Assessing COVID-19 preventive behaviours using the health belief model: A Sri Lankan study

Determinants of preventive behavior against Covid-19 in secondary school students based on Health Belief Model (HBM): a structural equations modeling (SEM)

Measures such as education, improving knowledge, attitude and taking preventive action to protect against COVID-19 are vital strategies for prevention. The aim of this study was to determine the predictability of Health Belief Model (HBM) constructs in performing preventive behaviors against COVID-19 among secondary school students in Chabahar, Iran. In this cross-sectional-analytical study, 400 secondary school students of Chabahar city were investigated by simple random sampling. The data collection tool was a questionnaire including demographic characteristics, knowledge, behavior, and Health Belief Model constructs' questions. Exploratory Factor Analysis (EFA) was used to evaluate the validity of HBM constructs, and the structural equation modeling (SEM) method was used to evaluate the direct and indirect effects of the relationship between knowledge, HBM constructs, and preventive behavior against COVID-19 based on the conceptual model. Based on the results of the structural modeling, the direct effect of knowledge on the constructs of the health belief model was positive and significant (β = 0.34, P-value < 0.001), and on the preventive behavior of students was insignificant (β = 0.12, P-value = 0.07) while the indirect effect of knowledge through increasing the constructs of the HBM on student behavior was positive and significant (β = 0.30, P < 0.001). The relationship between the constructs of the HBM constructs and student behavior was also positive and significant (β = 0.89, P-value < 0.001).Due to the fact that knowledge and HBM structures played a role in predicting the adoption of preventive behavior from COVID-19, it is possible to design appropriate interventions to increase knowledge, sensitivity, perceived severity, and self-efficacy, in order to recover from COVID-19 by adopting preventive behaviors.

Psychological well-being of healthcare workers during COVID-19: Relationship with risk perception and fear in the context of health belief model

This study aimed to evaluate the extent of fear and risk perception related to COVID-19 and their impact on the psychological well-being of healthcare workers. Data were gathered through an online survey, incorporating questions about risk perception utilizing the health belief model, the Fear of COVID-19 Scale, and the General Health Questionnaire-12. A total of 364 HCWs participated in the survey, with 94% of participants identified as being in the high-risk category for mental disorders based on their General Health Questionnaire scores. The assessment of COVID-19-related risk perception within the Health Belief Model demonstrated significant correlations between perceived susceptibility, perceived severity, perceived barriers, and self-efficacy with both the fear scale and General Health Questionnaire scores. Linear regression was employed to identify factors influencing General Health Questionnaire scores, revealing that risk perception, Fear of COVID-19 scores, marital status, and perceived health were significantly associated with General Health Questionnaire scores. These findings underscore the importance of monitoring the psychological well-being of healthcare workers throughout all stages of pandemic preparedness and response.

The Influence of COVID-19 Pandemic on the Health Seeking Behaviors of Adults Living With Chronic Conditions: A View Through the Health Belief Model

The COVID-19 pandemic resulted in disruption in every facet of life including health service delivery. This has threatened the attainment of global targets to improve health and wellbeing of all persons. In particular, for persons living with chronic diseases, who require consistent monitoring by health professionals and medication to enhance their health, understanding how the pandemic has disruption their access to health care delivery is critical for interventions aimed at improving health service delivery for all as well as preparedness for future pandemic. This study applied the constructs of the Health Belief Model, to explore the influences of the COVID-19 pandemic on the health seeking behaviors of persons living with chronic diseases. The design was exploratory descriptive. Semi-structured interviews were conducted to collect data among persons living with chronic diseases in the Cape Coast Metropolis of Ghana. Thematic analysis, both inductive and deductive, was conducted to unearth the findings. Awareness of increased susceptibility and risk of a more severe episode if they contracted COVID-19 as a result of the existing chronic diseases was identified. Lack of access to health professionals during the peak of the pandemic as well as the fear of contracting the virus while accessing their regular chronic disease clinic was the main barriers identified. Information in the media served as cues to action for adopting preventive health strategies. Behavior modifications; dietary and lifestyle, self-medication and adoption of COVID-19 related precautions were practiced. Susceptibility to contracting COVID-19 contributed to missed adherence to treatment appointment. The health belief model was a useful framework in exploring the health seeking behavior of the adults living with chronic conditions during the COVID-19 in this study setting. Intensifying targeted education for persons living with chronic diseases will contribute to the adoption of positive health seeking behaviors during future pandemic.

