Knowledge and Attitude of Market Traders in Using Masks as Personal Protective Equipment during the Covid-19 Pandemic

: Knowledge and attitudes towards health problems are factors related to health behavior. During the pandemic, the use of personal protective equipment is very important to prevent the occurrence of covid-19, for market traders, who must interact directly with buyers. The purpose of the study was to determine the relationship between knowledge and attitudes of traders towards the use of masks during the Covid-19 pandemic in the Leuwi Panjang market area. The method used is quantitative research with a cross sectional approach, data obtained from 75 respondents by random sampling using questionnaires and observations sheets. The results of this study indicate that 30 (40.0%). The results of chi square test obtained a p-value of 0.005 > 0.05, which means that there is a relationship between the knowledge of traders on the use of masks and the attitude of traders towards the use of masks, a p-value of 0.01 > 0.05, which means that there is a relationship. There is a relationship between knowledge and attitudes of traders towards the use of masks. The suggestion from this research is to collaborate with the Covid-19 task force and this research provides new knowledge for traders regarding the relationship between knowledge and attitudes of traders towards the use of masks as a personal protective equipment.


INTRODUCTION
The occurrence of Covid-19 is a public health problem today and also the world that is considered disturbing (1). On March 11, 2020, Covid-19 declared as a pandemic. Covid-19 transmitted from an infected person to others in the vicinity through coughing droplets. Based on data on the development of Covid-19 cases in early 2021, it was increasing. On April 14, 2021, Covid-19 cases in the world reached 137,060,867 people who were confirmed positive, who died as many as 2,952,671 people, while the number of cases of Covid-19 in Indonesia was confirmed positive for 1,583,182 people, confirmed recovered as many as 1,431,892. and the number who died (2). Data from the one-stop Covid-19 communication and information center in West Java, the number of cases of Covid-19 cases in West Java confirmed with 263,072 cases who recovered, 231,337 while those who died were 3,432. The number of Covid-19 spread on May 5, 2021, confirmed active as many as 824 people, confirmed recovered 16,590, and confirmed death as many as 300 people (3).
The market is a place that is prone to Covid-19 transmission. Most market conditions are dirty and allow germs to breed. The market is a meeting place for many people with various types so that in the early days of the spread of the covid-19 virus, many markets closed because traders experienced Covid-19. The awareness of traders and buyers in the market is still lacking, especially during the pandemic. Most shoppers are not used to buying raw groceries online, so they force themselves to keep shopping at the market. Meanwhile, the awareness of buyers and traders in the use of masks is still very less concerned, especially in the early days of the Covid-19 pandemic (4).
The use of masks is a health behavior that is influenced by knowledge, motivation, and family support (5). Research on 86 traditional traders at Pasar Kebon Semai Sekip showed that the health status of traditional traders consisted of 3 people under surveillance, 3 confirmed cases, and 80 healthy traders. Market traders are among those at risk of contracting Covid-19 (Octaviarni, Salim, & Anggina, 2021). The results of another study conducted in Yogyakarta showed that there was a relationship between the age and education of market traders in Kota Gede and the behavior of the Covid-19 health protocol (6).
From the results of observations when conducting a preliminary study, the respondents observed were 11 people, there were 7 people who did not wear masks on the grounds of being uncomfortable, congested, and difficult to interact with other traders and buyers. The other 4 respondents wore masks on the grounds that the Covid-19 pandemic was still ongoing, coupled with a report on the Leuwi Panjang market program, to be precise, on June 11, 2020, there were 2 positive Covid-19 traders. Based on the results of the report, it was felt that it was necessary to conduct research on market traders at Leuwi Panjang Market to determine the relationship between knowledge and attitudes of traders towards the use of masks during the Covid-19 pandemic in the Leuwi Panjang Market area, Bandung City.

