavior. Thus, it can be explained that respondents with a good attitude are not necessarily followed by good behavior as well. There are other factors that play a role in a person's behavior, including from the results of further analysis obtained information on age, education level, and occupation.
The research is also in line with the results of the study (Rahman et al., 2021) namely the significance level of p>0.05, so it is known that there is no significant relationship between knowledge about Covid-19 and stigmatizing attitudes toward people who come into contact with Covid-19. The factor causing the influencing of knowledge possessed by people with stigmatized attitudes is a wrong understanding of the information obtained. It appears that one of the efforts to prevent the transmission of Covid-19 recommended by WHO by maintaining distance between people is misinterpreted, especially for people who come into contact with Covid-19, causing someone with high knowledge about Covid-19, tends to have a stigmatized attitude towards people who come into contact with Covid-19. This is also in line with research related to people's religious attitudes in dealing with the Covid-19 outbreak. People tend to obey the advice to practice social distancing and worship at home to avoid crowds. Anomalies occur in the case of Eid al-Fitr prayers, even though the level is only sunnah worship, but it must be done in congregation, after all, people only experience the solemnity of the Eid prayer experience once a year, so as predicted, community participation in its implementation during the pandemic will be very high, people tend to ignore the recommendation to pray Eid al-Fitr at home. People also tend to be more irrational and are willing to take a big risk of exposure to Covid-19 to participate in observing the moment of prayer (Darmawan et al., 2020).

The Relationship of Knowledge to Behavior
The results showed that the p-value> 0.05, which means that there is no relationship between knowledge and Covid-19 prevention behavior. This is in accordance with research (Azrimadaliza et al., 2021) which states that there is no relationship between knowledge and Covid-19 prevention behavior through increasing immunity. The results obtained can be seen that there is a tendency to good knowledge also followed by a good attitude. This result is in line with several previous studies that found that poor knowledge will be followed by bad attitudes and vice versa related to COVID-19. Thus, it can be explained that respondents with good knowledge and a positive attitude are not necessarily followed by good behavior as well. This is influenced by several factors, namely the level of education, age and source of information.
Knowledge plays an important role in determining complete behavior because knowledge will form beliefs that subsequently perceive reality, provide a basis for decision making and determine behavior towards certain objects, so that it will affect a person in behavior. The formation of a new behavior, especially in adults, begins in the cognitive domain in the sense that the subject knows in advance the stimulus in the form of material or objects outside it, giving rise to new knowledge and will be formed in attitudes and actions. Knowledge has a close relationship with the decisions it will make, because with knowledge a person has a foundation for making choices 'Atiqoh, 2020).
Age affects a person's comprehension and mindset. With the increasing age of individuals, a person's comprehension and mindset will be more developed, so that the knowledge obtained will improve  This is in accordance with the results of the study that the majority of respondents are still in their late teens so that they are not mature enough to receive information obtained from outside related to Covid. It is explained that there are physical factors that affect and inhibit the learning process including visual or auditory impairment that makes a decrease in thinking. Other factors that also hinder the thought process are a person's physiological and psychological conditions such as a person's condition when sick or there are limitations in the senses.
This behavior must be based on public awareness, because many people actually know various knowledge related to health protocols or the Covid-19 pandemic but cannot carry it out properly in their daily lives. Research results that do not show a relationship between knowledge and Covid prevention behavior can also be based on information reasons. The possibility that can explain this is the respondent's personal experience regarding prevention against Covid-19 obtained from mass media and news from other communication media. This is due to the many appeals regarding the prevention of Covid -19 in mass media and other communication media such as social media. Fear in health communication can change a person's behavior. An individual participates in health behaviors when they feel the severity and susceptibility of a disease is high. In this case, it is possible that mass media and other communication media increase fear of Covid -19, causing preventive behavior (Sagala et al., 2020) Knowledge is a cognitive domain that is very influential in shaping one's actions. Acceptance of new behavior will be more lasting if it is based on knowledge, whereas the behavior will not last long without being based on knowledge. This supports the adaptation theory which states that a good level of knowledge can encourage someone to have good actions as well. Provision of specific, valid, and targeted knowledge can improve community prevention behavior against Covid -19 infection. Good attitudes and knowledge related to Covid are expected to be able to provide positive prevention behavior.

CONCLUSION
The results showed that there was no relationship between attitudes and knowledge with Covid-19 Prevention behavior in the community. It is hoped that future research can discuss related to interventions that can increase public knowledge related to Covid-19 prevention.