AMJ Vol 9 No 2 June 2022.indd
Althea Medical Journal. 2022;9(2)
93
Level of Knowledge and Attitude towards COVID-19 among High School
Students in Depok
Arnold,1 Fifi Veronica,2 Vycke Yunivita2
1Faculty of Medicine Universitas Padjadjaran, Indonesia, 2Department of Biomedical Sciences,
Faculty of Medicine Universitas Padjadjaran, Indonesia
Correspondence: Dr. Vycke Yunivita KD, dr., M.Kes, Department of Biomedical Sciences, Faculty of Medicine Universitas Padjadjaran,
Jalan Raya Bandung-Sumedang Km. 21, Jatinangor, Sumedang, West Java-Indonesia, E-mail: v.yunivita@unpad.ac.id
Introduction
Coronavirus disease 2019 (COVID-19) is
an infectious disease caused by the SARS-
CoV-2 virus.1 It can spread through human-
to-human transmission and indirect contact
with contaminated objects.2 Indonesia has
implemented a large-scale social distancing,
increasing the capacity of COVID-19 diagnostic
tests, and launching a national research
consortium to accelerate innovations to
combat the disease.3 Washing hands regularly,
wearing a mask, physical distancing, and
other health protocols are the best strategy
to prevent transmission of the virus.4,5 The
COVID-19 has infected 118,058,503 people
in the world (March 12, 2021), 1% infected
Indonesian that happened in 2% of people in
West Java, and 15% were living in Depok.6
The World Health Organization (WHO)
on March 11, 2020, declared the novel
coronavirus (COVID-19) a global pandemic, all
countries imposed restrictions on community
activities and some countries were locked
down.7 This condition causes some people to
feel anxiety in their daily life. When anxiety
affects large numbers of people, panic buying
can occur and make some consequences such
as restrictions in daily activities, avoidance
behaviours leading to limited sociability,
and self-medication.8 With limited activities,
electronic media has become the public’s
main in getting the latest information about
COVID-19. The obtained information can affect
the knowledge, understanding, behavior, and
even habits of the community’s perception of
COVID-19.9–11
Knowledge and attitude are important
factors in determining health decisions and
health outcomes.8 Knowledge and attitude
Althea Medical Journal. 2022;9(2):93–99
Abstract
Background: Depok is the city with the largest COVID-19 cases in West Java, Indonesia. The application
of health protocol for high school student as the second-largest age group depends on the level of
knowledge and attitudes that can be affected by gender. This study aimed to determine the level of
knowledge and attitudes based on the gender of high school students towards COVID-19 in Depok.
Methods: This study was a cross-sectional analytic study, conducted from June 2020 to June 2021.
The data was collected using a Google form application with a validated questionnaire and the
research subjects were high school students in Depok. Knowledge of COVID-19 was assessed with
18 questions, true or false questions. Correct answer was assigned 1 point. Points were summed for
a total knowledge score of Poor, Moderate, or Good. Attitude was assessed with 6 questions. For each
answer given, subjects with a total score of >18 were assessed as a positive attitude.
Results: Of a total of 273 respondents, 238 had met the inclusion criteria. Most of the respondents
had a moderate level of knowledge (60.5%) and most of the respondents (89%) had a positive attitude
towards COVID-19. No significant differences in level of knowledge or attitude between males and
females (p>0.05).
Conclusions: High school students in Depok have a moderate level of knowledge and have a positive
attitude in dealing with COVID-19 which is not influenced by gender. The lack of information regarding
the timing of vaccine administration and examination of COVID-19 needs to be a concern for high
school students in Depok.
Keywords: Attitude, COVID-19, Depok, high school students, knowledge
https://doi.org/10.15850/amj.v9n2.2513
Althea Medical Journal. 2022;9(2)
94
information are necessary because unclear
information and negative attitudes toward
COVID-19 can generate stress and panic
among the population.12 Therefore, efforts are
needed to evaluate people’s knowledge and
behavior related to COVID-19 to assess the
public’s awareness of COVID-19 and behavior
related to preventing transmission and taking
action when infected by the disease.
