INTRODUCTION:

“Adolescent health is a unique stage of human development and an important time for laying the foundations of good health.” Adolescence is a period of life with specific health and developmental needs and rights. It is also a time to develop knowledge and skills, learn to manage emotions and relationships, and acquire attributes and abilities that will be important for enjoying the adolescent years and assuming adult roles.¹

In India, adolescents contribute to 23% of the total population, which is 243 million adolescents. This represents a huge opportunity that can transform the social and economic fortunes of the country. To enable adolescents to fulfil their potential, substantial investments must be made in education, health, development and other areas.²

The Adolescent Health Awareness Program [AHP], takes inspiration from the Rashtriya Kishore Swasthya Karyakram [RKSK]. RKSK is a health program launched by the ministry of health and family welfare for adolescents, in the age group of 10-19yrs, which target adolescent nutrition and health aspects.²

Adolescents represent the potential influences of future economic growth and development and this period between 10 -19 years of life is the ground for investment and provide a window of opportunity for laying a strong foundation to a brighter and healthier future.³

Adolescents are more likely to engage in risky health practices related to COVID 19. Their compliance with infection control measures is a key factor to mitigate the spread of the disease.⁴

Although adolescents are less likely to experience severe symptoms of COVID-19, they contribute to the spread of the virus. Majority of adolescents reported that practicing effective health protective behaviours to prevent the spread of COVID-19, which was predicted significantly by their attitude and knowledge towards these measures.⁴

Returning to college has taken on new meaning and a new set of worries for parents and other care givers during the age of Coronavirus disease 2019(COVID-19). Colleges must now balance the educational, social and emotional needs of their students along with the health and safety of the students and staff in the midst of the evolving COVID-19 Pandemic.⁵

In the wake of many adolescents getting infected with COVID-19, a group of college students, along with an NGO, have started creating awareness about basic COVID-19 standard operating procedures among adolescents and children below the age of 12 years.⁶

There have been reports that many adolescents are getting infected. But there are no proper awareness programs on wearing masks, hand washing and personal distancing targeting adolescents.⁶ Trauma faced at this developmental stage may have long-term consequences across their lifespan.⁷

In addition to everyday steps to prevent COVID-19, physical, or social distancing is one of the best tools. We have to avoid being exposed to the virus and slow its spread. Adolescents may struggle when asked to change their social routines-from choosing to skip in person gatherings, to consistently wear masks in public settings.⁷

It is important for adults to help adolescents to take personal responsibility to protect themselves and others, as well as support them in safely taking time to connect with friends and family remotely.⁷It is important for adolescents to know that the disease generally does not affect them the same way as it affects adults. Parents can reassure them that it is not likely to make them seriously sick if they do not have underlying conditions that put them at risk.⁸

Some adolescents process things much more emotionally while others are more logic oriented. That will impact what kind of information you share with them. Helping adolescents develop a feeling that consistent schedule is important for maintaining a sense of normalcy. A routine should help young people to feel grounded and reduce stress to some extent.⁸

Although the early cases have been linked to the Wuhan South China Seafood Market, where snakes, birds, and other animals including bats were traded, the origin and source of the SARS-CoV-2 remain unknown. It was hypothesised that either a human-to human transmission or a more -broad animal source was responsible for the early patients' disproportionately high rates of market employment or market visits compared to the exported cases.⁹

The positive-sense, single-stranded RNA in SARS-CoV-2 is 29,891 bases long and belongs to the beta subgrouping of the Coronaviridae family. 29 proteins that are necessary for infection, replication, and virion assembly are encoded by the genome. They share characteristics with other coronaviruses in that they have spikes that resemble crowns on their surface. The human angiotensin-converting enzyme 2 (ACE2) is bound by the receptor binding domain (RBD) of the spike S protein from SARS-CoV-2, which facilitates membrane fusion and the endocytosis of the virus into human cells.⁹

Coronaviruses are a large family of viruses that are known to cause illness ranging from the common cold to more severe diseases such as Middle East respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome SARS). A novel coronavirus (COVID 19) was identified in 2019 in Wuhan, China. This is a new coronavirus that has not been previously identified in humans.¹⁰

COVID-19 is probably spread when a person who is infected coughs, sneezes, talks, sings, or breathes close to you (within six feet) and the virus spreads in respiratory droplets. A person infected with COVID-19 who is more than six feet distant or who has since left the area is considered to have disseminated the virus primarily by small respiratory droplets that linger in the air for minutes to hours.¹¹

Infected people in all different age groups including adolescents can transmit the virus to other people, even if they have mild symptoms or do not feel ill. The virus is spread from person to person through liquid particles such as aerosols (smaller) and droplets (larger) from the nose or mouth which are spread when a person with COVID-19 coughs, sneezes or speaks. People can catch COVID-19 if they breathe in these droplets from an adolescents infected with the virus.¹²

The clinical symptoms of COVID-19 ranges from mild to severe which includes Fever, Cough, Tiredness. Early symptoms of COVID-19 may include a loss of taste or smell. Other symptoms can include: Shortness of breath or difficulty in breathing, Muscle aches, Chills, Sore throat, Runny nose, Headache, Chest pain, Pink eye (conjunctivitis) Nausea, Vomiting, Diarrhoea, Rash etc,. Children have similar symptoms to adults and 3 generally have mild illness. The severity of COVID-19 symptoms can range from very mild to severe. Some people may have only a few symptoms. Some people may have no symptoms at all, but can still spread it (asymptomatic transmission). Some people may experience worsened symptoms, such as worsened shortness of breath and pneumonia, about a week after symptoms start. Some people experience COVID-19 symptoms for more than four weeks after they're diagnosed. These health issues are sometimes called post COVID-19 conditions.¹³

Some children experience multisystem inflammatory syndrome, a syndrome that can affect some organs and tissues, several weeks after having COVID-19. Rarely, some adults experience the syndrome too. People who are older have a higher risk of serious illness from COVID-19, and the risk increases with age. People who have existing medical conditions also may have a higher risk of serious illness. Certain medical conditions that may increase the risk of serious illness from COVID-19 include diabetes mellitus, hypertension, asthma dementia and even other conditions.¹³

The diagnosis can be done by taking oropharyngeal or nasopharyngeal swab. Clinicians may also collect lower respiratory tract samples when these are readily available for example, in mechanically ventilated patients. Dual infections with other respiratory infections (viral, bacterial and fungal) have been found in COVID-19 patients. Depending on local epidemiology and clinical symptoms, test for other potential etiologies (e.g. Influenza, other respiratory viruses, malaria, dengue fever, typhoid fever) as appropriate. For COVID-19 patients with severe disease, also collect blood cultures, ideally prior to initiation of antimicrobial therapy.¹⁴

Prevention of COVID-19 includes that, Individuals must maintain a minimum distance of 6 feet in common places as far as feasible. Practice frequent hand washing with soap (for at least 40-60 seconds) even when hands are not visibly dirty. Use of alcohol -based hand sanitizers (for at least 20 seconds) can be made wherever feasible. Strict practice of covering one’s mouth and nose while coughing/sneezing with a tissue/handkerchief/ flexed elbow and disposing off used tissues properly. Self-monitoring of health by all and reporting any illness at the earliest to the immediate health care officer.¹⁵

Quarantine is the separation and restriction of movement or activities of persons who are not ill but who are believed to have been exposed to infection, for the purpose of preventing transmission of diseases. Persons are usually quarantined in their homes, but they may also be quarantined in community-based facilities. Separating contacts of COVID 19 patients from community. Monitoring contacts for development of sign and symptoms of COVID-19, and Segregation of COVID-19 suspects, as early as possible from among other quarantined persons.¹⁶

The world health organization declared it a public health emergency of international concern on January 30th and called for collaborative efforts of all countries to prevent the rapid spread of COVID-19. In response to this serious situation of COVID-19 spread, the World Health Organization on 11th March 2020 declared COVID-19 a pandemic, pointing to the over 1,18,000 cases of the coronavirus illness in over 110 countries and territories around the world and the sustained the risk of further global spread.¹⁷

NEED FOR THE STUDY:

As of June10, 2021, coronavirus cases were 175,193,829. Deaths were: 37,77,496. Recovered cases were: 158,717,136. The virus had infected over 151 million people worldwide and the number of deaths had reached almost 3.2million. The most severely affected countries include the U.S., Brazil and India.¹⁸

According to Indian health system history, as of June10 2021, total coronavirus cases were 29,183,121. Deaths occurred due to this virus were 3,59,695 and total recovered cases were 27,655,493.¹⁹

According to Karnataka health history, the first case of the COVID-19 pandemic in Indian state of Karnataka was confirmed on 8th March 2020. Two days later, the state became the first in India to invoke the provisions of the epidemic disease act, 1897, which are set to last for a year, to curb the spread of the disease. As of June 9 2021, Karnataka has had 27.2Lakh cases and recovered cases were 24.6L and deaths were 32,099.²⁰

According to Mysuru health history of COVID-19 statistics, as of June 9, 2021, positive cases were 1,163 and deaths were 22.²¹According to global statistics of COVID-19, as of August 01, 2022, the total COVID-19 cases were 582,390,835. Deaths occurred due to COVID-19 were 6,419,987. Recovered cases were 552, 690,772.²¹

REVIEW OF LITERATURE:

A cross sectional survey was conducted in colleges across various universities to assess the COVID-19 and depression; prevalence and risk factors in youth from Maharashtra. Internet survey was done by using convenient snowball sampling. Data was collected by prepared questionnaire. Collected data was tabulated and analyzed by descriptive statistics. The conclusion of the study revealed that, the depression in the youth of Maharashtra found the prevalence rate of depression to be high at 51.8% and found no association with sociodemographic factors such as age, birth position, period of hostel stay, gender and educational qualification of participants or their parents, some of which were previously found to be associated with depression.²²

The consumer pyramid household survey was conducted to assess the prevalence of COVID-19 among volunteers in urban and rural areas of the state of Karnataka. Samples were selected randomly. Data were collected by requested 5ml of blood and a nasopharyngeal swab from 1 volunteer per household. Data analyses were conducted in stata version 16.1. conclusion of the study stated that, the adjusted seroprevalence of COVID-19 in Karnataka was 46.7% which indicates that more people than the 327, 076 cases reported by august 29, 2020, perphaps 31.5 million were infected. This gap might be brought on by low testing rates, as well as the fact that many illnesses in Karnataka are asymptomatic.²³

A quantitative approach and cross-sectional survey research study design was conducted to assess the knowledge of coronavirus among 145 nursing students of district Sirmaur, Himachal Pradesh. Convenience sampling technique was adopted to select the samples. The data collection procedure was done through online self-structured questionnaire. Data was analyzed by using descriptive statistics which includes SPSS. The results of this study stated that only 31.7% of students had good knowledge about COVID-19 and 68.3% had average knowledge.²⁴

A prospective cohort research study was conducted to assess the knowledge, attitudes, and practices among adolescents and young people in Bihar and Uttar Pradesh, India. Data was collected by implementing rapid phone-based survey regarding knowledge, attitude and practices towards COVID-19 among adolescents and young people. Total sample size includes 20,574 in Bihar(n=10,433) and Uttar Pradesh(n=10,141). Survey was conducted on monthly basis. The baseline results shows that awareness of COVID-19 symptoms, perceived risk and ability to carry out preventive behaviors and fears will inform the government for interventions and strategies.²⁵

OBJECTIVES:

1. To assess the awareness of adolescents regarding COVID-19.

2. To assess the attitude of adolescents regarding COVID-19.

3. To find the relationship between awareness and attitude of adolescents regarding COVID-19.

4. To find the association between level of awareness and attitude of adolescents regarding COVID-19 with their selected personal variables.

5. To develop health awareness program for adolescents regarding COVID-19.

HYPOTHESIS:

H₁: There will be significant relationship between awareness and attitude of adolescents regarding COVID-19.

