Paper Writing Templates in Jurnal Ilmu Kesehatan Masyarakat (JIKM)

LEVEL OF KNOWLEDGE AND ATTITUDE OF BLUE LAGOON TOURISM

MANAGERS IN THE IMPLEMENTATION OF THE COVID-19 HEALTH

Subagyono1 , Novita Sekarwati2 , Hartalina Mufidah3 *

1
Subagyono, sekolah tinggi ilmu kesehatan wira husada, sleman, yogyakarta
2
Novita Sekarwati, sekolah tinggi ilmu kesehatan wira husada, sleman, yogyakarta
3
Hartalina Mufidah, universitas dr. soebandi, jember, jawa timur

* Correspondence Author: hartalina18@gmail.com, 085230532538

ABSTRACT
There were 2,955 confirmed positive cases of COVID-19 in Ngemplak District in 2021, with 98 deaths. Indonesia is
in a transitional stage from the pandemic to the endemic. The policy of easing the use of masks causes a decrease in
hand hygiene behaviour and a lack of sanitation facilities increasing the risk factors for transmission of COVID-19
in tourist attractions. This study aims to determine the management of knowledge and attitudes towards the Blue
Lagoon tourism health in implementing health protocols during the transition from the pandemic to the endemic of
COVID-19. This type of research is analytical descriptive research with a cross-sectional approach. The research
instrument used a questionnaire with an accidental sampling technique totalling 30 respondents. Data were
analyzed by univariate and bivariate. The results showed that 29 people (93.5%) had good knowledge of the
respondents with the protocol implementation with a p-value of 0.853. Respondents' attitudes to the protocol
implementation showed a positive category of 28 people (90.3%) with a p-value of 0.790. This study concludes that
there is no significant relationship between knowledge and attitudes in implementing o COVID-19 health protocols.

Keywords: management, knowledge, attitude, COVID-19

ABSTRACT
Kasus terkonfirmasi positif COVID-19 di Kecamatan Ngemplak tahun 2021 sebanyak 2.955 orang dengan jumlah
kasus meninggal sebanyak 98 orang. Indonesia berada pada tahap transisi dari tingkat Pandemi ke tingkat Endemi.
Kebijakan pelonggaran pemakaian masker menimbulkan turunnya perilaku hand hygiene dan kurangnya sarana
sanitasi mengakibatkan meningkatnya faktor risiko penularan COVID-19 di tempat wisata. Penelitian ini bertujuan
untuk mengetahui tingkat pengetahuan dan sikap kesehatan pengelola wisata Blue Lagoon dalam implementasi
protokol kesehatan di masa transisi dari pandemi ke endemi COVID-19. Jenis penelitian ini adalah penelitian
diskriptif analitik dengan pendekatan cross-sectional. Instrumen penelitian menggunakan kuesioner dengan teknik
sampling accidental sampling berjumlah 30 responden. Data dianalisis secara univariat dan bivariat. Hasil penelitian
menunjukkan bahwa pengetahuan responden dengan implementasi protokol menunjukkan kategori baik sebanyak 29
orang (93,5%) dengan nilai p value sebesar 0,853. Sikap responden dengan implementasi protokol menunjukkan
kategori positif sebanyak 28 orang (90,3%) dengan nilai p value sebesar 0,790. Berdasarkan hasil penelitian dapat
disimpulkan bahwa tidak ada hubungan yang signifikan antara pengetahuan dan sikap dengan implementasi protokol
kesehatan COVID-19.

