Background Coronavirus disease 19 (COVID-19) is an emerging contagious respiratory infection that brings a big puzzle to global health. In Ethiopia, the number of cases and related deaths are increasing exponentially. Prevention is currently available effective management, and its implementation has not been assessed adequately.Objective To assess the COVID-19 prevention practices in three zones of Southwest Ethiopia.Methods A community-based cross-sectional study was conducted in the Bench

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... o, Kafa, and West Omo zones. A multistage sampling technique was employed to select 845 study participants. The data collection tool was adapted from the WHO resources and related literature. SPSS version 20 was used to analyze the data. Participants who scored at least a mean score of practice questions were categorized as having good practice. Binary logistic regression was fitted to identify factors associated with the practice.Results In this study, 803 participants participated. About two-thirds (64.7%) of the respondents had a history of going to crowded places, while only 30.3% of the participants had a history of wearing a mask when leaving home. Two-thirds of the respondents had a history of maintaining their distance at 2 meters (64.4%) and washing their hands with soap and water or using alcohol-based hand sanitizers (64.8%). Generally, less than two-thirds (59.4%) of study participants had a good practice of COVID-19 prevention methods. Urban residence, good knowledge, positive attitude, intention to seek care, and perceived mortality were positively associated with good practice.Conclusion The proportion of individuals who had good COVID-19 prevention practices was inadequate. For such highly infectious diseases, prevention should be the priority intervention, and improving its implementation needs further effort. Community-based interventions such as risk communication and mass education should center on scaling up community knowledge and practice by prioritizing vulnerable groups such as rural residents.