H₂: There will be significant association between the level of awareness of adolescents regarding COVID-19 and their selected personal variables.

H₃: There will be significant association between the level of attitude of adolescents regarding COVID-19 and their selected personal variables.

METHODOLOGY:

RESEARCH APPROACH/DESIGN:

Descriptive research approach and descriptive design was adopted for the study.

VARIABLES UNDER STUDY:

Research Variables:

· Awareness of COVID-19 among adolescents.

· Attitude of COVID-19 among adolescents.

Setting of the study:

The setting of the present study is in selected Pre-University colleges at Mysuru

Sampling criteria:

The study samples were selected in view of the following pre-determined criteria.

Inclusion criteria Adolescents who were

Aged between (16-18years)

· Willing to participate in this study

· Belongs to II^nd year PUC

· Available at the time of data collection

Exclusion criteria:

· Adolescents who were sick

· Adolescents who were absent at the time of data collection

Sample and sample size:

The sample of the present study comprises of adolescents (16-18years) in selected Pre-University colleges of Mysuru. 100 adolescents were selected.

Sampling technique:

Non probability convenience sampling technique adopted to select the subjects for the study.

Data collection technique and instruments:

The following tools were used to collect the data from subjects.

1. Proforma for selected personal variables

2. Structured awareness questionnaire

3. Self- administered attitude rating scale

1. Description of proforma for selected personal variables:

This section contains the basic information about the adolescents viz. age of adolescents, gender, class of study, religion, type of family, area of residence, previous exposure to health education regarding COVID-19, source of information, have you been vaccinated or vaccination status, if not vaccinated why? Reason, have you been infected by COVID-19, has any of your family member got infected by COVID-19.

2. Description of structured awareness questionnaire:

Structured awareness questionnaire consists of 32 questions. Each question has four alternative answers. The correct answer carries one mark and the wrong answer carries zero mark. The maximum score is 26 and minimum score is zero. The total score ranges from zero to thirty- two (0 to 32), which is further arbitrarily divided into three level of awareness scores.

Poor awareness: 0-16

Average awareness: 17-24

Good awareness: 25-3

3. Description of self-administered attitude rating scale Self-administered attitude rating scale:
The self -administered attitude rating scale was consists of 18 items. Strongly disagree- 1, Disagree-2, Neutral-3, Agree-4, Strongly agree-5 and score on five -point scale. The maximum score is 90 and the minimum score is 18. The total score ranges from, 18 to 90 which is further arbitrarily divided into positive and negative attitude.

· Positive attitude: 45 to 90

· Negative attitude: 18 to 45

RESULTS:

Section I- Description of selected personal variables

Table: 1 Frequency and percentage distribution of adolescents according to their selected personal variables n=100

Sl.No

Sample characteristics

Frequency

Percentage (%)

Age in years

16 years

17 years

18 years

Gender

Male

Female

Religion

Hindu

Muslim

Christian

Others

Type of family

Nuclear family

Joint family

Area of residence

Rural

Urban

Previous exposure to health education regarding COVID-19?

Yes

Source of information

Parents

Mass media

Relatives

Health personnel

Have you been vaccinated for COVID-19?

Yes

If not vaccinated why? Reason….

3-Health issues

6-Planning to take

10.

Have you been infected COVID-19?

Yes

Is any of your family members got infected by COVID-19?

Yes

Section II Description of awareness of adolescents regarding COVID-19.

Table 2: Frequency and percentage distribution of awareness scores of adolescents regarding covid-19. n=100

Sl.no	Level of awareness	Frequency	Percentage
1.	Poor awareness (0-16)	39	39
2.	Average awareness (17-24)	57	57
3.	Good awareness (25-32)	4	4

Table:3 Mean, median, range and standard deviation of awareness scores n=100

Level of awareness	Mean	Median	Range	SD
Awareness scores	17.28	17	7-30	+4.47

a) Description of attitude of adolescents regarding COVID-19.

