Study Area, Study Period and Study Design
The study was a community-based cross-sectional design conducted at the Gedeo zone from March–April 2020. It has a total population of 847,434, of whom 424,742 are men and 422,692 women, and 359 km far from Addis Ababa (the capital city of Ethiopia, the main road from Addis Ababa to Kenya crosses.
Eligibility Criteria
The inclusion criteria of this study were respondent’s age 18+ and able to listen and respond with either of the local languages, Amharic, or Gedeoffa local languages. The exclusion criteria of this study were those who weren’t able to listen to the questions asked and not present during the data collection period due to different reasons (not in the house during the data collection period, acutely or severely ill).
Sample Size Calculation
The sample size was calculated using a single proportion formula population. We used the p value of the previous study done in China 53.8% [7].
$${\text{P}} = 0.54\% ,\,{\text{Where}},\,{\text{n}} = {\text{required}}\,{\text{sample}}\,{\text{size}}\,{\text{n}} = {\text{Z }}\left( {\alpha /2} \right) \, 2\,{\text{pq}}/{\text{d}}2,{\text{p}} = 0.54 \, = \, \left( {1.96} \right) \, \left( {1.96} \right) \, \left( {0.54} \right) \, \left( {0.46} \right)/\left( {0.05} \right) \, \left( {0.05} \right) = 382$$
where z is the reliability coefficient at a 95% confidence interval (1.96)
W (margin of error) = 0.05 and N = non-response rate 10% = 38.
The final total sample size was, 382 + 38 = 420.
Sampling Technique and Procedure
The sampling technique of this study was a multi-stage random sampling. Gedeo zone has seven woredas, Namely, Bule, Dilla town, Dilla zuria, Gedeb, kochere, Wenago, and Yirgacheffe. It has 179,677 households. At first, we selected all woredas in the zone. Then, we proportionally allocate to each kebeles of the hose holds found in the woredas. To select each household of the kebeles, we used simple random sampling and lottery method.
Data Collection Tools
The first part of the questioner is about the socio-demographic characteristics of respondents.
The second part of the questioner was about the mental health crisis and assessed using the Depression, Anxiety and Stress Scale (DASS-21) a 21- item Likert scale and sored < 30 (Normal), 30-43 (mild) and 43-59 (moderate) > 60 (severe) [9].
The third part of the questioner was about knowledge, attitude, and practice regarding the coronavirus, which has 12-items and scored as a continuous variable. The higher score is good knowledge [10].
Variables
Dependent variable—mental health crisis
Independent variables- Age, sex, educational status, occupational status, family size, and monthly income, and KAP about COVID-19.
Data Collection Procedures
First we carefully designed the questioner then we trained data collectors, supervisors for about four days about the aims of the study by considering the value of privacy and confidentiality. Each day the supervisors were checked the data about its completeness.
Data Quality Control
The pretest was done on the 5% populations before two weeks of the actual data collection period.
The questioner translated into the Amharic and Gedeoffa language and back-translated to English to check the consistency. The Amharic and Gedeoffa version questioner used for data collection.
Data Processing and Analysis
Data was entered into the Epi-Data 3.4 software package and exported to the Statistical Package for Social Science version 22. Descriptive statistics such as frequencies, percentages, graphs, and tables used to describe the data.
Logistic regression analysis used to determine the predictor variable of outcome variable at (95 CI and p value < 0.05).