Application of behavioral change theory and models on COVID-19 preventive behaviors, worldwide: A systematic review

Objective:

This systematic review aimed to assess the global application of behavioral change theory and models on COVID-19 preventive behaviors.

Methods:

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Databases such as PubMed/MIDLINE, Web of Science, Scopus, EMB ASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of application of behavioral change theory and model on COVID-19 preventive behavior until October 1, 2022. Studies published in another language other than English were excluded. Two independent reviewers did the article selection and quality check. A third reviewer asked if any disagreement were found.

Result:

Seventeen thousand four hundred thirty-six total articles were retrieved from all sources after the removal of duplicated articles and those not evaluating the outcome of interest were excluded. Finally, 82 articles done using behavioral change theory and model on COVID-19 preventive behaviors were included. The health belief model (HBM) and theory of planned behavior (TPB) were most commonly used in COVID-19 preventive behaviors. The constructs of most behavioral theories and models were significantly associated with COVID-19 preventive behaviors such as hand washing, face mask use, vaccine uptake, social isolation, self-quarantine, social distance, and use of sanitizers.

Conclusion:

This systematic review summarizes comprehensive evidence on the application of behavioral change theory and model on COVID-19 preventive behaviors globally. A total of seven behavioral change theories and models were included. The HBM and TPBs were most commonly used for COVID-19 preventive behaviors. Therefore, the application of behavioral change theory and models is recommended for developing behavioral change interventional strategies.

Cognitive and Emotional Motivation to Explain Infection-Prevention Behaviors with Social Support as a Mediator During the COVID-19 Pandemic: A Nationwide Cross-Sectional Study in Korea

Purpose

To predict the performance of infection-prevention behaviors among adults in Korea based on the health belief model, using social support as a mediator.

Patients and Methods

A nationwide cross-sectional survey of 700 participants from the local community was conducted using both online and offline methods from 8 metropolitan cities and 9 provinces in Korea from November 2021 to March 2022. The questionnaire was composed of 4 sections: demographic information, motivational factors for behavior change, social support, and infection-prevention behaviors. Data were analyzed using structural equation modeling with the AMOS program. The general least-squares method was applied to assess the fit of the model and the bootstrapping method was tested for indirect effect and the total effect.

Results

Motivation factors that directly affected infection-prevention behaviors were self-efficacy (γ=0.58, p<0.001), perceived barriers (γ=-.08, p=0.004), perceived benefits (γ=0.10, p=0.002), perceived threats (γ=0.08, p=0.009), and social support (γ=0.13, p<0.001), after controlling for related demographic variables. Cognitive and emotional motivation factors together explained 59% of the variance in infection-prevention behaviors. Social support exerted significant mediating effects between each cognitive and emotional motivation variable and infection-prevention behaviors, along with a significant direct effect on infection-prevention behaviors (γ=0.12, p<0.001).

Conclusion

The engagement of prevention behaviors among community-dwelling adults was influenced by their self-efficacy, perceived barriers, perceived benefits, and perceived threats with social support as a mediator. Prevention policy approaches could include providing specific information to improve self-efficacy and build awareness of the severity of the disease while establishing a supportive social environment for promoting health behaviors during the COVID-19 pandemic.

Health Literacy, Misinformation, Self-Perceived Risk and Fear, and Preventive Measures Related to COVID-19 in Spanish University Students