Depok as one of the big cities in the
province of West Java, Indonesia, is located
between Jakarta and Bogor, and has 11 sub-
districts. COVID-19 was first detected in
Depok and became the city with the highest
COVID-19 cases in West Java.13 The high risk
of spreading COVID-19 and positive cases in
Depok city can be caused by many factors,
such as geographical location, human mobility,
knowledge, and attitudes of Depok City
residents.14
About 9.43% of Indonesia’s population is in
the age range of 15–19 years.15 The population
at this age is categorized as teenagers, at the
level of high school students. High school
students are the most active in traveling
during the pandemic, therefore, they are at
risk of getting COVID-19. Due to the lack of
information regarding the level of knowledge
and attitudes of high school students related to
COVID-19 in Depok, this study was conducted
to determine the level of knowledge and
attitudes of high school students about
COVID-19 in Depok.
Recent studies have shown that gender
and age can affect a person’s behavior and
knowledge. Gender is associated with a
person’s roles and obligations given by society,
as well as his status in the family and society.
These aspects influenced the risks that they
take and face, as well as their efforts to improve
their health.16 This study aimed to determine
the level of knowledge and attitude based on
the gender of high school students towards
COVID-19 in Depok.
Methods
This study was an analytic research with a
cross-sectional study design and was carried
out from April to June 2021 in high schools in
Depok. The tool or material used was a valid
questionnaire (18 questions for knowledge
and 6 questionnaires for attitude) in the form
of a Google form. The knowledge questionnaire
was tested using the Pearson correlation test,
and the reliability test used the Cronbach’s
alpha (α) test with a 95% confidence level
showing the results of α=0.671 (reliable),
and α=0.786 (reliable) for the attitude
questionnaire.
The inclusion criteria in this study were high
school students in Depok who could access
the questionnaire link. Subjects’ answers
were included if the subjects agreed to fill out
the form and excluded if the response have
exceeded the deadline; multiple responses
from the same person; did not complete the
questionnaire or fill out the questionnaire.
Sampling was carried out using a total sampling
technique from probability sampling based on
a sub-district in Depok. Determination of the
number of samples based on the Slovin formula
with the results of 110 research respondents.17
This study had been approved by the Research
Ethics Committee, Universitas Padjadjaran no.
323/UN6.KEP/EC/2021.
The questionnaire evaluated the level
of knowledge in the form of questions with
true/false answers. The correct answer was
given a score of 1 and the wrong answer was
given a score of 0. The level of knowledge was
considered “Good” if the correct answer was
>75%, “moderate” if the correct answer =56–
75%, and “poor” if the correct answer was
<56%. The questionnaire assessing attitudes
towards COVID-19 used a Likert scale, which
Althea Medical Journal June 2022
Table 1Characteristics of Respondents
Characteristic Frequency (Total = 238) Percentage
Age (years)* 18 (14-21)
Gender
Male
Female
90
148
37.8
62.2
Grade level
10
11
12
110
101
27
46.2
42.4
11.3
Note: *=data presented in median (min, max)
Althea Medical Journal. 2022;9(2)
95Arnold et al.: Level of Knowledge and Attitude towards COVID-19 among High School Students in Depok
specified the responders’ level of agreement
on four points, namely 4 for strongly agree,
3 for agree, 2 for disagree, and 1 for strongly
disagree. Subjects with a score greater than
or equal to 75% of the maximum score were
classified as “positive”, and subjects with a
score less than 75% of the maximum score
were classified as “negative”.10
The data were analysed using the SPSS
software computer program and were
analyzed by descriptive statistics and Chi-
square correlation analysis. Data were
presented in tables and diagrams.
