Introduction: Currently after its existence, the number of patients infected and its complication is increasing. However, safety measures are not implemented well in all parts of the country. Understanding how people perceive the risk of COVID-19 outbreak and its impact on undertaking protective behavior can guide the public health policymakers in taking the required measures more. The aim of this study is to assess the knowledge, risk perceptions, and uptake of preventive measures towards COVID-19 in East Gojjam zone.

Methods: A mixed method study in four randomly selected district of East Gojjam Zone. We had used pretested data collection tool from non-study district and data quality was assured. Binary logistic regression analysis was conducted to analyze quantitative data, and while content analysis was used for qualitative component.

Results: In this study, a total of 661 study participants were included. Two-third (65.5%) of respondents is rural area residence. Three-fifth (66%) of respondents had better knowledge, 14.5% of individuals had favorable attitude and 20.9% of study participants had good preventive practices. Nearly one third (30%) of individuals believed that COVID-19 comes for sinners and wearing mask in crowded area where as 41% of them maintain physical distancing. Factors associated with better knowledge towards COVID-19 are urban residence (AOR: 0.1, 95%CI: 0.08, 0.2), age 35-45 years (AOR: 0.4, 95%CI: 0.2, 0.8), and having secondary and above education level (AOR: 0.2, 95%CI: 0.1, 0.5). On the other hand study participants who had comorbidity (AOR: 0.3; 95% CI: 0.1, 0.6), better knowledge (AOR: 3.0, 95%CI: 1.7, 5.5), and urban residence are associated with better attitude. Urban residence (AOR: 0.2, 95% CI: 0.1, 0.3) had good preventive practice towards COVID-19. Information and communication weaknesses, social barriers and information overload, and lack of trusted sources are some of the challenges on COVID-19 prevention.

Conclusion and recommendation: In this study, attitude and preventive practice towards COVID-19 is too low below one fourth. Rural residence, younger age group and those not having formal education are significantly associated with KAP that betterment on attitude change and preventive practice should be enhanced and continued.

Keywords: knowledge, attitude, practice, COVID-19, risk perception