Introduction: After COVID-19 outbreak, governments adopted several containment measures. Risk perception and knowledge may play a crucial role since they can affect compliance with preventive measures. This study aimed to explore the extent and the associated factors of risk perception, knowledge regarding SARS-CoV2, and perception towards preventive measures among the Italian population.
Methods: A nationwide cross-sectional study involving adults was conducted in April-May 2021: an online survey was distributed through social media. The outcomes were: Knowledge Score (KS) (0 to 100%: higher scores correspond to higher COVID-19-related knowledge); Risk Perception Score (RPS) (1 to 4: higher values indicate higher concern); Preventive measures Perception Score (PPS) (1 to 4: higher values indicate higher confidence). Multivariable regression models were performed.
Results: A total of 1120 participants were included. Median KS was 79.5% (IQR=72.7%-86.4%). Lower education and poor economic conditions were negatively associated with the KS. Median RPS was 2.8 (IQR=2.4-3.2). Female gender, sharing house with a fragile person, suffering from a chronic disease, having a family member/close friend who contracted SARS-CoV-2 infection were positively associated with the RPS. Median PPS was 3.1 (IQR=2.8-3.4). Lower educational level was negatively associated with the PPS. Vaccine hesitancy was negatively associated with all three outcomes. The three scores were positively associated with each other.
Conclusions: Fair levels of knowledge, risk perception and perception towards preventive measures were reported. Reciprocal relationships between the outcomes and a relevant relationship with vaccine hesitancy were highlighted. Further investigations should be focused on studying underlying determinants and consequences.
 AlAmodi AA, Al-Kattan K, Shareef MA. The current global perspective of the knowledge-attitude- behavior of the general public towards the corona virus disease -19 pandemic: Systematic review and meta-analysis on 67,143 participants. PLOS ONE. 2021;16(12):e0260240. doi:10.1371/journal.pone.0260240
 Moran C, Campbell DJT, Campbell TS, Roach P, Bourassa L, Collins Z, Stasiewicz M, McLane P. Predictors of attitudes and adherence to COVID-19 public health guidelines in Western countries: a rapid review of the emerging literature. J Public Health (Oxf). 2021 Dec 10;43(4):739-753. doi: 10.1093/pubmed/fdab070
 WHO Europe. Monitoring knowledge, risk perceptions, preventive behaviours and trust to inform pandemic outbreak response. Document number: WHO/EURO:2020-696-40431-54222 29 July 2020.
 ECOM (Effective Communication in Outbreak Management for Europe). Standard questionnaire on risk perception of an infectious disease outbreak. Version November 2015. Available at: http://ecomeu.info/wp-content/uploads/2015/11/Standard-questionnaire-risk-perception-ECOM-november-2015.pdf
 Hosmer D, Lemeshow S.Applied Logistic Regression. John Wiley & Sons, Inc; 1989.
 Clavel N, Badr J, Gautier L, Lavoie-Tremblay M, Paquette J. Risk Perceptions, Knowledge and Behaviors of General and High-Risk Adult Populations Towards COVID-19: A Systematic Scoping Review. Public Health Reviews. 2021;42. doi:10.3389/phrs.2021.1603979
 Russo S, Bani M, Ardenghi S, Rampoldi G, Strepparava MG. Waiting for the COVID-19 vaccine: vaccine intention, trust in authorities and information needs in an Italian sample. Psychology, Health & Medicine. 2022:1-18. doi:10.1080/13548506.2022.2105913
 Lorettu L, Mastrangelo G, Stepien J, Grabowski J, Meloni R, Piu D, Michalski T, Waszak PM, Bellizzi S, Cegolon L. Attitudes and Perceptions of Health Protection Measures Against the Spread of COVID-19 in Italy and Poland. Front Psychol. 2021 Dec 24;12:805790. doi: 10.3389/fpsyg.2021.805790
 Gualano MR, Lo Moro G, Voglino G, Bert F, Siliquini R. Is the pandemic leading to a crisis of trust? Insights from an Italian nationwide study. Public Health. 2022;202:32-34. doi:10.1016/j.puhe.2021.10.015