RESEARCH METHODS
A quantitative research design with a cross-sectional approach used in this study. Knowledge and attitudes of traders in the use of masks are independent variables, and the dependent variable is the use of masks by market traders. The population in this study were traders who were in the Pasar Leuwi Panjang area amounting to 300 and the number of samples calculated using the Slovin formula, obtained a total sample of 75 respondents who met the inclusion criteria, namely willing to participate in the study by filling out informed consent. Samples randomly using a simple random sampling technique. Sampling was drawn from list of names of traders. The instrument used was a valid and reliable knowledge and attitude questionnaire, and an observation sheet to determine the use of masks by market traders. Observations were made within 5 days of observation to determine the use of masks at market traders. The category does not wear a mask, a score of 1, a score of 2 if the mask covers the mouth and nose, and a score of 3 for the mask covering the nose, mouth, and chin properly. The usage category becomes 3, namely a score of 5 = Less, 6-10 = Enough, and 11-15 = Good. The research location is in the Leuwi Panjang Market area in July 2021. Data analysis uses the Chi Square test to determine the relationship between the independent and dependent variables.  Table 1 shows that most of the respondents aged 31 to 35 years were 23 respondents (30.7%), almost all of the respondents were male, namely 42 respondents (56%), and the last education of respondents was mostly junior high school graduates amounting to 37 respondents (49.3 %). Some respondents have sufficient knowledge of 30 people (40.0%). Most of the respondents had a supportive attitude as many as 47 people (62.7%), and the overall use of masks from day 1 to day 5 some respondents had less than 30 people (40.0%).

RESULT AND DISCUSSION
The observations showed that some of respondents did not wear masks as many as 58 (77.3%). On second day, most respondents did not wear masks as many as 54 (72.0%), day 3 most of the respondents did not wear masks as many as 51 (68.0%), day 4 some respondents did not wear masks as much as 48 (64.0%), and on day 5 some respondents did not wear masks as much as 41 (54.7%). The relationship between the independent and dependent variables is shown in Table 2, which explains the relationship between knowledge, attitudes and wearing masks at market traders at Leuwi Panjang Market, Bandung City.  Table 2 shows the relationship between knowledge and attitude variables with the use of masks. As many as 23 respondents were included in the category of lack of knowledge, it turned out that 56.5% also had the category of wearing less masks, while respondents with the category of unsupportive attitude were 28 people, it turned out that 50.0% were also included in the category of wearing masks less. The proportion of respondents using masks in the good category, the highest is good knowledge (50.0%), then sufficient (13.3%0 and less (7.1%).The proportion of respondents who use masks in the good category, as many as 22, 7% have a supportive attitude, while respondents with a non-supportive attitude are not included in the use of masks in the good category.
The results of statistical tests using the Chi Square test showed that the p-value for the relationship between knowledge and the use of masks was 0.005, and the relationship between attitudes and wearing masks was 0.001. Both p-values are smaller than the alpha values (5%), so it can be concluded, that there is a relationship between knowledge and attitudes with the use of masks by market traders in Leuwi Panjang, Bandung City.

The relationship between knowledge and the use of masks
The results showed that there was a relationship between the knowledge of market traders and the use of masks at a significance level of 5%. Health behavior based on knowledge usually lasts longer and becomes a culture compared to behavior that have not developed by knowledge. The results of this study are in line with previous studies. Research conducted on traditional market traders in Kebon Semai Sekip on the knowledge, attitudes and behavior of occupational safety and health in the Covid-19 era, it was found that there were still many unfavorable behavior of traders, in fact there were 3 people who were confirmed positive for Covid-19 (7). Research on market traders in Kota Gede Yogyakarta obtained the same results as this study that there is a relationship between knowledge and Covid-19 prevention behavior. One of the efforts to prevent the Covid-19 disease is to use a mask when interacting with other people, and maintain a distance and use a good hand sanitizer (8).
The results of research on fish traders regarding efforts to prevent Covid-19 transmission at the Kasih Market, Kupang City, showed that the level of knowledge was good at 77.1%, but continuous education efforts were still needed to discipline the community in implementing health protocols to reduce the risk of Covid -19 transmission (9). The results of this study indicate that even good knowledge still need education. They should be had education to strengthen health behavior. Research on Ploso market Research also suggests the need for massive socialization to be able to change the behavior of market traders who have not complied (10). The results of research with different conclusions found in research conducted on market traders in the City of Pare-Pare. The results showed that knowledge was not related to the compliance of traders in the use of masks, so it was necessary to socialize and supervise the use of masks to traders (11). In line with behavior, so there needs to be supervision from supervisors or from other authorized persons. From the results of the study, it found that knowledge related to the use of masks by traders, and education and socialization efforts and supervision still needed in the implementation of health protocols, especially in the use of masks. There needs to be a reward and punishment in the implementation of monitoring the use of masks at market traders.