Table 2 Distribution of the Answers of Knowledge Level on COVID-19 in the High School
Students in Depok
No Knowledge
Male (n=90)
Female
(n=148)
Total
(n=238)
Correct Correct Correct
n (%) n (%) n (%)
1 Corona virus can survive in the air for three hours in aerosol
form
72 (80) 131 (88.5) 203 (85.3)
2 Corona virus has similarities with the SARS virus 72 (80) 131 (88.5) 203 (85.3)
3 Patients without comorbid diseases such as obesity and
hypertension are more susceptible to corona virus infection
53 (58.8) 76 (51.3) 129 (54.2)
4 Children are more susceptible to corona virus infection than
the elderly
72 (80) 122 (82.4) 194 (81.5)
5 Corona virus cannot enter through the eyes 51 (56.6) 95 (64.1) 146 (61.3)
6 If a person's hands touch items that have been contaminated
and then touch the nose area, the virus can enter and cause
symptoms
87 (96.6) 147 (99.3) 234 (98.3)
7 Loss of smell is one of the specific complaints of being
infected with the corona virus
84 (93.3) 147 (99.3) 232 (97.5)
8 Sore throat, cough, runny nose, and fever can be one of the
early symptoms of corona virus infection
84 (93.3) 148 (100) 232 (97.5)
9 Being in a crowd increases the risk of being infected by the
corona virus
89 (98.8) 148 (100) 237 (99.6)
10 Masks made of cotton cloth have higher effectiveness in
filtering virus particles than surgical masks
48(53.3) 100 (67.5) 148 (62.2)
11 Antibiotics are effective in preventing and treating corona
virus infections
32 (35.5) 57 (38.5) 89 (37.4)
12 It is not safe to receive letters or packages from abroad 46 (51.1) 60 (40.5) 106 (44.5)
13 Spraying alcohol all over the body can treat the corona virus 69 (76.6) 97 (65.5) 166 (69.7)
14 PCR test results can be known no later than 1 day 30 (33.3) 45 (30.4) 75 (31.5)
15 The accuracy rate of rapid antigen test is almost 100% 27 (30) 46 (31) 73 (30.7)
16 The antibody rapid test procedure begins with taking a blood
sample from the fingertip which is then dropped onto the
rapid test kit
76 (84.4) 141 (95.2) 171 (71.8)
17 The corona virus vaccine works by stimulating the formation
of specific immunity against the corona virus. So that when
exposed, a person will be able to avoid 100% transmission or
serious illness due to the disease
30 (33.3) 47 (31.7) 77 (32.4)
18 The corona virus vaccine is carried out 2 times and according
to the schedule, which is at least 1 week from the first vaccine
15 (16.6) 35 (23.6) 50 (21)
Althea Medical Journal. 2022;9(2)
96
Results
Of the hundreds of schools in 11 sub-districts
in Depok, only 10 schools from 8 sub-districts
were collected. It was because most schools
were busy preparing for the admission of
new students (Penerimaan Peserta Didik
Baru, PPDB), so the responses received
tended to be slow and needed to be followed
up. Furthermore, some schools did not allow
research to be carried out because the school
was a boarding school, and students were
prohibited from using gadgets. There were
also some schools that refused because they
had not been accredited. From a total of 238
respondents, the majority of respondents in
this study were 18 years old, female, and in
the 10th grade (Table 1).
Althea Medical Journal June 2022
Table 3 Level of Knowledge and Attitude toward COVID-19 among the High School Students
No Attitude
Male Female Total
SA
n(%)
A
n(%)
D
n(%)
SD
n(%)
SA
n(%)
A
n(%)
D
n(%)
SD
n(%)
SA
n(%)
A
n(%)
D
n(%)
SD
n(%)
1
I always wash
my hands
regularly to
avoid and
prevent the
transmission
of the corona
virus
65
(72.2)
25
(27.8)
0 0 112
(75.7)
36
(24.3)
0 0 177
(74.4)
61
(25.6)
0 0
2
I limit my
activities by
staying at
home to avoid
transmission
of the corona
virus
47
(52.2)
38
(42.2)
3 (3.3) 2 (2.2) 72
(48.6)
64
(43.2)
11
(7.4)
1
(0.7)
119
(50)
102
(42.9)
14
(5.9)
3
(1.3)
3
T a k i n g
m e d i c i n e s
such as herbs,
supplements,
and vitamins
to prevent
corona virus
infection is
not a problem
for me
39
(43.3)
42
(46.7)
0 9
(10)
49
(33.1)
92
(62.2)
7
(4.7)
0 88
(37)
134
(56.3)
16
(6.7)
0
4
I feel calm
during the
lockdown
20
(22.2)
33
(36.7)
22
(24.4)
15
(16.7)
25
(16.9)
89
(60.1)
28
(18.9)
6
(4.1)
45
(18.9)
122
(51.3)
50
(21)
21
(8.8)
5
I always wear
a mask every
time I leave
the house
55
(61.1)
32
(35.6)
2
(2.2)
1
(1.1)
119
(80.4)
29
(19.6)
0 0 174
(73.1)
61
(25.6)
2
(0.8)
1
(0.4)
6
I don’t mind
doing self-
isolation for
a few days
after traveling
out of town/
country
0 45
(50)
36
(40)
2
(2.2)
0 80
(54.1)
61
(41.2)
0 97
(40.8)
125
(52.5)
13
(5.5)
2
(0.8)
Note: SA= Strongly agree, A= Agree, D= Disagree, SD= Strongly disagree
Althea Medical Journal. 2022;9(2)
97
Table 4 Proportion Categorized of Knowledge and Attitude towards COVID-19
Items Frequency (Total=238) Percentage (%)
Knowledge
Good
Moderate
Poor
51
144
43
21.4
60.5
18.1
Attitude*
Positive
Negative
212
25
89.1
10.5
Note: *one subject is not included because missed one answer
Most respondents (85.2%) knew that the
corona virus was able to survive longer in
the air in aerosol form, knew the symptoms
when infected with the corona virus, and
knew that the virus was transmitted through
contaminated items (Table 2). However, there
were still many respondents who did not
know that co-morbidities were factors that
aggravate the course of the disease (45.8%),
the ability of the coronavirus to enter the body
through the eyes (38.7%), the ineffectiveness
of cloth masks (37.9%), the procedure of rapid
test (68.5%) and the antibiotics that could not
kill viruses (62.7%) (Table 2).
In the corona virus examination, most of
the respondents (69.4%) did not know the
accuracy of the rapid antigen test and when
the PCR test results could be received (68.5%)
(Table 2). There was a misconception among
the most respondents (67.7%) that vaccination
could prevent 100% of corona virus infections
(Table 2).
Based on the results of knowledge research,
it was found that 17.8% of male respondents
had good knowledge and 23.6% of female
respondents had good knowledge. There was
no difference in the proportion of moderate
and poor level of knowledge between males
and females. There was also no significant
difference between the knowledge categories
in males vs females (p>0.05) nor by age (data
not presented).
Based on the results of attitude research, it
was found that 74.6% of respondents strongly
agreed in terms of washing hands, 50% in term
of limiting activities outside the home, 73.1%
in terms of using masks, 18.9% in terms of
feeling calm during the pandemic, and 40.7% in
term of self-isolation for a while after traveling
out of town/country. Of the 91.9% of female
respondents had positive attitudes and 84.4%
of male respondents had positive attitudes but
there was no significant correlation difference
between attitudes and gender (p>0.05) or by
age (data not presented).
Discussions
The respondents of this study were aged 4–21
years, the majority were female, and most
had moderate knowledge towards COVID-19.
Similar studies were conducted in Saudi10 (18–
28 years old), India11 (more than 18 years)
and Ethiopia18 (18–29 years old) which also
used the same type of study and questionnaire
instrument. The results are good level of
Table 5 Comparison between Males and Females in Terms of Knowledge and Attitude
towards COVID-19
Items Malen (%)
Female
n (%) p-value
Knowledge
Good
Moderate
Poor
16 (17.8)
55 (61.1)
19 (21.1)
35 (23.6)
89 (60.1)
24 (16.2)
0.438
Attitude*
Positive
Negative
76 (84.4)
13 (14.4)
136 (91.9)
12 (8.1)
0.131
Note: *one subject is not included because missed one answer
Arnold et al.: Level of Knowledge and Attitude towards COVID-19 among High School Students in Depok
Althea Medical Journal. 2022;9(2)
98
knowledge in Saudi,10 moderate in India11 and
poor level of knowledge in Ethiopia.18 Whereas
in the Ploso District, Jombang Regency19, it
was found that 67% of high school students
had a good level of knowledge towards
COVID-19. In contrast to the others, with
different knowledge categories, the results
of study in the Philippines showed that the
level of knowledge of respondents aged 16–29
years was low (scores 75% and below).20 The
difference in these results could be influenced
by the age of the subject participating in
each study. The present study did not show
a correlation between age and knowledge
toward COVID-19 but studies in Saudi and the
Philippines did.10,20
Based on the results of attitudes, it was
discovered that most of the respondents
have a positive attitude towards COVID-19
as well as the results of study in Saudi,10
India,11 Ethiopia,18 and Philippine.20 In this
study, female are superior to males in terms
of knowledge and attitudes although there is
no correlation between gender and level of
knowledge nor attitude towards COVID-19. The
results of this study conform to researches in
Bangladesh,21 which states that the proportion
of good knowledge, positive attitudes, and
good practices is higher in female respondents.
