Factors associated with preventive behaviors of COVID-19 among adolescents: Applying the health belief model

Abstract

BACKGROUND: The emergence of a new pandemic caused by a novel coronavirus (COVID-19) is a unique challenge for public health (all age and sex groups). OBJECTIVE: This study aimed to explore the adolescents' perceptions of preventive behaviors to avoid COVID-19 disease based on the health belief model (HBM). METHOD: This cross-sectional study was conducted on 797adolescents (aged between 12 and 18 years old), who were 7th-12th -grade students of 24 randomly selected schools from 28th May to June 28, 2020 in Isfahan, Iran. An online self-administered questionnaire was adapted to measure the adolescents' perceived threats, barriers, benefits, self-efficacy, and cues to action toward protective behaviors. RESULTS: Findings indicated that the adolescents' mean age was 14.7 (SD = 1.7) and 53.7 of them were female. Regardless of gender difference, there was a significant positive correlation between the adolescents' protective behaviors and their self-efficacy (r = 0.62, P < 0.001), perceived benefit (r = 29, P < 0.001), and perceived severity (r = 0.15, P < 0.001), while there was a significant negative correlation between the adolescents' protective behaviors and their perceived susceptibility (r = -0.11, P < 0.001), as well as their perceived barrier (r = -0.21, P < 0.001). The result of the Hierarchical regression analysis also revealed that the HBM model had a significant predictive power for preventing measures towards coronavirus disease in adolescents (Adj R(2) = 0.46, p < 0.001). The results also showed that self-efficacy was the strongest predictor (β = 0.59, P < 0.001) in explaining protective behaviors in adolescents. CONCLUSION: In the context of coronavirus disease pandemic in adolescents, the health belief model could provide a useful framework for planners to develop educational programs. Moreover, in such a context, strategies to promote self-efficacy in adolescents should be considered more carefully to help them improve their protective behaviors.