The relationship between attitude and the use of masks
The results showed that there was a relationship between attitudes and the use of masks at market traders in Leuwi Panjang, Bandung City. The attitude that does not support the use of masks actually causes traders not to use masks. The use of masks can indeed be a burden for the wearer because it considered disturbing in communicating. Moreover, market traders who require transactions with buyers, if masks are used, it will hinder communication. The results of this study are in line with research conducted in several traders, including at Kota Gede market traders, Yogyakarta, which states that there is a relationship between attitudes and the implementation of health protocols. A good attitude will cause traders' behavior in implementing health protocols to be good too (8).
Similarly, research conducted on MSME traders in the Kutoarjo Purworejo square. The results show that there is a relationship between attitudes and the level of compliance of market traders in using masks (12). In addition, research conducted on traders in Kebon Semai Sekip also showed that there was a relationship between attitudes and the safety and health behavior of traders in the era of the Covid-19 pandemic. The results showed that attitudes that do not related to health behavior in wearing masks were not good. Knowledge and good attitude will cause someone to behave well. However, in the behavior of using masks, many factors taken into consideration, namely the existence of other studies that are not in line with this study, namely research conducted on traders in the City of Pare-Pare. Knowledge and attitudes shown to be unrelated to the use of masks in the prevention of Covid-19. Good knowledge and good attitude did not determine preventive behavior in the study (11).
Masks are one of the personal protective equipment used to prevent the spread of Covid-19. The use of masks makes the wearer uncomfortable, especially if they used continuously. Masks considered as an obstacle on breathing and communicating between traders and buyers, so that although knowledge and attitudes towards Covid-19 are included in the good category, there are comfort factors and communication needs between traders and buyers that make market traders disobedient in using masks. Therefore, it is necessary to carry out supervision from market officers. In the market, the Covid-19 task force needed to provide warnings and supervision in the implementation of the use of masks. The warned and reminded to use masks as a personal protective equipment especially for traders and buyers who come in to the market to buy some things. People are reluctant to use masks for reasons of convenience. Many stated that they were uncomfortable using a mask at work, for reasons of being reluctant, stuffy and unable to breathe properly when wearing a mask (13).
Follow up by providing education to buyers and trader needed as the result of the research. Not only buyers and traders, but also every people who come in to the market. They have to use masks properly and have not implemented health protocols. Increasing public awareness in healthy behavior and implementing health protocols can help control Covid-19 so that it ends soon.

CONCLUSION
Based on the data analysis and the previous discussion, the conclusions that drawn from this study are: the knowledge of traders on the use of masks shows that some respondents have sufficient knowledge with a sufficient category of 30 people (40.0%). The attitude of traders towards the use of masks during the Covid-19 pandemic in the Leuwi Panjang Market area, most of the respondents had a supportive attitude as many as 47 people (62.7%). The use of masks from the results of observations made in 5 days obtained results of 40% in the less category. There is a relationship between knowledge of the use of masks during the covid-19 pandemic in the Leuwi Panjang Market area with a p-value of 0.005 and there is a relationship between attitudes towards the use of masks during the covid-19 pandemic in the Leuwi Panjang Market area with a p-value of 0.001.