Keywords
Coronavirus, COVID-19, preventive behavior, Health Belief Model
Abstract
Background: In the absence of effective treatment and successful vaccines, the COVID-19 pandemic has become a grave threat to public health. The present study aimed to investigate health beliefs and sample characteristics associated with COVID-19 preventive health behaviors among an Iranian sample. Methods: This is a cross-sectional study, using a multi-stage randomized sampling method. Participants (N = 250 males and 236 females) were recruited from health centers in a major Iranian city. Self-administered questionnaires included sociodemographic information, health behaviors, and constructs associated with the Health Beliefs Model (HBM). Data were analyzed using independent t-tests, analysis of variance, and multiple regression with significance level set at α ≤ 0.05. Results: Perceived disease susceptibility (β=0.44, P<0.001), self-efficacy to enact preventative behaviors (β=0.24, P<0.01), education (β=0.20, P<0.001), non-smoking status (β=0.14, P<0.01), marital status (β=0.10, P<0.03), and perceived barriers to disease preventative behaviors (β=-0.10, P<0.04) were important predictors of prevention practices for COVID-19, and accounted for 61.4% (adjusted R2) of the variance associated with preventive behavior for COVID-19. Conclusion: As there is accepted therapy for COVID-19, it is especially important to control COVID-19 through behavior change. Results indicate that two behavioral constructs that have the most impact on prevention are perceived disease susceptibility and self-efficacy. Therefore, public health initiatives are needed to enhance perceived susceptibility to the disease and improve self-efficacy to perform preventative behaviors in spite of perceived barriers.References
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[3] Geldsetzer, P., Use of rapid online surveys to assess People's perceptions during infectious disease outbreaks: a cross-sectional survey on COVID-19. Journal of medical Internet research, 2020. 22(4): p. e18790.
[4] Guan, W.-j., et al., Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine, 2020.
[5] Huang, C., et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 2020. 395(10223): p. 497-506.
[6] Yoo, J.-H., The fight against the 2019-nCoV outbreak: an arduous March has just begun. Journal of Korean Medical Science, 2019. 35(4).
[7] Peng, L., et al., Epidemic analysis of COVID-19 in China by dynamical modeling. arXiv preprint arXiv:2002.06563, 2020.
[8] Lipsitch, M., D.L. Swerdlow, and L. Finelli, Defining the epidemiology of Covid-19—studies needed. New England Journal of Medicine, 2020.
[9] Rothan, H.A. and S.N. Byrareddy, The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity, 2020: p. 102433.
[10] Wang, X., X. Zhang, and J. He, Challenges to the system of reserve medical supplies for public health emergencies: reflections on the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in China. BioScience Trends, 2020.
[11] Alsahafi, A.J. and A.C. Cheng, Knowledge, attitudes and behaviours of healthcare workers in the Kingdom of Saudi Arabia to MERS coronavirus and other emerging infectious diseases. International journal of environmental research and public health, 2016. 13(12): p. 1214.
[12] Alfahan, A., et al., In the era of corona virus: health care professionals’ knowledge, attitudes, and practice of hand hygiene in Saudi primary care centers: a cross-sectional study. Journal of community hospital internal medicine perspectives, 2016. 6(4): p. 32151.
[13] Karimy, M., et al., Does the theory-driven program affect the risky behavior of drug injecting users in a healthy city? A quasi-experimental study. Medical journal of the Islamic Republic of Iran, 2016. 30: p. 314.
[14] Taher, M. and Z.S. Bayat, Correlation between compliance regimens with health locus of control in patients with hypertension. Medical journal of the Islamic Republic of Iran, 2015. 29: p. 194.
[15] Karimy, M., H. Azarpira, and M. Araban, Using health belief model constructs to examine differences in adherence to Pap test recommendations among Iranian women. Asian Pacific journal of cancer prevention: APJCP, 2017. 18(5): p. 1389.
[16] Rosenstock, I.M., V.J. Strecher, and M.H. Becker, Social learning theory and the health belief model. Health education quarterly, 1988. 15(2): p. 175-183.
[17] Elgzar, W.T., et al., COVID-19 Outbreak: Effect of an Educational Intervention Based on Health Belief Model on Nursing Students' Awareness and Health Beliefs at Najran University, Kingdom of Saudi Arabia. African Journal of Reproductive Health, 2020. 24(2): p. 78-86.
[18] Carpenter, C.J., A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health communication, 2010. 25(8): p. 661-669.
[19] Vijaya, K., et al., Public knowledge, attitude, behaviour and response to the SARS outbreak in Singapore. International Journal of Health Promotion and Education, 2004. 42(3): p. 78-82.
[20] Kwok, K.O., et al., Community responses during the early phase of the COVID-19 epidemic in Hong Kong: risk perception, information exposure and preventive measures. MedRxiv, 2020.
[21] Lin, Y., et al., Influence of mass and social media on psychobehavioral responses among medical students during the downward trend of COVID-19 in Fujian, China: Cross-Sectional study. Journal of Medical Internet Research, 2020. 22(7): p. e19982.
[22] Mukhtar, S., Mental health and emotional impact of COVID-19: applying health belief model for medical staff to general public of Pakistan. Brain, Behavior, and Immunity, 2020.
[23] Araban, M., K. Baharzadeh, and M. Karimy, Nutrition modification aimed at enhancing dietary iron and folic acid intake: an application of health belief model in practice. European journal of public health, 2017. 27(2): p. 287-292..
[24] Lee, M. and M. You, Psychological and behavioral responses in South Korea during the early stages of coronavirus disease 2019 (COVID-19). International Journal of Environmental Research and Public Health, 2020. 17(9): p. 2977.
[25] Call, C.C., et al., Perceived barriers to physical activity during and after a behavioural weight loss programme. Obesity Science & Practice, 2020. 6(1): p. 10-18.
[26] Nowak, B., et al., Adaptive and maladaptive behavior during the COVID-19 pandemic: The roles of Dark Triad traits, collective narcissism, and health beliefs. Personality and Individual Differences, 2020. 167: p. 110232.
[27] Zhong, B.-L., et al., Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey. International journal of biological sciences, 2020. 16(10): p. 1745.
[28] Gyekye, S.A. and S. Salminen, Educational status and organizational safety climate: Does educational attainment influence workers’ perceptions of workplace safety? Safety science, 2009. 47(1): p. 20-28.
[29] Lippi, G. and B.M. Henry, Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). European journal of internal medicine, 2020.