The "infodemic" is one of the main obstacles in the fight against the COVID-19 pandemic. In order to face it, health literacy (HL) is essential since it allows for knowledge about COVID-19 and the practice of preventive measures to be fostered. This is especially relevant in university students due to their idiosyncrasy. This study aims to evaluate the level of HL related to COVID-19 (HLC), risk perception, misinformation, and the attitudes and behaviors adopted to prevent the spread of coronavirus in Spanish university students. An online questionnaire was administered to 499 Spanish university students. The HLC index presented a mean of 33.89 out of 50; a total of 63.8% had an inadequate level of HLC. They practiced a mean of 7.54 out of 9 preventive behaviors, and the mean knowledge score was 10.40 out of 13. The HLC showed significantly different scores for the degree, the practice of preventive measures, and some sources of information. The level of HL correlates with the adoption of preventive measures. The higher the severity and perceived susceptibility, the more preventive measures are taken by the students. Therefore, there is a need to strengthen the HL skills of university students and address the dissemination of misinformation. Although caution should be taken when generalizing these results due to the limitations inherent within a cross-sectional study and the convenience sampling, our results can guide the establishment of health education strategies and policies for the management of the infodemic in pandemic situations, according to this target population.

The health belief model's ability to predict COVID-19 preventive behavior: A systematic review

Objective

The health belief model specifies that individuals' perceptions about particular behavior can predict the performance of respective behavior. So far, the model has been used to explain why people did not follow COVID-19 preventive behavior. Although we are using it, to our best knowledge, its predictive ability in COVID-19 preventive behavior is unexplored. So, this review aimed to assess the model's predictive ability and identify the most frequently related construct.

Method

A systematic review was conducted to examine the predictive ability of health belief model in COVID-19 preventive behavior using research done all over the world. Preferred reporting items for systematic review and meta-analysis guidelines were used. Comprehensive literature was searched using databases such as PubMed, Google scholar, and African Online Journal to retrieve related articles. Descriptive analyses such as the proportion of studies that better explained COVID-19 prevention behavior and the significance ratio of each construct of the model were made.

Result

Overall, 1552 articles were retrieved using a search strategy and finally 32 articles fulfilling the inclusion criteria undergo the review. We found that in the majority (87.5%) of the studies health belief model has a good predictive ability of COVID-19-related behavior. Overall the explained variance for health belief model ranged from 6.5% to 90.1%. The perceived benefit was the most frequently significant predictor; highest significance ratio (96.7%) followed by self-efficacy, cues to action perceived barrier, susceptibility, and severity in decreasing order.

Conclusion

Health belief model has a good predictive ability of COVID-19-related behavior in the majority of reviewed studies. The perceived benefit was the most frequently significant predictor of COVID-19-related behavior. Professionals who are in need can effectively use health belief model in planning and designing interventions to prevent and control the pandemic.

Health information seeking and sharing behavior of young adults on social media in Pakistan

Social media such as Facebook, YouTube, WhatsApp, and Twitter have radically enhanced the public access to health information. Still, studies have unexplored the factors that contribute toward such behaviors especially in developing countries. Therefore, this study identifies the factors that contribute to the likelihood of young adults’ health information seeking and sharing on social media. Specifically, drawing upon health belief model (HBM), the study attempts to understand how health belief and e-Health literacy affects health information seeking and sharing on social media. The study collected data from 413 young adults through Google Forms on a random basis. The results generated applying structural equation modeling confirmed that HBM related factors such as perceived susceptibility, perceived severity and perceived benefits positively while perceived barriers negatively influence young adults’ health information seeking and sharing intentions on social media. Furthermore, e-Health literacy was positively associated with health information seeking and sharing intentions on social media. This study is amongst a first few studies in the context of developing world to investigate the young adults’ intentions of seeking and sharing health information on social media based on HBM.

Effects of Health Belief, Knowledge, and Attitude toward COVID-19 on Prevention Behavior in Health College Students

This study aimed to identify the factors affecting the practice of COVID-19 prevention behaviors among college students as future medical workers. A cross-sectional online survey was conducted in September 2021. A total of 526 health college students were included in this study. A hierarchical regression analysis was performed to examine the effect on the practice of COVID-19 prevention behavior. As a result of the analysis, experiences of education on infectious diseases had significant positive effects on the practice of prevention behavior (β = 0.22, p < 0.001). Additionally, a higher COVID-19 health belief had a significant positive effect on the practice of prevention behavior (β = 0.15, p = 0.004). Increased smoking and drinking among lifestyle changes after COVID-19 had significant negative effects on the practice of prevention behavior compared with decreased physical activity (β = -0.12, p = 0.007). Based on these findings, the study discussed the importance of education on the prevention of infectious diseases among health college students, promotion of health beliefs related to infectious diseases, and formation of healthy lifestyle habits in daily life.