TABLE:4 Frequency and percentage distribution of attitude scores of adolescents regarding covid-19. n=100

Sl. No

Level of attitude

Frequency

Percentage (%)

Positive attitude

(18-44)

Negative attitude

(45-90)

TABLE:5 Mean, median, range and standard deviation of attitude scores n=100

Level of attitude	Mean	Median	Range	SD
Attitude scores	63.53	65	18-80	+11.45

Section III: Description of relationship between awareness and attitude of adolescents regarding COVID-19.

Tabel:6 Correlation co-efficient of awareness and attitude of adolescents. n=100

Variables

Mean

Correlation coefficient

Awareness

Attitude

17.28

63.53

0.31

r₍₉₈₎:1.95; p>0.05

Section IV:

a) Association between the level of awareness of adolescents regarding COVID-19 and their selected personal variables.

Table: 7 Chi-square value of awareness of adolescents with their selected personal variables. n=100

Sl.

Sample characteristics

Poor awareness

Average awareness

Chi square value

Age in years

1.1 16 years

1.2 17 years

1.3 18 years

6.17#*

Gender

2.1 Male

2.2 Female

3.87*

Religion

3.1 Hindu

3.2 Muslim

3.3 Christian

3.4 Others

1.52#

Type of family

4.1 Nuclear family

4.2 Joint family

0.69

Area of residence

5.1 Rural

5.2 Urban

0.70

Previous exposure to health education regarding COVID-19

6.1 Yes

6.2 No

0.005

Source of information

7.1 Parents

7.2 Mass media

7.3 Relatives

7.4 Health personnel

5.75#

Have you been vaccinated for COVID-19?

8.1 Yes

8.2 No

6.25#*

Have you been infected for COVID-19?

9.1 Yes

9.2 No

1.12#

10.

Is any of your family members got infected by COVID-19?

10.1 Yes

10.2 No

2.46

χ²_{(1) =3.84,}χ²_(2)
=5.89,χ²_{(3) =7.82, p>0.05, p<0.05 #-Yates
correction done, *- Significant}

b) Association between the level of attitude of adolescents regarding COVID-19 and their selected personal variables.

Table: 8 Chi-square value of attitude of adolescents with their selected personal variables. n=100

Sl.

Sample characteristics

Positive attitude

Negative attitude

Chi square value

Age in years

1.1 16 years

1.2 17 years

1.3 18 years

0.87#

Gender

2.1 Male

2.2 Female

0.34#

Type of family

3.1 Nuclear family

3.2 Joint family

0.03#

Area of residence

4.1 Rural

4.2 Urban

0.002#

Previous exposure to health education regarding COVID-19

5.1 Yes

5.2 No

1.081#

Have you been vaccinated for COVID-19?

6.1 Yes

6.2 No

0.77#

Have you been infected by COVID-19?

7.1 Yes

7.2 No

0.10#

Is any of your family members got infected by COVID-19?

8.1 Yes

8.2 No

4.68#*

χ²_{(1) =3.84,}χ²_{(2)
=5.89,p>0.05, p<0.05, #-yates correction done, *-Significant}

CONCLUSION:

The present study was conducted to assess the awareness and attitude of adolescents regarding COVID-19 in selected Pre-University college at Mysuru. In order to enhance the awareness and attitude of adolescents regarding COVID-19, Health awareness programme was conducted at the end. So that health care professionals play an important role in educating the adolescents to facilitate healthy growth and development and healthy practices in day -to -day activities.

ACKNOWLEDGEMENT:

Our deepest gratitude to authority of JSS PU College and Nataraja PU College, Mysuru for providing the permission for conducting the study. Sincere thanks to all the participants for their cooperation in the study. Also we are grateful to ethical committee of JSS Academy of Higher education for providing ethical clearance to conduct the study among adolescents.