Kata Kunci: manajemen, pengetahuan, sikap, COVID-19

Introduction
Coronavirus disease 19 (COVID-19) is a disease caused by a viral infection of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) and caused a global pandemic (1). Cases of the
coronavirus began to appear and attacked humans for the first time in Wuhan, China. The initial
appearance was suspected of pneumonia, with symptoms similar to the common flu. These symptoms
include coughing, fever, fatigue, shortness of breath, and no appetite. However, unlike influenza, the
coronavirus can develop rapidly, resulting in more severe infections, organ failure, and death. This
emergency condition mainly occurs in patients with pre-existing health problems (2).
COVID-19 transmit through droplets, contact with sufferers, and fomites (3). Clinical symptoms of
COVID-19 infection are fever, dry cough, and fatigue, but evidence has been found that some COVID-19
patients are asymptomatic (4). About 80% of COVID-19 patients recover without requiring special hospital
care. The severity of the disease increases in the elderly and those with co-morbidities such as
hypertension, heart disease, diabetes, cancer, and chronic lung disease. However, anyone can be infected
with COVID-19 and develop into a serious illness (5). Prevention efforts that can be done are washing
hands regularly, wearing masks when leaving the house, maintaining a minimum distance of 1 meter from
other people, applying coughing and sneezing ethics, limiting interaction/contact with other people, and
implementing a clean and healthy lifestyle (PHBS). Implementing during the COVID-19 pandemic is
especially important to reduce the risk of infection (6).
World Health Organization data for 2021 explains that in December 2021, the number of COVID-19
cases was 278,714,484 cases with 5,393,950 deaths. The country with the first highest number of cases is
the United States, with a total of 97,359,631 cases and 1,650,729 deaths (7). Data on confirmed cases of
COVID-19 in Indonesia as of 31 December 2021 totalled 4,262,720 cases, with active cases of 4,292,
recovered cases were 4,114,334, and cases died were 144,094 (8). Meanwhile, in the Special Region of
Yogyakarta, the case positivity rate of COVID-19 in 2021 at 38.3% (9).
The spread of COVID-19 infection in the Special Region of Yogyakarta initially occurred because
residents had contact with sufferers outside the area, and then local transmission spread due to contact
with the initial sufferer or carrier without symptoms. It is exacerbated by the low level of public
awareness regarding the discipline of keeping a distance, continuing to wear masks when travelling and
staying at home, and ignoring self-isolation for residents who are exposed to COVID-19 (10).
The development of COVID-19 in Indonesia is in a transitional stage from the Pandemic to the
Endemic. The COVID-19 endemic period they caused habits or behaviour in the community to also
change compared to during the COVID-19 Pandemic, namely the reduced behaviour of wearing masks,
washing hands, and hand washing facilities.
 Blue Lagoon Tourism is located in Ngemplak District, Sleman, Yogyakarta. COVID-19 data for
Sleman Regency shows that in Ngemplak District, 2,955 cases of COVID-19 were confirmed by PCR,
with 98 deaths and 2,970 recovered cases (11). Blue Lagoon Tourism has just completed construction and
road access with funding from the Ministry of Tourism and Creative Economy. This condition has a
positive impact on the tourism sector. The policy of relaxing the use of masks can increase the number of
visits to these tourist attractions and impact risk factors for disease transmission, including COVID-19.
The causes, symptoms, transmission, and comorbid factors of COVID-19 must be known to the
public to control COVID-19 infection (12). This study aims to determine the level of health knowledge and
attitudes of Blue Lagoon tourism managers in implementing health protocols during the transition from
the pandemic to the endemic of COVID-19.

Method
This type of research is an analytical descriptive research approach cross-sectional which is located
in the Blue Lagoon Padukuhan Dalem, Widodomartani, Ngemplak, Sleman, Yogyakarta. The research
was carried out in September 2022.
The population of this research is the Blue Lagoon tourism management community. The sample
of this research is the Blue Lagoon tourism management community, who agreed to be the research
respondents, as many as 31 people who were determined by accidental sampling technique. The data
collection instrument used was a questionnaire. The results were analyzed univariately using the
frequency distribution method and bivariate using the Chi-square SPSS method at the p-value level <0.05
and 95% confidence level. This research was approved by the Health Research Ethics Commission at the
School of Health Science Wira Husada No 225/KEPK/STIKES-WHY/IX/2022.

Results
The characteristics of the respondents in this study included age group, education level,
occupation, history of COVID-19 disease that had been suffered by both the respondent and the
respondent's family members, and socialization about COVID-19. Based on Table 1, the characteristics of
the respondents based on the highest age group were the late adolescent age group (17-25 years) and late
adulthood (36-45 years), with eight people each (25.8%), while the least age group was in the final
elderly age group (56-65 years) as many as three people (9.7%). The education level of the respondents
obtained results of 24 people (77.4%) with a high school education level and the lowest education level,
namely elementary school, with two people (6.5%). Based on occupation, 11 people (35.5%) work as
farmers/farm labourers, and at least one person (3.2%) has a job as a civil servant. There were two
respondents with a positive history of COVID-19 (6.5%) and a negative history of COVID-19, as many
as 29 people (93.5%). Based on socialization about COVID-19, it was obtained that all respondents, as
many as 31 people (100%), had received socialization about COVID-19. It can significantly affect the
level of knowledge and attitudes of Blue Lagoon tourism managers in implementing health protocols at
these tourist sites.
Founded in Table 2, the results of the description of knowledge with the implementation of the
COVID-19 health protocol, it was found that there were no respondents with low knowledge with poor
implementation and one respondent with good implementation (100%). Respondents with high
knowledge with poor implementation were one person (3.3%), and respondents with good
implementation were 29 people (96.7%). Chi-square test results are p-value 0.853 (>0.05). Based on
Table 3 description of attitudes towards the implementation of the COVID-19 health protocol, it is known
that there were no respondents with a negative attitude with poor implementation and two respondents
with good implementation (100%). While respondents with a positive attitude with bad implementation
were one person (3.4%), and respondents with good implementation were 28 people (96.6%). Chi-square
test results are p-value 0,790 (>0,05).
Table 1. Characteristics of Respondents
Variables Frequency Percentage