Without exception, female are more likely than
male to do recommended preventions,21 and
they have more time to read or discuss with
their environment. This causes female to have
a tendency to behave better than male.22 This
finding is further validated by a meta-analysis
demonstrating that women were 49.5% more
likely to practice and adopt health-protective
behaviors in the context of a pandemic
outbreak.16
Thereby, increasing COVID-19 education
and health protocol socialization to the
community, both gender and young age, is
needed to increase knowledge and reduce
negative attitudes toward COVID-19.
There are some limitations of our study, we
used a different questioning tool from others
studies, which could influence the analysis of
the results.
To conclude, high school students in Depok
have a moderate level of knowledge and
positive attitude towards COVID-19. Further
improvements need to be implemented
in school to increase knowledge, positive
attitudes, and simplify information regarding
the transmission and spread of COVID-19 to
students.
Acknowledgements
The authors would like to thank Kurnia
Wahyudi and Sri Yusnita from the Department
of Public Health, Faculty of Medicine,
Universitas Padjadjaran, Indonesia, for their
advice on methodology of research. We also
thank all respondents for their cooperation in
this study.
References
1. Yang L, Liu S, Liu J, Zhang Z, Wan X, Huang
B, et al. COVID-19: immunopathogenesis
and immunotherapeutics. Sig Transduct
Target Ther. 2020;5(1):128.
2. Lotfi M, Hamblin MR, Rezaei N. COVID-19:
Transmission, prevention, and potential
therapeutic opportunities. Clin Chim Acta.
2020;508:254–66
3. Setiati S, Azwar MK. COVID-19
and Indonesia. Acta Med Indones.
2020;52(1):84–9.
4. Adhikari SP, Meng S, Wu Y, Mao Y, Ye
R, Wang Q, et al. A scoping review of
2019 novel coronavirus during the early
outbreak period: epidemiology, causes,
clinical manifestation and diagnosis,
prevention and control. Infect Dis Poverty.
2020;9(1):29.
5. Lewnard JA, Lo NC. Scientific and ethical
basis for social-distancing interventions
against COVID-19. Lancet Infect Dis.
2020;20(6):631–3.
6. Kahar F, Dirawan GD, Samad S, Qomariyah
N, Purlinda DE. The epidemiology of
covid-19, attitudes and behaviors of the
community during the covid pandemic
in Indonesia. Int J Innov Sci Res Technol.
2020;5(8):1681–7.
7. Cucinotta D, Vanelli M. WHO declares
COVID-19 a pandemic. Acta Biomedica.
2020;91(1):157–60.
8. Bhat SS, Vashisth A, Kumari S, Singh OK,
Farooque N, Baccha S. Development of
social stigmatization during a pandemic
caused by COVID-19. J Adv Med Dent Sci
Res. 2020;8(5):71–4.
9. Bao H, Cao B, Xiong Y, Tang W. Digital
media’s role in the COVID-19 pandemic.
JMIR Mhealth Uhealth. 2020;8(9):e20156.
10. Baig M, Jameel T, Alzahrani SH, Mirza AA,
Gazzaz ZJ, Ahmad T, et al. Predictors of
misconceptions, knowledge, attitudes, and
practices of COVID-19 pandemic among
a sample of Saudi population. PLoS One.
2020;15(12):e0243526.
11. Roy D, Tripathy S, Kar SK, Sharma N,
Verma SK, Kaushal V. Study of knowledge,
attitude, anxiety & perceived mental
Althea Medical Journal June 2022
Althea Medical Journal. 2022;9(2)
99
healthcare need in Indian population
during COVID-19 pandemic. Asian J
Psychiatr. 2020;51:102083.