REFERENCES:

1. WHO: Adolescent Health And Development. https://www.who.int>q-a-detail(accessed)

2. Adolescent Health Awareness https;//www.YouthforSeva.org.(accessed) Program(Youth For Seva).

3. Latefa Ali Dardas and Inaam Khalaf, Manar Nabolsi. Developing an understanding of adolescent’s knowledge, attitude and practices toward COVID-19. The Journal of school Nursing sep29

4. Mohan Kumar M, Karpaga Priya P, Sunil K, Panigrahi, Utsav Raj, Vincent K. Pathak. Impact of COVID-19 pandemic on adolescent health in India. Journal of Family Medicine and Primary Care. 2020(9) Nov 2020.

5. Safety tips for returning to school during COVID-19 from Mayo clinic. http://www.Mayoclinic.org(accessed 20490441).

6. Vivek Narayanam.COVID-19 awareness programme for children in semen cherry, Chennai(accessed Nov 21 2021)

7. COVID-19 parental Resources Kit-Adolescence Centres for disease control And Prevention. https://www.cdc.gov.(accessed Feb 16,2021).

8. Mendelson, Marshall. The impact of the COVID-19 pandemic on adolescents(accessed May 11 2020).

9. Wagner Gouvea Dos Santas. Natural history of COVID-19 and current knowledge on treatment therapeutic options. National Center for Biotechnology Information. 2020 Jul 3;.

10. Introduction to COVID-19: Methods for detection, prevention, response and control. https://openwho.org.>courses>introduction.

11. 301926003. To assess the effectiveness of information booklet on prevention of COVID-19 among adolescents at selected village, Coimbatore [pdf]. [P.P.G College of Nursing];2021 p. 2-4.

12. Coronavirus disease (COVID-19): Adolescents and Youth. https://www.who.int>q-a detail (accessed 4 May 2020) 66

13. Mayo-Clinic Org>Syc.20479963. Patient Care and Health Information> Diseases and conditions coronavirus disease 2019. Mayo Clinic.

14. Ministry of Health and Family Welfare. National Clinical Management Protocol COVID-19 Government of India. 2021.

15. Ministry of Health and Family Welfare. SOP on preventive measures to contain the spread of COVID-19, Government of India. https://www.mofhw.gov.in>2021.

16. Ministry of Health and Family Welfare. Guidelines for quarantine facilities for COVID 19; To provide the interim guidance for setting up of quarantine facilities. https://www.mofhw.gov.in>2021.

17. International Journal of physiotherapy and research, Int J physiotherres2020.https://dx.doi.org/10.16965/ijpr.2020.139(accessed)

18. COVID-19 WORLDOMETER (2021). https://worldometer.info/coronavirus/coronavirus-age-sex-demographics.

19. COVID-19 WORLDOMETER (2021). https://worldometer.info/coronavirus/coronavirus-age-sex-demographics.

20. COVID-19 Pandemic In Karnataka Karunadu.gov.in/htw (accessed)

21. COVID-19 Information Page Mysuru. https://mysuru.nic.in(accessed)

22. Mini Narayanan, Sujata Sriram. COVID-19 and depression; Prevalence and risk factors in youth from Maharashtra, India. 2021sep 29.j. [10.1007/s42087-021-00252-9].

23. Manoj Mohanan, Anup Malani, Kaushik Krishnan. To assess the prevalence of SARS cov-2 among volunteers in urban and rural areas of the state Karnataka. Jody W. Zylke M. D, Editor. 2021 Feb 4;[10.1001/jama.2021.0332].

24. Anjali Devi Sharma, Kavitha Verma, Manisha Sehgal, Yachna Verma, K.A. To assess the knowledge of COVID-19 among nursing students Sirmaur, Himachal Pradesh. International Journal of Research in Medical Sciences.2020. Nov17:

25. Rajib Acharya, Mukta Gundi, Sangram Kishor Patel. COVID-19 Related Knowledge, Attitude and Practices Among Adolescents and Young People in Bihar And Uttar Pradesh, India. April 2020.

Received on 27.01.2024 Modified on 10.02.2024

A and V Pub Int. J. of Nursing and Medical Res. 2024; 3(1):25-32.

DOI: 10.52711/ijnmr.2024.06