Measures

The theory of planned behavior questionnaire developed by Aldalaykeh et al., (2019) was used and adapted to the targeted behavior (COVID-19 help seeking). This survey is already in Arabic and has been used on a Jordanian sample previously. This survey includes four concepts:

Attitude Towards COVID19 help seeking (ATT-COVID19). This scale includes 5 semantic differential items, each item has two opposite adjectives. Participants have the option to choose between 6 points and check the point that is closer to their feeling or appraisal toward COVID-19 help seeking. An example of the items used is “for me, COVID-19 help seeking (e.g., PCR testing or calling the primary care provider) is considered Very good/Very Bad”. The total score of this scale ranges between 6–30, with higher scores indicating more positive attitude towards COVID-19 help seeking. This scale showed good internal consistency (Cronbach’s alpha = 0.82) (Aldalaykeh et al., 2019). In this study, ATT-COVID19 showed also good internal consistency (Cronbach’s alpha = 0.80).

Subjective Norm (SN). This scale measures the social influence of family, friends, and relatives on participant’s decision to seek help for COVID-19. SN included three items; each item has 6-point Likert scale. An example of the items used is “Most people who are important to me think that I should seek help for COVID-19 (e.g., PCR testing or calling the primary care provider) if I show typical signs and symptoms”. The total score ranges between 3–18, with higher scores indicating higher social approval for COVID-19 help seeking. This scale approached acceptable levels of internal consistency in a previous study (Cronbach’s alpha = 0.69) (Aldalaykeh et al., 2019). In this study, SN showed acceptable internal consistency (Cronbach’s alpha = 0.74).

Perceived Behavioral Control (PBC). This scale measures the barriers of COVID-19 help seeking and the level of control a person has over his/her decision to seek help for COVID-19 independently and voluntarily. PBC included three items, each item has 6-point Likert scale. An example of the items used is “The decision to seek help for COVID-19 depends solely on me”. The total score ranges between 3–18, with higher scores indicating higher ability and controllability to seek COVID-19 screening test. PBC showed acceptable level of internal consistency (Cronbach’s alpha = 0.71) (Aldalaykeh et al., 2019). In this study, PBC showed acceptable internal consistency (Cronbach’s alpha = 0.70).

COVID-19 help seeking intention (COVID-19 IN). This scale measures people’s intention towards COVID-19 help seeking. COVID-19 IN included three items, each item has 6-point Likert scale. An example of the items used is “I plan to seek help for COVID-19 (e.g., PCR testing or calling the primary care provider) if I develop typical signs and symptoms”. The total score ranges between 3–18, with higher scores indicating higher intention towards COVID-19 help seeking. Acceptable levels of internal consistency were reported previously for this scale (Cronbach’s alpha = 0.76) (Aldalaykeh et al., 2019). In this study, COVID-19 IN showed acceptable internal consistency (Cronbach’s alpha = 0.78).

COVID19 knowledge. As no existing tools were found at the time of conducting this study that measured COVID-19 knowledge, a tool was developed by the researchers to measure participants’ level of knowledge regarding the signs and symptoms of COVID-19. This tool was developed to estimate the ability of the participant to differentiate between the correct signs/symptoms of COVID-19 and unrelated signs/symptoms. According to WHO (2020) the three most common signs/symptoms of COVID-19 are fever, dry cough, and shortness of breath (dyspnea). The tool included these three signs/symptoms along with four unrelated symptoms (sneezing, itchy skin, red eyes, and vomiting). It included a total of seven signs/symptoms, and participants were asked to select only the correct signs/symptoms that are associated with COVID-19. There are 3 correct choices and 4 false choices. The total score is calculated by summing correct answers (range = 0–7) and transforming it to a percentage. So, the range of scores is between 0–100% with higher scores indicating higher knowledge about COVID-19 signs and symptoms. This tool has been reviewed by a panel of Jordanian experts in terms of face and content validity.