COVID-19: Examining Adherence through the Health Belief Model

Abstract

Over 6.4 million individuals have died due to COVID-19. Although the vaccine has been distributed and made more accessible, it is important for individuals to continue adhering to guidelines that prevent the spread of this deadly virus. The current study explored adherence to COVID-19-related health behaviors (wearing a mask, social distancing, properly washing hands, and receiving the COVID-19 vaccine) in a U.S. sample (recruited through Amazon MTurk) and examined the role of interactions among various identities. The study was informed by the Health Belief Model (HBM) and participants completed questionnaires that assessed COVID-19 health behaviors, constructs comprising the HBM (perceived severity, perceived susceptibility, perceived benefits, perceived barriers, self-efficacy, and cues for action), measures of knowledge of COVID-19, COVID-19-related distress, as well as a full range of demographic parameters. The total sample of 756 individuals was made up of the following demographics: male (52.6%), White (82.7%), less than a high school education (47.1%), living in an urban area (67.1%), liberal political orientation (69.2%), identifying as not having a disability (80.2%), Christian religion (47.4%), identifying as straight/heterosexual (87.4%), younger than age 60 (90.9%), and lower SES (65.3%). With the exception of perceived susceptibility, constructs from the HBM predicted the odds of engaging in COVID-19-related health behaviors. Perceived severity of the virus and perceived barriers were significantly associated with engagement in all COVID-19 health behaviors. Self-efficacy was associated with all COVID-19 health behaviors except for receiving the vaccine and perceived benefits were associated with all COVID-19 health behaviors except for handwashing. Cues to action only significantly predicted receiving the COVID-19 vaccine. Demographic variables (except for disability and sexual orientation) were significantly related to engaging in various COVID-19-related health behaviors, such that there were more African Americans (compared to White participants), females (compared to males), nonreligious (compared to Christian), older participants (compared to younger participants), and liberal participants (compared to conservative participants) who reported engaging in health behaviors. The relation between gender, education, religion, political orientation, age, and SES, but not race/ethnicity, and some COVID-19-related health behaviors were significantly mediated by HBM constructs. Patterns of engagement in COVID-19 health behaviors varied a good bit when demographic variables were examined within the context of other demographic variables. For example, non-religious, political liberals engaged in more COVID-19 health behaviors than non-religious, political conservatives, but Christian political liberals engaged in fewer COVID-19 health behaviors than Christian political conservatives. Similarly, single African Americans engaged in more COVID-19 health