TY - JOUR
T1 - Health Beliefs and Preventive Behaviors Among Adults During the Early COVID-19 Pandemic in the United States
T2 - a Latent Class Analysis
AU - Smail, Emily
AU - Schneider, Kristin E.
AU - DeLong, Stephanie M.
AU - Willis, Kalai
AU - Arrington-Sanders, Renata
AU - Yang, Cui
AU - Alexander, Kamila A.
AU - Johnson, Renee M.
N1 - Funding Information:
The Understanding America Study is funded from several sources, including the Social Security Administration and the National Institute on Aging under grant 5U01AG054580. The survey that collected the mental health and COVID-19-related data used in this paper was funded by the Center for Economic and Social Research at USC. Work on the current manuscript was in part supported by a RAPID grant from the National Science Foundation (grant number 2028683). Ms. Smail is supported by the NIA Epidemiology and Biostatistics of Aging Training Program (T32AG000247). Dr. Schneider is supported by NIDA grant 5T32DA007292-25, and Dr. DeLong is supported by NIH/NIAID grant T32AI102623. Dr. Sanders is also supported by the National Institutes of Health (NIDA grant R01DA043089), and the Johns Hopkins University Center for AIDS Research (P30AI094189) supports the Adolescent and Young Adult Scientific Working Group, whose membership contributed to conceptualization and manuscript preparation.
Publisher Copyright:
© 2021, Society for Prevention Research.
PY - 2021/11
Y1 - 2021/11
N2 - The objectives of this study are to (1) characterize patterns of preventive behaviors 3 months after the COVID-19 pandemic was declared a national emergency in the USA and (2) identify how health beliefs (e.g., perceived risk of infection, perceived risk of death upon infection, and perceived effectiveness of CDC-recommended preventive behaviors) and sociodemographic characteristics are associated with preventive behaviors. Data were obtained from two waves of the Understanding America Study (UAS) conducted in March (wave 1) and May to June of 2020 (wave 2) (n = 4445); UAS is a nationally representative panel of US adults. We conducted a latent class analysis (LCA) using wave 2 data to identify our outcome, patterns of 10 COVID-preventive behaviors (e.g., wearing a facemask, handwashing, social distancing), and then used a three-step regression (R3STEP) to test associations between the likelihood of class membership with (1) health beliefs and sociodemographic characteristics (age, sex, race/ethnicity, and educational attainment) in bivariate models and (2) health beliefs adjusted for sociodemographic characteristics in multivariate models. The LCA identified a three-class model of preventive behaviors characterized by high likelihood of engagement in the set of preventive behaviors (“high”), low likelihood of the preventive behaviors (“low”), or engagement in some behaviors (“mixed”). Respondents of older age (i.e., age 50 or older) and those with higher levels of educational attainment (i.e., a 4-year college degree or higher) were less likely to be in the low engagement versus the mixed engagement class compared to those who are younger (18–29) and have lower levels of educational attainment (i.e., high school), respectively. Women (compared to men) and respondents who were Black and/or Hispanic/Latinx (compared to White) were more likely to be in the high (vs. mixed) engagement class. In separate models adjusted for sociodemographic characteristics, respondents with a high perceived risk of infection, high perceived risk of death, and high perceived effectiveness of COVID-preventive behaviors were statistically significantly less likely to be in the low engagement relative to the mixed engagement class. Engagement in COVID-preventive behaviors varies by sociodemographic characteristics (i.e., age, sex, race/ethnicity and educational attainment) and health beliefs (i.e., perceived risk of infection, perceived risk of death, and perceived effectiveness of CDC-recommended behaviors). Our findings highlight the potential utility of using health beliefs to inform targeted prevention efforts to help reduce the spread of COVID-19 and future pandemics.
AB - The objectives of this study are to (1) characterize patterns of preventive behaviors 3 months after the COVID-19 pandemic was declared a national emergency in the USA and (2) identify how health beliefs (e.g., perceived risk of infection, perceived risk of death upon infection, and perceived effectiveness of CDC-recommended preventive behaviors) and sociodemographic characteristics are associated with preventive behaviors. Data were obtained from two waves of the Understanding America Study (UAS) conducted in March (wave 1) and May to June of 2020 (wave 2) (n = 4445); UAS is a nationally representative panel of US adults. We conducted a latent class analysis (LCA) using wave 2 data to identify our outcome, patterns of 10 COVID-preventive behaviors (e.g., wearing a facemask, handwashing, social distancing), and then used a three-step regression (R3STEP) to test associations between the likelihood of class membership with (1) health beliefs and sociodemographic characteristics (age, sex, race/ethnicity, and educational attainment) in bivariate models and (2) health beliefs adjusted for sociodemographic characteristics in multivariate models. The LCA identified a three-class model of preventive behaviors characterized by high likelihood of engagement in the set of preventive behaviors (“high”), low likelihood of the preventive behaviors (“low”), or engagement in some behaviors (“mixed”). Respondents of older age (i.e., age 50 or older) and those with higher levels of educational attainment (i.e., a 4-year college degree or higher) were less likely to be in the low engagement versus the mixed engagement class compared to those who are younger (18–29) and have lower levels of educational attainment (i.e., high school), respectively. Women (compared to men) and respondents who were Black and/or Hispanic/Latinx (compared to White) were more likely to be in the high (vs. mixed) engagement class. In separate models adjusted for sociodemographic characteristics, respondents with a high perceived risk of infection, high perceived risk of death, and high perceived effectiveness of COVID-preventive behaviors were statistically significantly less likely to be in the low engagement relative to the mixed engagement class. Engagement in COVID-preventive behaviors varies by sociodemographic characteristics (i.e., age, sex, race/ethnicity and educational attainment) and health beliefs (i.e., perceived risk of infection, perceived risk of death, and perceived effectiveness of CDC-recommended behaviors). Our findings highlight the potential utility of using health beliefs to inform targeted prevention efforts to help reduce the spread of COVID-19 and future pandemics.
KW - COVID-19
KW - Health behavior
KW - Health belief model
KW - Health beliefs
KW - Prevention
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U2 - 10.1007/s11121-021-01273-0
DO - 10.1007/s11121-021-01273-0
M3 - Article
C2 - 34275054
AN - SCOPUS:85110744583
VL - 22
SP - 1013
EP - 1022
JO - Prevention Science
JF - Prevention Science
SN - 1389-4986
IS - 8
ER -