Lennon R, Ruffin M, Miller E, Van Scoy L, Zgierska A, Rabago D. Patient perceptions of the SARS-CoV-2 pandemic: a cross-sectional convergent mixed-methods questionnaire. Presented at the Virtual 2020 North American Primary Care Research Group (NAPCRG) Annual Meeting; November 20, 2020.


CONTEXT: Understanding public perception and knowledge during a pandemic can help inform messaging and communication strategy. Media surveys have suggested public misconceptions of SARS-CoV-2.

OBJECTIVE: Explore patient knowledge and perceptions about the SARS-CoV-2 pandemic.

STUDY DESIGN AND ANALYSIS: Cross-sectional convergent mixed-methods questionnaire.

SETTING: Convenience sample from central Pennsylvania.

POPULATION STUDIED: Adult enrollees of a Penn State Health – Hershey marketing list.

INSTRUMENT: Modeled after the European “Standard questionnaire on risk perception of an infectious disease outbreak.”

OUTCOME MEASURES: Online questionnaire assessing knowledge about public health issues related to the SARS-Co-V-2 pandemic); perceived likelihood of and concern about infection with SARS-Co-V-2; and qualitative assessment of worries, perceptions and informational needs related to the SARS-Co-V pandemic.

RESULTS: 5,948 patients completed the questionnaire (9.2% response rate of 126,654 patients emailed; 4% historical marketing list response rate). Weighted knowledge indices: over-the-counter treatments: 41/100 (95% CI [41, 43]); disease severity 88/100 (95% CI [88, 89]); prevention 90/100 (95% CI [89, 90]). There was a very weak relationship between patient concern of personal SARS-CoV-2 infection and their perceived likelihood of infection in bivariate analysis (intra-class correlation 0.19). Qualitative content analysis revealed primary concerns around societal issues (panic, hoarding, economics), medical concerns (illness, access to care), and epidemiologic concerns (disease spread, scarce resources). Patients felt most trusting of state government and Centers for Disease Control and Prevention, and less trusting of other federal information sources. Messaging concerns included over-information, mixed-messages and sensationalism.

CONCLUSIONS: While patients are knowledgeable about disease prevention and severity, they had lower knowledge about self-treatment. Patients expressed overwhelming concern about societal and public health issues in addition to concern about their personal risk. As the risk posed by an event is the product of that event’s likelihood and severity, perceived risk of infection from SARS-CoV-2 should be correlated with concern for infection. Instead, a weak relationship was observed, which may be explained by qualitative data suggesting that concern for society supersedes personal concerns.

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