Analysis of Preventive Behaviors of Rural Tourism Hosts in the Face of COVID-19 Pandemic: Application of Health Belief Model

The novel coronavirus (COVID-19) is one of the most severe public health crises in recent history. Therefore, in order to prevent the spread of COVID-19 and its negative effects on the health of rural tourist hosts and the rural community, it is necessary to pay attention to the conservation and health behaviors of rural tourist hosts. This study was conducted with the purpose of analyzing preventive behaviors of rural tourism hosts in the face of COVID-19 pandemic with the application of the health belief model (HBM) that is one of the most widely used models to study behavior to prevent and control diseases. In this study, all 80 tourism hosts of tourism target villages in Kermanshah province (the west of Iran), were studied as study population. A questionnaire was used to collect data which its validity and reliability were confirmed. Structural equation modeling (SEM) using Smart PLS software was used to analyze the data. The results of SEM indicated that perceived severity, perceived susceptibility, self- efficacy, perceived benefits, and cues to action accounted for 56% of the variance of "COVID-19 preventive health behavior" among the hosts of rural tourists in Kermanshah province. Moreover, the perceived susceptibility was the strongest predictor of preventive health behavior, while perceived barriers were not significant on behavior. Therefore, planning based on the HBM with emphasis on increasing awareness to improve and modify the health behavior of rural tourist hosts is recommended.

Psychological impact of COVID-19 and contributing factors of students' preventive behavior based on HBM in Gondar, Ethiopia

BACKGROUND

The Ethiopian Federal government has locked down schools as one measure to contain Covid-19 pandemic. Psychological effect of COVID-19 on students is increased due to the reopening of schools. The psychological effect of the pandemic is increasing along with physical aspect of health. Therefore, this study aimed to assess the psychological impact of Covid-19 and its contributing factors of students' behavior in Ethiopia.

METHODS

A cross sectional design was conducted from November to December 2020. Data were collected using pre tested self- administered questionnaire from secondary school students in Gondar city North West Ethiopia. Stratified simple random sampling technique was used to select 403 secondary school students. Data were entered and cleaned with Epidata version 4.62 and exported for analysis STATA version 14. Multivariable logistic regression and multiple linear regression were used to show the association of dependent and independent variables. Independent variables in relation to dependent variable measured using odd ratios and B coefficient with 95% confidence interval for Covid-19 anxiety and preventive behavior of Covid-19 respectively were used.

RESULTS

A total of 370 students were participated giving response rate of 92%. The prevalence of Covid-19 anxiety and obsession among secondary school students were 38.1% and 40.27% respectively. Being 11thgrade 54% (AOR = 0.46; 95%CI:0.22, 0.95) and increased knowledge16% (AOR = 0.84;95%CI: 0.77, 0.89) score associated with decreased COVID-19 anxiety while Covid-19 obsession, 14.51 times (AOR = 14.51;95%CI: 8.05, 26.17), and being female 1.6 times (AOR = 1.6; 95%CI: 1.01, 2.51) increased Covid-19 Anxiety. Furthermore, increased self-efficacy 0.5 times (B = 0.5; 95%CI: 0.28, 0.62), and increased cues to action 0.4 times (B = 0.4; 95% CI: 0.19, 0.69) increased preventive behavior of Covid-19 while perceived barrier 0.1 times (B = -0.1; 95%CI:-0.22, 0.01) decrease preventive behavior of Covid-19.

CONCLUSION

Almost two individuals of five participants developed COVID-19 anxiety and COVID-19 obsession. Being grade 11th and knowledge were negatively associated with anxiety while being female and being obsessed with COVID-19 were positively associated with anxiety. No variable was associated with obsession of Covid-19. Intervention is needed to reduce anxiety among females. Furthermore, perceived barrier, self-efficacy and cues to action were significant factors of preventive behaviour of Covid-19. Therefore, to increase preventive behaviour of Covid-19, information, education and communication and behavioural change communication should be targeted on reducing barriers and increasing motivations and confidences.