Education
Elementary School 2 6.5
Junior High School 5 16.1
Senior High School 24 77.4
Amount 31 100.0

Occupation
Civil Servant 1 3.2
Private Employee 4 12.9
Self-Employed 8 25.8
Farmer 11 35.5
Other 7 22.6
Amount 31 100.0

History of COVID-19
Positive 2 6.5
Negative 29 93.5
Amount 31 100.0

Outreach about COVID-19

 Yes 31 100.0
No 0 0.0

Table 2. The Association between Knowledge and Implementation of the COVID-19 Health
Protocol
Implementation of the COVID-19 Health
Protocol
Bad Good Total
Knowledge p-value
N % N % N %
Low 0.0 0.0 1.0 100.0 1.0 100
High 1.0 3.3 29.0 96.7 30.0 100 0,853
Amount 1.0 3.2 30.0 93.0 31.0 100

Table 3. The Association between Attitudes and Implementation of the COVID-19 Health
Protocol
Implementation of the COVID-19 Health
Protocol
Bad Good Total
Attitude p-value
N % N % N %
Negative 0.0 0.0 2.0 100.0 2.0 100
Positive 1.0 3.4 28.0 96.6 29.0 100 0,790
Amount 1.0 3.2 30.0 93.0 31.0 100

Discussion
The results showed that most of the respondents were in the late adolescent age group (17-25 years)
and late adulthood (36-45 years), with eight people each (25.8%). This study's results align with Mariska
and Yusria's research in 2022 that the 26-45 year old group mostly has good knowledge (13). The results of
this study are also in line with Yangzom et al., 2022 and Al-Hanawi et al. 2020 show that the adult age
group has good knowledge and behaviour compared to the younger age group (14,15). Age affects one's
mindset and behaviour in receiving instructions and being more responsible.
Most respondents have a high school education level totalling 24 people (77.4%). The results of this
study are by Mariska and Yusria's research in 2022 which shows that respondents are dominated by high
school education. Based on Hatami et al., 2021 it was found that the high school-educated group had
sufficient knowledge about the causes of COVID-19 infection, transmission and self-isolation (16). It is
supported by the ease of knowledge of COVID-19 through access to information media such as television
and social media (13). A sufficient level of knowledge is expected to have more obedient behaviour
towards regulations (17).
Most of the respondents worked as farmers/labourers, 11 people (35.5%). It can be seen that in the tourist
area of the Blue Lagoon, Widodomartani Hamlet is still dominated by rice fields. All professions can
access access to information about COVID-19. Information can be easily accessed through family,
friends, health workers, print media and information media (18).
According to Notoatmodjo in 2018, knowledge is individual curiosity about objects through the
senses they have (19). Knowledge is related to compliance because knowledge is a very important domain
for forming behaviour (20). Knowledge gained by the community about wearing masks, keeping a distance
and washing hands will affect the behaviour of implementing health protocol compliance (21). The study
found that most Blue Lagoon tourism management communities knew about implementing the COVID-
19 health protocol. This result was in line with Mukhlis et al., 2020 and Nopitasari et al., 2022 that public
knowledge about the COVID-19 pandemic is in a good category and the community has complied with
health protocols during the COVID-19 pandemic (22,23). However, the statistical test results showed no
significant relationship between knowledge and implementation of the COVID-19 health protocol. These
results align with Christine and Agustiany, 2021 (24).
The study results found that the Blue Lagoon tourism management community dominantly owned
a positive attitude towards implementing the COVID-19 health protocol. Attitudes are feelings and beliefs
about certain people, objects, events or ideas that result in a tendency to act (25). A positive attitude is
based on good knowledge (26). A positive attitude in implementing the COVID-19 health protocol results
from good public knowledge about COVID-19. Government policies regarding the prevention and control
of COVID-19 in the community are one of the things that shape people's positive attitudes (27). The results
of research by Azlan et al., 2020 in Malaysia showed similar results; most respondents had good
knowledge, attitudes and behaviour towards COVID-19 (28). However, the statistical test results show no
relationship between attitude and implementation of the COVID-19 health protocol. This study's results
align with Putri and Nurwiyono, 2022 and Albina et al.,2022, which showed no relationship between
attitudes and implementing the COVID-19 health protocol (29,30).
The government has conducted various efforts to provide health information related to the COVID-
19 pandemic through the Ministry of Health. Health promotion activities (promote) are carried out
through socialization, education, and the use of various information media to provide understanding and
understanding for everyone, as well as exemplary leadership, community leaders, and mainstream media
.
(31)
Conclusion
The conclusion of this study is that there is no significant relationship between knowledge and
implementation of health protocols and there is no significant relationship between attitude and
implementation of health protocols.

Acknowledgement
The author would like to blue lagoon tourism manager for allowing this research to be carried out.

Funding
This study was funded by School of Health Science Wira Husada.

Conflict of Interest
The authors declare that they have no conflict of interest.

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