Community Perception on Effective Approaches to Promote Acceptance and Adherence to Public Health Measures for COVID-19 Prevention and Control

While much of published research regarding COVID-19 has focused on virology, epidemiology and clinical aspects of COVID-19, commentaries, editorials and letters from sociologists, economists and political scientists have highlighted the social impacts of COVID-19, particularly in China. It is, therefore, very important to explore the community perception of the impact this illness is having on the lives of the general public and the practices which they are adopting to contain the disease. These kinds of insights are important for national public health officials looking to implement control measures that may have clear biomedical rationale but require social and behavioral cooperation from citizens to be effective. Rapid identification of these impacts and research is necessary to generate evidence that can inform approaches to mitigate them. This is because public health authorities are not operating in a vacuum, but in already functioning communities and societies with established socio-cultural systems that include different forms of authority, organization and coping and resilience mechanisms to face adversity. Local knowledge and perception of COVID-19 will, therefore, drive local reactions and responses.

Among all the affected countries, Pakistan has also been affected with more than 76,398 confirmed cases and 1621 deaths till June 2, 202014. In March 2020, the government of Pakistan published a National Action Plan (NAP) on COVID-19 to deal with the illness. Among the important factors that focused on COVID-19, one was the generation of evidence to guide better decision making15. Pakistani communities are very diverse in their cultural and social norms and therefore their response to COVID-19 might also be varied. It is, therefore, important to identify the perception, practice and attitude of the community towards containing this disease. This is because clinical management of COVID-19 patients can only be effective if the healthcare system is not overburdened with a constant flow of patients which is increasing day by day. This increase in the percentage of patients is directly proportional to the measures that the community takes to contain the disease.

STUDY DESIGN A descriptive study design with a cross-sectional approach will be adopted whereby nationally representative sample of respondents (based on latest census 2018) across Pakistan through Computer Assisted Telephonic Interviewing (CATI) will be interviewed. CATI is a research and analysis program with no direct human-human interaction whereby data is collected telephonically through tablets/computers with incorporated questionnaires with logical checks. CATI has the capacity of respondent randomization, full central server quota control, sample management, appointments and automatic dialing.

Upon local ethical clearance, development of the questionnaire, its pre-testing and development of its CATI based version, the enumerators will be trained remotely through , Skype or MS teams. Skype will be used as a priority. These enumerators are our collaborator International Research Force (IRF)'s trained data collectors.

For this particular study the enumerators will be trained on obtaining consent from the respondents followed by data collection on the questionnaire. They will: