Role of knowledge, attitude, and practice behaviors in preventing COVID-19 infection and transmission  in  the  early phase of the pandemic among airport taxi drivers in Thailand: A structural equation modeling approach

<ns3:p> Background Coronavirus disease 2019 (COVID-19) is primarily transmitted through respiratory droplets during close contact with infected persons. Taxi drivers are especially vulnerable to exposure due to the nature of their occupation. This study examines airport taxi drivers’ knowledge, attitude, and practices (KAP) regarding COVID-19 prevention and identifies the causal relationships among these factors. Methods A convenient sample of 445 airport taxi drivers from two major international airports in Thailand was recruited in 2020 using an online questionnaire. Data on demographic and occupational characteristics, information access, and KAP for COVID-19 prevention were analyzed using descriptive statistics. Structural equation modeling (SEM) was applied to assess direct and indirect associations among variables. Results The majority of participants (98.6%) were middle-aged men (mean age 52.53 years; standard deviation 8.4). Most taxi drivers demonstrated a moderate level of knowledge (40.68%), attitude (42.7%), and practice (42.24%) toward COVID-19 prevention and control. Finally, the SEM model demonstrated good fit indices. Information access had a significant positive direct effect on knowledge (β = 0.315, <ns3:italic>p</ns3:italic> < 0.001) and an indirect effect on attitude (β = 0.105, <ns3:italic>p</ns3:italic> < 0.001). Knowledge had a significant positive direct effect on attitude (β = 0.259, <ns3:italic>p</ns3:italic> < 0.001) and both direct and indirect effects on practice (β = 0.313, <ns3:italic>p</ns3:italic> < 0.001). Attitude also had a significant direct effect on practice (β = 0.282, <ns3:italic>p</ns3:italic> < 0.001). Conclusion During pandemics, the continuous and consistent public dissemination of accurate information is critical. Tailored, accessible, and comprehensible media targeting high-risk groups such as taxi drivers should be prioritized. Dissemination through multiple channels can strengthen knowledge acquisition and promote preventive practices. </ns3:p>