Levels of Sanitation Since COVID-19

Middle school students indicated to what extent they had changed their daily sanitation activities since COVID-19. They were queried whether they "Wash hands frequently", "Avoid touching own face", "Do not share personal items", or are "reluctant to go to crowded places due to hygiene problems." The respondents indicated their levels of sanitation since COVID-19 by choosing one of the following: strongly disagree, disagree, neutral, agree, or strongly agree. Each item was summed, with higher scores indicating greater levels of sanitation since COVID-19. The Cronbach's α of the five-point Likert-type scale was 0.71 (*M* = 16.42; *SD* = 2.72; ranging from 8 to 20).

#### Perceptions Regarding the Risk of COVID-19

Respondents stated to what extent they were aware of COVID-19. This scale consisted of four items which were rated on a five-point Likert-type scale with response options ranging from 1 (strongly disagree) to 5 (strongly agree). The specific items were as follows: COVID-19 is different than flu; [I] do not know when COVID-19 is gone, [COVID-19] damage[s] my health status, and [COVID-19] negatively influence[s] my daily life (e.g., by decreased frequency of dining out). The items were summed and higher scores indicated greater perception of risk regarding COVID-19. Cronbach's α of this scale was 0.70 (*M* = 18.06; *SD* = 2.23; ranging from 10 to 20).

#### *2.3. Analysis Strategy*

Analysis of variance and chi-squared tests were used to examine gender differences in individual, family, and environmental factors. A multiple linear regression was conducted to explore what factors influence protective behavior changes since COVID-19. Statistical Package for the Social Sciences (SPSS) 22.0 (IBM, Armonk, NY, USA) was employed to investigate the relationships between indicators and protective behavior changes since COVID-19. In the multiple linear regression model, individual factors were first considered, and then family factors and environmental factors sequentially addressed in the model. In other words, individual factors were included in model 1 while family factors were entered in model 2 with individual factors. Environmental factors were lastly added in model 3. Figure 1 shows the research design for the current study.

**Figure 1.** Research Design.