12. Lin Y, Huang L, Nie S, Liu Z, Yu H, Yan W,
et al. Knowledge, attitudes and practices
(KAP) related to the pandemic (H1N1)
2009 among Chinese general population:
a telephone survey. BMC Infect Dis.
2011;11:128.
13. Rochmyaningsih D. Indonesia finally
reports two coronavirus cases. Scientists
worry it has many more. Washington, DC:
American Association for the Advancement
of Science; 2020. [cited 2020 September
09]. Available from: https://www.science.
org/content/article/indonesia-finally-
reports-two-coronavirus-cases-scientists-
worry-it-has-many-more.
14. Firmansyah T. Ini alasan mengapa Depok
rawan penyebaran Covid-19. Republika
[Internet]. 2020 [Cited 2020 September 9].
Available from: https://www.republika.
c o . i d / b e r i t a / q e x t 7 w 3 7 7 / i n i - a l a s a n -
m e n g a p a - d e p o k- ra wa n - p e nye b a ra n -
covid19
15. Badan Pusat Statistik. Penduduk berumur
15 tahun ke atas menurut golongan umur
dan jenis kegiatan selama seminggu
yang lalu, 2008–2022. [cited 2022 June
23]. Available from: https://www.bps.
go.id/statictable/2016/04/04/1904/
p e n d u d u k - b e r u m u r - 1 5 - t a h u n - k e -
a t a s - m e n u r u t - g o l o n g a n - u m u r - d a n -
jenis-kegiatan-selama-seminggu-yang-
lalu-2008---2022.html.
16. Moran KR, Del Valle SY. A meta-analysis
of the association between gender and
protective behaviors in response to
respiratory epidemics and pandemics.
PLoS One. 2016;11(10):e0164541.
17. Tejada J, Punzalan J. On the misuse of Slovin’s
formula. Philipp Stat. 2012;61(1):129–36.
18. Haftom M, Petrucka P, Gemechu K, Mamo
H, Tsegay T, Amare E, et al. Knowledge,
attitudes, and practices towards covid-19
pandemic among quarantined adults in
Tigrai region, Ethiopia. Infect Drug Resist.
2020;13:3727–37.
19. Saputro AA. Tingkat pengetahuan virus
Covid-19 pada peserta didik kelas X SMA,
SMK, dan MA wilayah Kecamatan Ploso
Kabupaten Jombang. Prosiding Seminar
Nasional Olahraga. 2020;2(1):12–18.
[cited 2022 June 23 ]. Availbale from:
https://www.academia.edu/59211970/
T I N G K A T _ P E N G E TA H U A N _ V I R U S _
C O V I D _ 1 9 _ PA D A _ P E S E R TA _ D I D I K _
KELAS_X_SMA_SMK_DAN_MA_WILAYAH_
K E C A M ATA N _ P L O S O _ K A B U PAT E N _
JOMBANG_Oleh_Arnaz_Anggoro_Saputro_
STKIP_PGRI_Jombang.
20. Tuppal CP, Ninobla MMG, Ruiz MGD,
Loresco RD, Tuppal SMP, Panes II, et al.
Knowledge, attitude, and practice toward
covid-19 among healthy population in
the philippines. Nurse Media J Nurs.
2021;11(1):61–70.
21. Hossain MB, Alam MZ, Islam MS, Sultan S,
Faysal MM, Rima S, et al. Do knowledge and
attitudes matter for preventive behavioral
practices toward the COVID-19? A cross-
sectional online survey among the adult
population in Bangladesh. Heliyon.
2020;6(12):e05799.
22. Wulandari A, Rahman F, Pujianti N, Sari
AR, Laily N, Anggraini L, et al. Hubungan
karakteristik individu dengan pengetahuan
tentang pencegahan coronavirus disease
2019 pada masyarakat di Kalimantan
Selatan. J Kesehat Masy Indones.
2020;15(1):42–6.
Arnold et al.: Level of Knowledge and Attitude towards COVID-19 among High School Students in Depok